Examining the Impact of Nursing Interventions Based on Clinical Pathways on Patient Outcomes: A Systematic Review

Öz

Objective: The purpose of the review is to systematically examine the effects of nursing interventions based on clinical pathways on patient outcomes. This systematic review provides evidence for nurses, who are members of a professional profession, to plan, develop, implement and evaluate clinical pathways. The main research question is “how do nurses, who are an important team member in the studies conducted, proceed in clinical pathway-based care?” Method: In the systematic review, studies from 2002 to 2024 were searched in MEDLINE, Scopus databases and the National Thesis Center. The search was conducted using the English keywords “clinical pathways’’, “care pathways’’, “care map’’, “clinical paths’’, “critical paths’’, “nursing care’’. As a result of the search, 877 articles were reached. 21 articles, whose eligibility was evaluated according to the inclusion criteria, were included in this review. Findings: Nurses were team leaders responsible for the development, implementation or evaluation of the clinical pathway as researchers in 57% (n=12) of the studies reviewed.Other clinical pathway duties of nurses within the multidisciplinary team are specialized tasks such as data collection, retrospective review of health records, organization of expert panels, creation of tumor records, home visits, independent clinical pathway implementation and decision-making for nursing care, communication, supervision, quality control, opinion reporting, case manager and coordination manager. Conclusion: The results obtained within the framework of a systematic review of studies examining the effects of nursing interventions based on clinical pathways on patient outcomes provided an opportunity to examine in detail the date, location, patient sample, the way clinical pathways were developed, research outputs and nurses' work items. This systematic review provides evidence to empower nurses to respond to the increasing quality expectations in health care.

Anahtar Kelimeler

• Patient Outcomes
• Nursing Care
• Clinical Pathways

Klinik Yollar ile Temellenen Hemşirelik Müdahalelerinin Hasta Sonuçları Üzerinde Etkisinin İncelenmesi: Sistematik Derleme

Öz

Amaç: Derlemenin amacı klinik yollar ile temellenen hemşirelik müdahalelerinin hasta sonuçları üzerinde etkisinin sistematik olarak incelenmesidir. Bu sistematik derleme de profesyonel bir meslek üyesi olan hemşirelerin klinik yolları planlaması, geliştirmesi, uygulaması ve değerlendirmesi için kanıtlar sunulmuştur. Temel araştırma sorusu “yapılan araştırmalar içerisinde önemli bir ekip üyesi olan hemşirelerin klinik yollar ile temellenen bakımda nasıl bir yol aldığıdır. Yöntem: Sistematik derlemede 2002 yılından 2024 yılına kadar olan çalışmalar MEDLINE, Scopus veri tabanlarında ve Ulusal Tez Merkezinde tarandı. Tarama İngilizce dilinde “clinical pathways’’, “care pathways’’, “care map’’, “clinical paths’’, “critical paths’’, “nursing care’’ anahtar kelimeleri kullanılarak yapıldı. Yapılan tarama sonucunda 877 makaleye ulaşılmıştır. Araştırmaya dahil edilme kriterlerine göre uygunlukları değerlendirilen 21 makale bu derleme kapsamına alınmıştır. Bulgular: Hemşireler incelenen araştırmaların % 57’sinde (n=12) araştırmacı olarak klinik yolun geliştirilmesi, uygulanması veya değerlendirilmesinden sorumlu ekip lideriydi. Multidisipliner ekibin içerisinde yer alan hemşirelerin diğer klinik yol görevleri veri toplama, sağlık kayıtlarını retrospektif olarak inceleme, uzman panelleri düzenleme, tümör kayıtları oluşturma, ev ziyaretleri, bağımsız klinik yol uygulamalarına ve hemşirelik bakımına karar verme, iletişim, denetleme, kalite kontrolü, görüş bildirme, vaka yöneticisi ve koordinasyon yöneticisi gibi özelleşmiş işlerdir. Sonuç: Klinik yollar ile temellenen hemşirelik müdahalelerinin hasta sonuçları üzerinde etkisini inceleyen araştırmaların sistematik olarak incelenmesi çerçevesinde elde edilen sonuçlar yapılan araştırmaların tarihini, yerini, hasta örneklemini, klinik yolların geliştirilme şeklini, araştırma çıktılarını ve hemşirelerin iş kalemlerini ayrıntılı inceleme fırsatı sunmuştur. Bu sistematik derleme sağlık bakımında artan kalite beklentisine yanıt oluşturabilmek için hemşireleri güçlendirme yolunda kanıt oluşturmaktadır.

Anahtar Kelimeler

• Hasta Sonuçları
• Hemşirelik Bakımı
• Klinik Yollar

Kaynakça

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