腹腔鏡 膽囊切除術 患者를 위한 標準診療指針(Critical pathway, CP) 開發 = Development of the Critical Pathway for Laparoscopic Cholecystectomy Patient

다국어 초록 (Multilingual Abstract)

The final goal of current medical service is to have both medial institute and patients satisfied by reaching proper balance between the cost and quality of nursing care. In spite of some merits of disease-related group(DRG) payment system, such as elimination of unnecessary service and decrease of medial cost, impaired quality of medical service appeared to be a major disadvantage. Advanced measure to offer cost-effective and quality-improved medical service is case management and the schematized model of case management is critical pathway. The purpose of this study is to develop critical pathway for the patient with gallbladder disease receiving laparoscopic cholecystectomy.
Development team was composed with seven members including a surgical diplomat, two surgical residents, two professors of adult nursing, a head nurse and a regular nurse of surgical ward. Thirty-two medical records of the patients received laparoscopic cholesystectomy were reviewed and preliminary critical pathway was made. Medical area in y-axis of critical pathway was divided into eight sections; monitoring/assessment, treatment, medication, activity, diet, test, consultation, and education/discharge plan. Date area in x-axis was diveded into seven from preoperative day to fifth postoperative day. Preliminary critical pathway was applied for the six new patients to testify and correct the adequacy, and final critical pathway was established.

목차 (Table of Contents)

• 목차 = ⅰ
• 표차례 = ⅱ
• 그림차례 = ⅲ
• Abstract = ⅳ
• Ⅰ. 서론 = 1
• A. 연구배경 = 1
• B. 연구목적 = 2
• Ⅱ. 이론적 배경 = 3
• A. CP의 개념 및 사례관리 = 3
• B. CP의 실행을 위한 준비 및 개발과경 = 5
• C. 복강경 담낭절제술과 CP 관련연구 동향 = 8
• D. CP개발을 위한 이론적 개념 틀 = 10
• Ⅲ. 연구방법 = 12
• A. 연구대상 및 연구기간 = 12
• B. 연구진행 과정 = 12
• Ⅳ. 연구결과 = 16
• A. 예비 CP 작성을 위한 의무기록 분석 = 16
• B. 예비 CP에 대한 전문가 집단의 내용 타당도 검증 = 25
• C. 예비 CP의 임상 타당도 검증 = 26
• D. 복강경 담낭절제술 환자를 위한 최종 CP 작성 = 30
• Ⅴ. 고찰 = 46
• Ⅵ. 요약 및 결론 = 48
• 참고문헌 = 50
• 부록 = 53