TY - EJOU
AU - McLellan, R. Ashley
AU - Bell, David G.
AU - Rendon, Ricardo A.
TI - Effective analgesia and decreased length of stay for patients undergoing radical prostatectomy: effectiveness of a clinical pathway
T2 - Canadian Journal of Urology
PY - 2006
VL - 13
IS - 5
SN - 1488-5581
AB - Objectives: To assess the impact of a clinical pathway (CP) on length of stay (LOS), complications, readmission rates, and patient satisfaction for patients undergoing a radical retropubic prostatectomy (RRP).
Materials and methods: A standardized CP for all patients undergoing RRP was developed and implemented. Post-operatively, patients enrolled in the CP received oral ibuprofen and acetaminophen analgesia, with oral and subcutaneous narcotics available for breakthrough pain. Patients enrolled in the CP were compared to a pre-CP historical cohort. Patients were asked to complete a short, validated satisfaction questionnaire 10 days post-operatively.
Results: Sixty-eight consecutive patients underwent a RRP following CP implementation and were compared to a historical cohort of 147 pre-CP patients. Median LOS decreased by 50% (4 days versus 2 days, p<0.0001) while complication and readmission rates were unchanged. Patient satisfaction was high in all domains. Overall, 29.4% of patients treated within the CP required no narcotic analgesia during their admission.
Conclusions: The implementation of a CP for patients undergoing a RRP is a simple and effective method for reducing LOS without compromising complication, readmission rates or patient satisfaction.
KW - clinical pathway
KW - radical prostatectomy
KW - analgesia
DO -