Document Type : Original Article
Authors
1
Medical-Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt
2
Lecturer of Pediatric Nursing, Faculty of Nursing, Menoufia University, Egypt
3
Assistant Professor of Pediatric Nursing, Faculty of Nursing, Menoufia University, Egypt
4
Assistant Professor of Pediatrics, Damanhour Teaching Hospital, Egypt
5
Assistant Professor of Pediatric Nursing, Faculty of Nursing, Menoufia University, Egypt.
Abstract
Pediatric heart failure (HF) is a complicated clinical illness that has several causes as well as
common disease development pathways. The developing evidence clinical pathway will most
certainly enhance the outcomes of children with HF in the future. Purpose: effects of application of
a nurse driven clinical pathway guidelines on selected health outcomes in children with congestive
heart failure. Design: Quasi-experimental research design. Setting: pediatric intensive care unit
(PICU) at Menoufia University Hospital, Shebine Elkom city, Menoufia Governorate. Subjects: a
purposive sample of sixty children with congestive heart failure who divided into study & control
groups and a convenient sample of 50 care providers including nursing staff, pediatricians,
pharmacist, dietitian and physiotherapist. Tools: four tools were used; I: congestive heart failure
children's assessment, II: congestive heart failure complications, III: modified clinical pathway
guidelines variances checklists and IV: Nurse driven clinical pathway guidelines competency
evaluation tool. Results: there was statistical significant difference between study and control
groups as regards hemodynamic state, chest sound, edema, dyspnea, chest pain, systemic
complications, length of stay in PICU, and variance deviations. In addition, there was statistical
significant difference between competency score at pre and post clinical pathway guidelines
sessions among multidisciplinary team. Conclusion: Children with congestive heart failure in study
group reported a more hemodynamic stability, lower mean scores of chest pain, episodes of dyspnea
and edema. Also, it contributed to no systemic complications in the majority of these children with
higher positive variation than children in control group. Recommendations: replication of the study
on large probability sampling
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