Postoperative Regimentation Of Treatment Optimizes Care and Optimizes Length of Stay (PROTOCOL) after pyloromyotomy

Journal of Pediatric Surgery
Joshua T ClaytonLi Ern Chen

Abstract

A non-standardized approach to caring for infants after pyloromyotomy for pyloric stenosis was associated with prolonged postoperative length of stay (pLOS) at our institution. We studied the impact of a standardized postoperative care protocol on pLOS, patients' clinical course, and nursing care. A retrospective chart review identified that 27% of infants who underwent uncomplicated pyloromyotomy had prolonged pLOS, defined as more than one postoperative midnight. A comprehensive postoperative care protocol was developed for infants undergoing pyloromyotomy. Patients were recruited prospectively and those with complications were excluded. A sample size of 70 in each cohort (historic and prospective) allowed 80% power to detect a 50% reduction in the proportion of patients with prolonged pLOS (α=0.05). The prospective group and historic cohort were compared using nonparametric statistics. The historic cohort had 70 patients and the prospective cohort had 66. Protocol implementation resulted in fewer patients with prolonged pLOS, shorter time to feeds, fewer feeds to discharge, less emesis, and improved nursing documentation. Implementation of a postoperative care protocol improved various aspects of patient care and nursing car...Continue Reading

References

Jun 9, 2005·Archives of Pediatrics & Adolescent Medicine·Teresa ToJacob C Langer
Sep 13, 2008·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Jerzy Kuzma
Jul 10, 2012·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·David JuangShawn D St Peter
Jan 21, 2014·Journal of Pediatric Surgery·Obinna O AdibeShawn D St Peter

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Citations

Feb 16, 2016·Journal of Pediatric Surgery·Brian G A DaltonShawn D St Peter
Aug 16, 2016·Seminars in Pediatric Surgery·Matthew Jobson, Nigel J Hall
Jun 14, 2016·Journal of Pediatric Surgery·Justin B MahidaJonathan I Groner

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