Date of Award

Spring 3-28-2018

Degree Type

Final Project

Degree Name

DNP Doctor of Nursing Practice

Department

Nursing

Advisor

Mary Ellen Roberts, D.N.P.

Committee Member

Patricia Clark Pappas, D.N.P.

Committee Member

Laura Mansfield, M.S.N.

Abstract

Clinical pathways are a common component in the quest to improve the quality of health. Clinical pathways are used to reduce variation, improve quality of care and maximize the outcomes for specific groups of patients (Lawal, et al., 2016). The purpose of this project is to develop and initiate a Coronary Artery Bypass Grafting (CABG) clinical pathway to reduce variation in care as a way to improve quality of care and patient outcomes for CABG patients CABG surgery is considered a high risk, high cost, yet highly profitable surgery with considerable post-operative complications that affect numerous quality metrics including Length of Stay (LOS), hospital acquired infections (HAI), mortality rate, readmission rates and patient satisfaction. The importance of delivering high quality clinical management of CABG patients and minimizing postoperative complications is essential for the growth of a Center of Excellence and for financial sustainability. Therefore, implementation of CABG Clinical Pathways (CPW) will improve quality of care delivered to patients who undergo coronary revascularization via CABG. As a result of the implementation of the CABG clinical pathway there was a reduction in HAI including central line associated blood stream infection, catheter associated urinary tract infection and surgical site infection. In addition to the reduction of HAI the CABG clinical pathway also presented an initial reduction in the LOS of CABG patients.

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