He Tao, Zhu Xiaojun, Chi Guanghao, Chen Huan, Hao Min, Huang Xin, Wang Guanrong
College of Health Management, Shanghai Jian Qiao University, Shanghai, 201306, People's Republic of China.
Operating Room, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, 266000, People's Republic of China.
BMC Surg. 2025 Aug 25;25(1):392. doi: 10.1186/s12893-025-03135-w.
The impact of surgical care pathways (CP) on efficiency and patient outcomes in orthopedic operating rooms (OR) is unclear, and we aim to optimize nursing strategies and enhance service quality.
From July 2019 to June 2024, 3,836 patients undergoing orthopedic surgery at a single Grade 3 Chinese hospital were retrospectively analyzed and divided into two equal groups, with or without CP (1,918 patients in each group). The effectiveness of CP was assessed by comparing surgical site infection (SSI) rates, pathogens, OR turnover times, and patient satisfaction. Statistical analyses included between-group comparisons and multivariate logistic regressions.
Baseline characteristics were balanced across groups (SMD < 0.1). Overall SSI rates were 2.1%, significantly lower in the CP group than in the Non-CP group (1.6% vs. 2.6%, P < 0.05), and translating to a 43% risk reduction (OR 0.57, 95% CI: 0.36-0.88, P < 0.05). Gram-positive bacterial infections notably decreased (OR 0.331, 95% CI: 0.093-0.959, P < 0.05). CP implementation also improved OR turnover times (95% CI: 0.504-0.839, P < 0.001) and patient satisfaction (95% CI: 1.038-2.301, P < 0.05). No significant differences were observed in other nursing quality indicators.
Standardized CPs are effective in significantly reducing the incidence of postoperative SSIs, particularly those caused by Gram-positive bacteria, thereby enhancing infection control. Furthermore, these pathways improve OR operational efficiency and patient satisfaction, supporting reforms in OR management practices.
手术护理路径（CP）对骨科手术室（OR）效率和患者预后的影响尚不清楚，我们旨在优化护理策略并提高服务质量。
回顾性分析2019年7月至2024年6月期间在中国一家三级医院接受骨科手术的3836例患者，并将其分为两组，每组1918例，分别采用或不采用CP。通过比较手术部位感染（SSI）率、病原体、手术室周转时间和患者满意度来评估CP的有效性。统计分析包括组间比较和多变量逻辑回归。
各组基线特征均衡（标准化均数差<0.1）。总体SSI率为2.1%，CP组显著低于非CP组（1.6%对2.6%，P<0.05），风险降低43%（比值比0.57，95%可信区间：0.36-0.88，P<0.05）。革兰氏阳性菌感染显著减少（比值比0.331，95%可信区间：0.093-0.959，P<0.05）。实施CP还改善了手术室周转时间（9%可信区间：0.504-0.839，P<0.001）和患者满意度（95%可信区间：1.038-2.）。在其他护理质量指标上未观察到显著差异。
标准化的CP可有效显著降低术后SSI的发生率，尤其是由革兰氏阳性菌引起的感染，从而加强感染控制。此外，这些路径提高了手术室运营效率和患者满意度，支持手术室管理实践的改革。
