Effects of Application of a Nurse Driven Clinical Pathway Guidelines on Selected Health Outcomes in Children with Congestive Heart Failure

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