Evaluation of clinical pathway implementation and clinical practice guidelines in the management of deep neck abscess (DNA) at Dr. Sardjito, General Hospital Yogyakarta, Indonesia

https://doi.org/10.19106/JMedSci005404202206

Dian Paramita Wulandari(1*), Hesti Dyah Palupi(2), Feri Trihandoko(3)

(1) Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada / Dr. Sardjito General Hospital Yogyakarta
(2) Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada / Dr. Sardjito General Hospital Yogyakarta
(3) Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada / Dr. Sardjito General Hospital Yogyakarta
(*) Corresponding Author

Abstract


Deep neck abscess (DNA) is an infectious condition categorized as anemergency case with high mortality and morbidity. The incidence decreasesover time due to extensive use of antibiotics, operative intervention, andimproved awareness of dental hygiene. Management of DNA must be carriedout appropriately and efficiently to prevent complications that may occur,such as jugular vein thrombosis, pericarditis, and pneumonia. Patients withDNA are often categorized as high-cost patients, because of the long durationof hospitalization, the need for special examinations, and complicatedmanagement. Clinical practice guidelines (CPG) and clinical pathways (CP)are a standard created for management, quality, and cost control. The studyaimed to evaluate the implementation of the CPG and CP in DNA patients atDr. Sardjito General Hospital, Yogyakarta. The study used medical recordsdata of DNA patients from January 2018 to December 2020 who met theinclusion and exclusion criteria. A total of 55 subjects were obtained, withcompliance to complete CPG filling of 98.3% and CP filling of 96.2%. There was100% completion in CPG filling categorized as good compliance, whilst thenumber of good compliances for CP was 92.7%. In conclusion, the diagnosisand management of DNA patients at Dr. Sardjito General Hospital has goodcompliance with CPG and CP available.

Keywords


deep neck abscess; clinical practice guideline; clinical pathway; laryngology; compliance

Full Text:

PDF


References

Kementerian Kesehatan Republik Indonesia. Permenkes nomor 464 tahun 2010 tentang Standar pelayanan kedokteran. Jakarta: Kementerian Kesehatan Republik Indonesia, 2010.
2.Firmanda D. Clinical pathways kesehatan anak. Sari Pediatri 2006; 8(3):195-208.
3.Cheach J. Development and implementation of a clinical pathway programme in an acute care general hospital in Singapore. Int J Qual Health Care 2000; 12(5):403-12.
https://doi.org/10.1093/intqhc/12.5.403
4.Schrijvers G, van Hoorn A, Huiskes N. The care pathway: concepts and theories: an introduction. Int J Integr Care 2012; 12:192.
https://doi.org/10-1-113788/ijic2012-192
5.Alias K, Colbert R, Devakumari S. Diagnosis and management of deeper neck infections: a review. IOSR J Dent Med Sci 2013; 9(5):36-41.
6.Dabirmoghaddam P, Mohseni A, Navvabi Z, Sharifi A, Bastaninezhad S, Safaei A. Is ultrasonography-guided drainage a safe and effective alternative to incision and drainage for deep neck space abscesses? J Laryngol Otol 2017; 131(3):259-263.
https://doi.org/10.1017/S002221511700007X
7.Gleeson M. Scott-Brown’s otorhinolaryngology head and neck surgery. London: Hodder Arnold, 2008.
8.Sataloff RT. Comprehensive textbook of otolaryngology, head and neck surgery. Daryaganj: Jaypee Brothers Medical Publishers, 2016.
9.Maharaj S, Ahmed S, Pillay P. Deep neck space infections: a case series and review of the literature. Clin Med Insights Ear Nose Throat 2019; 12:1179550619871274.
https://doi.org/10.1177/1179550619871274
10.Huang TT, Liu TC, Chen PR, Tseng FY, Yeh TH, Chen YS. Deep neck infection: analysis of 185 cases. Head Neck 2004; 26(10):854-60.
https://doi.org/10.1002/hed.20014
11.Saboo R, Modwal A. Deep neck space infection: a clinical study and review of literature. Sch J App Med Sci 2016; 4(4A):1143-56.
12.Pineda-Alvarado A, Lugo-Machado JA, Chanche-Martin E, Quintero JZ, Arellano-Ridriguez I, Lizarraga LL. Prevalence, morbidity, and mortality of deep neck abscess in a tertiary hospital from Northwestern Mexico. Rom J Rhinol 2020; 11(41):41-6.
https://doi.org/10.2478/rjr-2021-0008
13.Hurley RH, Douglas CM, Montgomery J, Clark LJ. The hidden cost of deep neck space infections. Ann R Coll Surg Engl 2018; 100:129-34.
https://doi.org/10.1308/rcsann.2017.0193
14.Biron VL, Kurien G, Dziegielewski P, Barber B, Seikaly H. Surgical vs ultrasound-guided drainage of deep neck space abscesses: a randomized control trial: surgical vs ultrasound drainage. J Otolaryngol Head Neck Surg 2013; 42(1):18.
https://doi.org/10.1186/1916-0216-42-18
15.Welsh Government. All Wales fundamentals of care audit. 2014: 35.
16.Mahmudin AA, Chalidyanto D, Suprabawati DGA, Triyono EA, Listiyani E, Ajeng IP. The compliance of clinical pathway on clinical supervision in decreasing the length of stay for patients undergoing mastectomy at an academic health centre. World J Transl Med 2020; 23(Suppl 1):107-14.
17.Sari I, Sundari S. Evaluasi implementasi clinical pathway krisis hipertensi di Instalasi Rawat Inap RS PKU Muhammadiyah Bantul. Proceeding Health Architecture 2017; 1(1):113-21.
18.He XY, Bundorf MK, Gu JJ, Zhou P, Xue D. Compliance with clinical pathways for inpatient care in Chinese public hospitals. BMC Health Serv Res 2015; 15:459.
https://doi.org/10.1186/s12913-015-1121-8
19.Yulianti S. Esensi clinical pathway/care pathway dalam sistem rujukan. Yogyakarta: Universitas Gadjah Mada. 2016.
https://kanalpengetahuan.fk.ugm.ac.id/esensi-clinical-pathway-care-pathway-dalam-sistem-rujukan/



DOI: https://doi.org/10.19106/JMedSci005404202206

Article Metrics

Abstract views : 179 | views : 208




Copyright (c) 2022 Dian Paramita Wulandari, Hesti Dyah Palupi, Feri Trihandoko

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

View My Stats

 

Creative Commons License
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) by  Universitas Gadjah Mada is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at http://jurnal.ugm.ac.id/bik/.