{"created":"2024-05-23T01:21:08.434734+00:00","id":2000181,"links":{},"metadata":{"_buckets":{"deposit":"b678a22e-868b-4752-8a2f-8893b2e97e11"},"_deposit":{"created_by":11,"id":"2000181","owner":"11","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"2000181"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:02000181","sets":["6:7:1716344963579:1716345164801"]},"author_link":["819","337"],"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2024-05-23","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"17","bibliographicPageStart":"14","bibliographicVolumeNumber":"38","bibliographic_titles":[{"bibliographic_title":"滋賀医科大学雑誌","bibliographic_titleLang":"ja"}]}]},"item_3_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"当院外科では所属する4名の医師による主治医制を採用している. 主治医不在時には他の医師が診察を行うが, 慣習的に主治医が退院判断を行っていたため術後在院日数が延長されている可能性があると考えた. 鼠径ヘルニア手術のクリニカルパスにおいて, 術後2日目に看護師が当日の診察担当医から退院許可をとるプロセスを導入した. 本研究の対象は, 2020年1月から2023年12月までに鼠径ヘルニア手術を全身麻酔下に受けた成人162症例であり, クリニカルパス改定前の117症例と改定後の45症例を比較した. 年齢、性別や術式は在院日数に有意な影響を及ぼさなかった. パスの改定により, 術後在院日数は中央値で4日から3日へと有意に短縮された(p=0.00038). また年齢中央値の72歳以上の症例では術後在院日数は5日から3日へとより大きな短縮を認めた(p=0.00013). 両群において重篤な術後合併症は確認されなかった. 本改定の結果, 在院日数の有意な短縮が確認された. また, 看護師を対象としたアンケート調査により, 退院指導の実施が以前よりも容易になったとの肯定的なフィードバックが得られた. 本研究よりクリニカルパスの適切な改定は, 医療の質の向上と標準化, また休暇の取りやすい診療科チーム制への移行に寄与しうることが示唆された.","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.14999/0002000181","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"滋賀医科大学雑誌編集委員会","subitem_publisher_language":"ja"}]},"item_3_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"村上, 耕一郎","creatorNameLang":"ja"},{"creatorName":"MURAKAMI, Koichiro","creatorNameLang":"en"},{"creatorName":"ムラカミ, コウイチロウ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"津留, 俊昭","creatorNameLang":"ja"},{"creatorName":"TSURU, Toshiaki","creatorNameLang":"en"},{"creatorName":"ツル, トシアキ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"田中, 成幸","creatorNameLang":"ja"},{"creatorName":"TANAKA, Naruyuki","creatorNameLang":"en"},{"creatorName":"タナカ, ナルユキ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"石田, 美奈","creatorNameLang":"ja"},{"creatorName":"ISHIDA, Mina","creatorNameLang":"en"},{"creatorName":"イシダ, ミナ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"安藤, ひみ華","creatorNameLang":"ja"},{"creatorName":"ANDO, Himika","creatorNameLang":"en"},{"creatorName":"アンドウ, ヒミカ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"森, 愛梨沙","creatorNameLang":"ja"},{"creatorName":"MORI, Arisa","creatorNameLang":"en"},{"creatorName":"モリ, アリサ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"清水, 勇帆","creatorNameLang":"ja"},{"creatorName":"SHIMIZU, Yuuho","creatorNameLang":"en"},{"creatorName":"シミズ, ユウホ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"浦木, 美里","creatorNameLang":"ja"},{"creatorName":"URAKI, Misato","creatorNameLang":"en"},{"creatorName":"ウラキ, ミサト","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"古谷, 友梨佳","creatorNameLang":"ja"},{"creatorName":"HURUTANI, Yurika","creatorNameLang":"en"},{"creatorName":"フルタニ, ユリカ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"谷田, 京子","creatorNameLang":"ja"},{"creatorName":"TANIDA, Kyoko","creatorNameLang":"en"},{"creatorName":"タニダ, キョウコ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"東, 里加","creatorNameLang":"ja"},{"creatorName":"AZUMA, Rika","creatorNameLang":"en"},{"creatorName":"アズマ, リカ","creatorNameLang":"ja-Kana"}]},{"creatorNames":[{"creatorName":"龍田, 健","creatorNameLang":"ja"},{"creatorName":"TATSUTA, Takeshi","creatorNameLang":"en"},{"creatorName":"タツタ, タケシ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"田中, 久富","creatorNameLang":"ja"},{"creatorName":"TANAKA, Hisatomi","creatorNameLang":"en"},{"creatorName":"タナカ, ヒサトミ","creatorNameLang":"ja-Kana"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2024-05-23"}],"filename":"jsums3801p014.pdf","filesize":[{"value":"846 KB"}],"format":"application/pdf","url":{"objectType":"fulltext","url":"https://shiga-med.repo.nii.ac.jp/record/2000181/files/jsums3801p014.pdf"},"version_id":"75f65951-4a87-4377-bd71-787fb9833a1f"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"クリニカルパス","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"チーム医療","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"外科手術","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"鼠径ヘルニア","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"在院日数","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin 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