Evaluation of comparative efficacy of nurse led clinical care pathway versus routine care to develop a nursing manual for improvement of quality of nursing care for children with lower respiratory tract infection

Abstract

ABSTRACT newlineBackground newlineLower respiratory tract infections (LRTIs) are highly prevalent among paediatric populations, newlinecontributing significantly to global morbidity and mortality rates, and posing substantial socio newlineeconomic challenges. These infections frequently precipitate conditions such as bronchitis, newlinebronchiolitis, and pneumonia, with aetiologies linked to allergenic stimuli, pharmacological newlineagents, respiratory viruses, and bacterial pathogens. According to WHO, Acute respiratory newlineinfections (ARI) are accountable for almost 20% of all mortality of children aged less than 5 newlineyears worldwide. newlineMethodology: newlineA randomized controlled trial was conducted among 122 children under five diagnosed with newlinelower respiratory tract infections (LRTIs), along with their 122 parents and 122 staff nurses. newlineParticipants were selected using simple random sampling and equally divided into control (n = newline61) and experimental (n = 61) groups. Nurses in the experimental group received a structured newlineseven-day training on a Nurse-Led Clinical Care Pathway (NLCCP), which focused on providing newlineholistic care across physical, psychological, spiritual, and sociocultural dimensions for children newlinewith LRTIs. The control group continued to provide routine care. Data collection tools included newlinethe Quality of Nursing Care Scale HARIC, the Pediatric Respiratory Knowledge Test, the newlineParental Satisfaction Scale (PSS-M), and hospital records to assess the length of hospital stay. newlineResults: newlineThe study demonstrated significant improvements across all outcome measures in the newlineexperimental group compared to the control group. Knowledge scores in the control group newlineincreased by 16.64% (from 36.39% to 53.03%), while the experimental group showed a newlinesubstantial 50% gain (from 36.88% to 86.88%), with a between-group difference of 33.36% newline(95% CI: 21.50% 45.20%). Quality of nursing care improved by 5.97% in the control group newline(from 49.39% to 55.36%) and by 41.34% in the experimental group (from 49.19% to 90.53%), newlinewith a 35.37% greater improvement in th