Efficacy of a Nurse-led Clinical Care Pathway in Improving the Quality of Nursing Care and Parent Satisfaction among Under-five Children with Lower Respiratory Tract Infections: A Prospective Interventional Study

Introduction: Lower Respiratory Tract Infections (LRTIs) are frequent among children of early young age due to polluted air, overcrowding, poor sanitation etc., that increase their susceptibility to infection. Limited healthcare resources in many rural districts postpone the treatment thereby, leading to severe illness.

Aim: To study the impact of Nurse-Led Clinical Care Pathway (NLCCP) for children under five with LRTI on nursing quality, hospital stay and parent satisfaction.

Materials and Methods: A prospective interventional study was conducted in Maharashtra, India from January to March 2024 among children diagnosed with LRTIs. A total of 60 children were enrolled in the study and divided equally into control and experimental groups. Paediatric nurses (n=30) provided the NLCCP to the experimental group, while the control group received routine care, including assessment, examination, symptom management, laboratory tests, antibiotics, discharge planning, etc. The experimental group also received play activities, psychological, sociocultural, and spiritual support. Data were collected using the 37-item Quality of Nursing Care Scale for Hospitalised Acute Respiratory Infection Children (QNCS-HARIC) checklist and analysed with Statistical Package for Social Sciences (SPSS) using descriptive statistics.

Results: Post-test findings from the QNCS-HARIC tool showed major differences between the groups. The control group recorded a mean score of 82.97 (SD 3.12), while the experimental group reached 138.47 (SD 10.74). The t-test value (27.169, p<0.01) showed that the pathway improved nursing care scores. Parent satisfaction followed a similar pattern. The t-test (-7.28, p<0.01) confirmed that parents in the experimental group reported much higher satisfaction at discharge.

Conclusion: The NLCCP supports healthcare workers (staff nurses) in enhancing their knowledge, skills, and the overall quality of nursing care. It also contributes to reducing hospital stays of children with LRTIs, while demonstrating significantly higher parent satisfaction compared to the control group.