NSI-driven quality program linked to faster ambulation after liver resection for HCC

A cohort study at a single center in China evaluated a structured, Nursing-Sensitive Indicator (NSI)-driven quality improvement program for patients undergoing curative liver resection for hepatocellular carcinoma. The study used propensity score matching to compare 86 patients receiving the intervention (featuring systematic monitoring, alert-triggered care bundles, and weekly audit/feedback) against 86 historical usual-care controls. The primary focus was on perioperative process compliance and short-term recovery metrics.

The main finding was a significant association between the intervention and a reduced time to first ambulation, with patients in the intervention group ambulating at 17.8 ± 8.5 hours compared to 24.3 ± 9.9 hours in the control group (p < 0.05). The intervention was also associated with improved adherence to other perioperative process metrics. Secondary outcomes included 1-year recurrence-free survival and patient-reported outcomes, but specific results for these were not detailed in the provided data.

Safety and tolerability data were not reported. Key limitations include the single-center, historical control design, which introduces potential for unmeasured confounding despite statistical matching. The use of a surrogate process metric (time to ambulation) as a primary outcome limits direct inference about long-term clinical benefits. Funding sources and conflicts of interest were not reported. The findings represent an observed association between a structured nursing care model and an early recovery indicator, not evidence of causation or definitive clinical superiority.