ABSTRACT
Deming cycle theory, namely the plan-do-check-act (PDCA) cycle theory, is a relatively advanced and widely used theory of quality management system in foreign countries, with both scientific and systematic features. The research group introduced the PDCA quality control theory into the eight-year clinical course assessment for the first time to carry out the reform of clinical course examination and actively promote the explanation and evaluation system for examination papers. After four years of follow-up research , the management means based on the PDCA cycle was continuously used to optimize the explanation and evaluation system for examination papers and improved the efficiency of clinical course examination. At present, certain achievements have been made, which include urging students to reflect on learning, promoting the implementation of the student-centered teaching philosophy, enhancing teachers' teaching input, and improving the management quality of teaching departments.
ABSTRACT
Deming cycle theory, namely the plan-do-check-act (PDCA) cycle theory, is a relatively advanced and widely used theory of quality management system in foreign countries, with both scientific and systematic features. The research group introduced the PDCA quality control theory into the eight-year clinical course assessment for the first time to carry out the reform of clinical course examination and actively promote the explanation and evaluation system for examination papers. After four years of follow-up research, the management means based on the PDCA cycle was continuously used to optimize the explanation and evaluation system for examination papers and improved the efficiency of clinical course examination. At present, certain achievements have been made, which include urging students to reflect on learning, promoting the implementation of the student-centered teaching philosophy, enhancing teachers' teaching input, and improving the management quality of teaching departments.
ABSTRACT
Objective@#To explore the effects of application of Plato analysis combined with plan-do-check-action (PDCA) cycle in scientific research management of nurses with primary position title.@*Methods@#Twenty-six nurses with primary position title were recruited in this self pre- and post-control study. From January 2012 to December 2013, they were guided by normal scientific research management. In January 2014, the factors which hinder these nurses from writing papers were investigated by the questionnaire titled " the impediments that hinder nurses with primary position title from writing papers" . Based on " twenty-eighty percent laws" of Plato analysis method, the main influencing factors which hinder nurses with primary position title from writing papers were " had no idea" and " did not know how to write although with ideas" . From January 2014 to December 2015, based on the results of the survey and combined with PDCA cycle method, interventions were planned, carried out, analyzed by stage, and then improved continuously. Impediments which hinder writing papers of 26 nurses in January 2014 and December 2015, specific scientific research achievement, total scientific research achievement, and average scientific research achievement of these 26 nurses before intervention (from January 2012 to December 2013) and after intervention (from January 2014 to December 2015) were analyzed. Data were processed with McNemar exact probability test, Wilcoxon signed rank sum test.@*Results@#(1) The cumulative percentages of main impediments " had no idea" and " did not know how to write although with ideas" were decreased from 76.93% in January 2014 to 23.07% in December 2015. The number of nurses who " had no idea" was significantly reduced from 14 in January 2014 to 4 in December 2015 (P<0.01). The total number of nurses who had impediments which hinder writing papers was significantly reduced from 26 in January 2014 to 10 in December 2015 (P<0.01). (2) The total scientific research achievement and average scientific research achievement of the 26 nurses were significantly increased from 5 before intervention to 32 after intervention and 0.19 before intervention to 1.23 after intervention, respectively (Z=-4.838, -3.703, P<0.01). Among which, numbers of specific scientific research achievement of papers published in Journals of Statistic Source, papers published in other journals, science and technology awards, fund projects, national utility model patents, and patents for invention after intervention were all increased than those before intervention (P<0.05 or P<0.01).@*Conclusions@#Plato analysis can accurately analyze the main impediments that hinder nurses with primary position title from writing papers. Plato analysis combined with PDCA cycle can improve the overall ability of scientific research of nurses with primary position title and affect the achievements in nursing scientific research, which is worthy of promotion.
ABSTRACT
Objective@#To investigate the promotional effect of the new teaching method of goal orientation combined with plan-do-check-act (PDCA) cyclic improvement on specialized medical knowledge and operation skills among physicians in critical care medicine.@*Methods@#A total of 84 physicians who received critical care medicine training in Department of Critical Care Medicine in Foshan Hospital of Traditional Chinese Medicine from January 2013 to December 2015 were selected, and according to the time of admission, they were divided into control group with 41 physicians and experimental group with 43 physicians. The physicians in the experimental group received the new teaching method of goal orientation combined with PDCA cyclic improvement, i.e., the physicians started systematic learning according to the learning goals sent out by the teaching secretary, summarized problems during learning and looked for optimal solutions every week, and then continued learning in the next week through PDCA cyclic improvement. The physicians in the control group received traditional teaching combined with bedside teaching, but no learning goals were set for them. The two groups were compared in terms of theoretical examination scores, clinical operation skills, and results of the questionnaire survey. The t-test and Wilcoxon ranksum test were used for comparison of scores between the two groups by SPSS 18.0.@*Results@#Compared with the control group, the experimental group had significant increases in the scores of theoretical examination (91.50±4.18 vs. 87.80±3.63) and operation skills (88.80±3.34 vs. 85.40±2.88). The questionnaire survey showed that compared with the control group, the experimental group had a significantly higher degree of satisfaction, significantly greater learning interests, and significantly greater improvements in operation skills, clinical thinking ability, and self-confidence.@*Conclusion@#The new teaching method of goal orientation combined with PDCA cyclic improvement can stimulate learning interests, clarify learning goals, help physicians to master important and difficult issues, and thus improve their learning outcomes and scores in Department of Critical Care Medicine.
ABSTRACT
Objective To investigate the promotional effect of the new teaching method of goal orientation combined with plan-do-check-act (PDCA) cyclic improvement on specialized medical knowledge and operation skills among physicians in critical care medicine.Methods A total of 84 physicians who received critical care medicine training in Department of Critical Care Medicine in Foshan Hospital of Traditional Chinese Medicine from January 2013 to December 2015 were selected,and according to the time of admission,they were divided into control group with 41 physicians and experimental group with 43 physicians.The physicians in the experimental group received the new teaching method of goal orientation combined with PDCA cyclic improvement,i.e.,the physicians started systematic learning according to the learning goals sent out by the teaching secretary,summarized problems during learning and looked for optimal solutions every week,and then continued learning in the next week through PDCA cyclic improvement.The physicians in the control group received traditional teaching combined with bedside teaching,but no learning goals were set for them.The two groups were compared in terms of theoretical examination scores,clinical operation skills,and results of the questionnaire survey.The t-test and Wilcoxon ranksum test were used for comparison of scores between the two groups by SPSS 18.0.Results Compared with the control group,the experimental group had significant increases in the scores of theoretical examination (91.50 ± 4.18 vs.87.80 ± 3.63) and operation skills (88.80± 3.34 vs.85.40 ± 2.88).The questionnaire survey showed that compared with the control group,the experimental group had a significantly higher degree of satisfaction,significantly greater learning interests,and significantly greater improvements in operation skills,clinical thinking ability,and self-confidence.Conclusion The new teaching method of goal orientation combined with PDCA cyclic improvement can stimulate learning interests,clarify learning goals,help physicians to master important and difficult issues,and thus improve their learning outcomes and scores in Department of Critical Care Medicine.
ABSTRACT
Objective To evaluate the effect of plan-do-check-act (PDCA) cycle management method on improving multidrug-resistant organisms (MDROs) prevention and control measures.Methods PDCA cycle management method was applied to improve the management system and management process of a hospital,prevention and control efficacy of MDROs in clinic departments between July-December 2014 (before PDCA implementation) and January-June 2015 (after PDCA implementation) was compared.Results After half a year implementation of PDCA cycle management,the total implementation rate of MDROs prevention and control measures increased from 57.14％ (360/630) to 79.69％ (510/640),difference was statistically significant(P＜0.05);implementation rate of recording by doctors during the disease course,recording by nurses during the nursing process,registration and reporting of MDROs,as well as posting isolation signs were all improved,difference was statistically significant (all P＜0.05).The total isolation rate of MDROs declined from 30.65％ (347/1 132)before PDCA implementation to 22.61％ (236/1 044) after PDCA implementation,difference was statistically significant (x2 =10.393,P＜0.05).Conclusion Application of PDCA cycle can improve the prevention and control measures of MDROs.
ABSTRACT
Objective To establish a management mode for patients with chronic kidney disease (CKD) of stage 3 to 4 by continuous quality improvement (CQI), and to observe the effect of CQI on renal function in CKD patients. Methods A total of 86 patients with CKD (50 in stage 3 and 36 in stage 4) were enrolled in this study, and they were regularly followed-up in the CKD outpatient of the Department of Nephrology of Jing’an District Zhabei Centre Hospital of Shanghai. The patients were randomly divided into observation group and control group, with 43 cases in each group. In the observation group, we used the management mode combining medical intervention and health education by plan-do-check-act (PDCA) four-step method; in the control group, we used the traditional management mode of medical intervention. All the patients were followed up once a month for one year. The end points included doubling serum creatinine (Scr) or entering end-stage renal disease, and occurence of cardiovascular and cerebrovascular events. The follow-up on time rate (%), Scr level, and estimated glomerular filtration rate (eGFR) were compared between the two groups. Results In the observation group, the average follow-up times were 10.7±2.8 and the follow-up on time rate was (89.9±12.8)%; while those were 4.1±2.2 and (34.2±4.9)% in the control group, and there were significant differences between the two groups (all P0.01). During the 1-year follow-up period, two cases had end-stage renal disease and one case had acute angina in the control group, while no end point was found in the observation group. Before the implementation of CQI, there were no significant differences in eGFR or Scr level between the two groups (all P0.05). The eGFR of the observation group after implementation of CQI was (39.35±12.23) mL/(min • 1.73 m2), which was significantly higher than those of the observation group before implementation ([37.22±11.02] mL/[min • 1.73 m2], P0.05) and the control group after implementation ([35.04±12.31] mL/[min • 1.73 m2], P0.05). The Scr level of the observation group after implementation of CQI was (139.25±14.15) µmol/L, which was significantly lower than those of the observation group before implementation ([145.16±15.41] µmol/L, P0.05) and the control group after the implementation ([148.06±15.63] µmol/L, P0.05). Conclusion CQI management method with the combination of medical intervention and health education can improve the renal function of patients with CKD stages 3-4, and reduce the incidence of end-stage renal disease and cardiovascular and cerevascular events.
ABSTRACT
Objective To explore the effect of Plan. Do-Check-Act on homogenization of nursing processes in ICU. Methods A total of 36 nurses were selected to implement Plan. Do-Check-Act in ICU according to evidence-based medicine. Their nursing was inspected by a senior nurse. The differences of the following items before and after Plan. Do-Check-Act were compared: nursing quality comprehensive quality control index and specialized quality control index. Results After the implementation of Plan. Do-Check-Act, comprehensive quality control index of clinical nursing quality score by (89.28 ± 2.36) points up to (97.45±1.38) points, and there was significant difference(t=-7.310, P<0.01). The specialized quality control indicators including the incidence of ventilator associated pneumonia, the incidence of catheter-related bloodstream infection, the incidence of catheter-associated urinary tract infections, the incidence of accidental extubation, the incidence of pressure sores, the incidence of glycemic out of control, the incidence of sedation out of control and retention time were 26.2%(53/202), 17.8%(36/202), 18.8%(38/202), 11.9%(24/202), 2.5%(5/202), 18.3%(37/202), 15.3%(31/202), (168.0 ± 3.3) h before the implementation and 7.1%(14/196), 3.1%(6/196), 4.1%(8/196), 0.5%(1/196), 0, 3.6%(7/196), 3.1%(6/196), (96.0±4.2) h after the implementation. There were significant differences (χ2=4.913-25.907, t=66.195, all P<0.01). Conclusions The Plan. Do-Check-Act is an effective way to improve nursing quality of ICU to make it homogeneous, reduce adverse nursing and iatrogenic complications.
ABSTRACT
Objective To investigate the management status of loaner surgical instruments,and evaluate the effect of plan-do-check-act cycle (PDCA)quality control on loaner surgical instrument management.Methods From July 2011 to June 2012,8 965 pieces of loaner surgical instruments before adopting PDCA quality control management was as control group;from July 2012 to June 2013,8 564 pieces of loaner surgical instruments adopting PDCA quality control was as ob-servation group.The defects of loaner surgical instruments during application process and effect of PDCA quality control on loaner surgical instrument management were analyzed.Results There were many problems in checking-tracking,cleaning quality and company personnel of loaner surgical instruments.The qualified rate of observation group was higher than that of control group(99.36% vs 96.27%)(χ2 =194.74,P <0.01).The main causes for unqualification of observation group were unqualified cleaning (n=21 ,38.18%)and incomplete function of instruments(n=8,14.55%);while the main causes for unqualification of control group were the loss of instruments(n=81,24.25%),lack of monitor and record (n=71, 21.26%),unqualified cleaning(n=55,16.47%)and the soaking of package(n=54,16.17%).Conclusion PDCA quality control is an effective method for loaner surgical instruments management,it is helpful for building long-term effective quali-ty control system for loaner surgical instruments,and make loaner surgical instrument management more scientific,system-atic,and standard.
ABSTRACT
Objective To evaluate the effect of plan-do-check-act (PDCA)cycle method in improving disinfection efficacy of object surface in intensive care unit (ICU).Methods On the basis of management of healthcare-associat-ed infection (HAI)and prevention of multidrug-resistant organisms,disinfection efficacy of object surface in an ICU was intervened,data about surface object specimens taken before,during,and after intervention,HAI in patients, as well as detection of MDROs were collected.Results The total qualified rate of specimens taken before,during, and after intervention was 58.24%,76.74%,and 88.71 %,respectively,there was an increased tendency,the difference was significant (χ2 =17.41 ,P =0.009);the incidence of HAI was 3.72%,2.42%,and 1 .78%,respec-tively,there was a decreased tendency(χ2 =6.03,P =0.039),case infection rate was 4.36%,2.75%,and 2.37%respectively,there was a decreased tendency (χ2 = 7.24,P = 0.046 );detection rate of MDROs was 34.03%, 27.45%,and 14.05%,respectively,there was a decreased tendency (χ2 =33.84,P =0.007),the percentage of pa-tients who were detected MDROs and HAI caused by MDROs showed a decreased tendency(χ2 =6.14,6.02,both P<0.05).Conclusion The implementation of PDCA cycle can effectively improve disinfectant efficacy of ICU object surface,and reduce the incidence of MDRO HAI.