Effect of Plan. Do-Check-Act on homogenization of nursing processes in ICU / 中国实用护理杂志

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.