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日间病房化疗护理安全管理中的PDCA循环与安全文化

PDCA cycle and safety culture in nursing safety management of Day Ward chemotherapy.

作者信息

Chen Xia

机构信息

Day Ward, Nantong First People's Hospital, The Second Affiliated Hospital of Nantong University (Nantong Hospital of Renji Hospital Afliated to Shanghai Jiao Tong University School of Medicine), No. 666 Shengli Road, Nantong City, Jiangsu, 226000, China.

Nantong Hospital of Renji Hospital Afliated to Shanghai Jiao Tong University School of Medicine, Nantong City, Jiangsu, 226000, China.

出版信息

World J Surg Oncol. 2025 Mar 22;23(1):99. doi: 10.1186/s12957-025-03738-w.

Abstract

OBJECTIVE

The PDCA cycle, also known as the PDCA (Plan-Do-Check-Act) cycle, is a well-established continuous quality improvement framework. This study aimed to evaluate the impact of implementing a nursing safety management strategy grounded in the PDCA cycle and safety culture principles in the context of Day Ward chemotherapy.

METHODS

This a prospective group comparison study (cohort comparison) based on principles of randomization. A total of 120 patients receiving intravenous chemotherapy at the Day Ward of Nantong First People's Hospital from January 2023 to December 2023 were recruited as research participants. They were randomly assigned to either a control group or a study group, which were managed using the conventional nursing quality management approach and the PDCA cycle-based safety culture management method, respectively. The primary outcomes measured were nursing satisfaction, chemotherapy-related symptom burden, and the incidence of total implantable venous access port catheter (TIVAP)-related adverse events.

RESULTS

After three months, the study group showed significantly lower scores on all MSAS-SF subscales (GDI: 1.05 ± 0.33, PHYS: 0.69 ± 0.35, PSYCH: 1.15 ± 0.42, TMSAS: 2.62 ± 0.34) compared to the control group (GDI: 1.22 ± 0.47, PHYS: 0.85 ± 0.32, PSYCH: 1.43 ± 0.73, TMSAS: 2.81 ± 0.36) (all P < 0.05). Nursing satisfaction was higher in the study group (95.00%) than in the control group (78.33%) (P < 0.05). Quality of life scores improved more in the study group (74.9 ± 9.2) than in the control group (68.2 ± 10.5) (P < 0.01). The study group also had fewer TIVAP-related adverse events (6.67%) compared to the control group (24.67%) (P < 0.05).

CONCLUSION

The adoption of a nursing safety management model rooted in the PDCA cycle and safety culture principles can effectively improve nursing quality and satisfaction, alleviate patient symptoms and enhance quality of life in the context of Day Ward chemotherapy. These findings underscore the merit of further disseminating and studying this management approach in nursing practice.

摘要

目的

PDCA循环,也称为PDCA(计划-执行-检查-行动)循环,是一个成熟的持续质量改进框架。本研究旨在评估在日间病房化疗背景下实施基于PDCA循环和安全文化原则的护理安全管理策略的影响。

方法

这是一项基于随机化原则的前瞻性组间比较研究(队列比较)。选取2023年1月至2023年12月在南通市第一人民医院日间病房接受静脉化疗的120例患者作为研究对象。将他们随机分为对照组和研究组,分别采用传统护理质量管理方法和基于PDCA循环的安全文化管理方法进行管理。测量的主要结果包括护理满意度、化疗相关症状负担以及完全植入式静脉通路导管(TIVAP)相关不良事件的发生率。

结果

三个月后,研究组在所有MSAS-SF子量表上的得分均显著低于对照组(GDI:1.05±0.33,PHYS:0.69±0.35,PSYCH:1.15±0.42,TMSAS:2.62±0.34)(对照组:GDI:1.22±0.47,PHYS:0.85±0.32,PSYCH:1.43±0.73,TMSAS:2.81±0.36)(所有P<0.05)。研究组的护理满意度(95.00%)高于对照组(78.33%)(P<0.05)。研究组的生活质量得分改善幅度(74.9±9.2)大于对照组(68.2±10.5)(P<0.01)。研究组TIVAP相关不良事件的发生率(6.67%)也低于对照组(24.67%)(P<0.05)。

结论

采用基于PDCA循环和安全文化原则的护理安全管理模式可有效提高护理质量和满意度,减轻患者症状,提高日间病房化疗背景下的生活质量。这些发现强调了在护理实践中进一步推广和研究这种管理方法价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3360/11929163/3086def0dc6f/12957_2025_3738_Fig1_HTML.jpg

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