Pereira Rosana Aparecida, Gimenes Fernanda Raphael Escobar
University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, SP, Brazil.
Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Avenida Bandeirantes, Bairro Monte Alegre, Ribeirão Preto/SP, Brazil.
Florence Nightingale J Nurs. 2025 Mar 3;33:1-9. doi: 10.5152/FNJN.2025.23269.
To assess whether adherence to decisions made by professionals involved in the preparation and administration of orally administered medications via short-term enteral access could be enhanced through the implementation of a Group Decision-Making Model within a quality improvement program, comparing the third Plan-Do-Study-Act cycle with the fourth Plan-Do-Study-Act cycle with the Group Decision-Making Model.
This study outlines a quantitative research approach using the Standards for Quality Improvement Reporting Excellence (SQUIRE) model. The study was conducted between June 2018 and April 2019. A total of 16 nurses and 40 nursing assistants/technicians were working in the clinical medical ward at the moment of data collection. Group Decision-Making Model in conjunction with the PDSA cycle, as part of the Plan-Do-Study-Act cycle within a hospital in the State of São Paulo, Brazil, for supporting the hospital's nursing team in the preparation and administration of oral medicines via enteral access device for short-term use, including the washing of the equipment.
The findings, when compared to a prior Plan-Do-Study-Act cycle conducted without any involvement in decision-making, indicated that utilizing the Plan-Do-Study-Act cycle in conjunction with the Group Decision-Making Model method significantly improved the likelihood of successful implementation of quality improvement practices. This was especially noticeable in the case of the pill-crushing technique, where compliance increased from 5.3% in the Plan-Do-Study-Act cycle without the Group Decision Making Model to 100% in the Plan-Do-Study-Act cycle with the Group Decision-Making Model.
The Plan-Do-Study-Act cycle serves as a supportive tool for the management team. Nevertheless, its effectiveness may be constrained when final decisions follow a top-down approach. The incorporation of a participatory phase using the Group Decision-Making Model has demonstrated substantial potential to enhance the prospects of successfully implementing quality improvement practices regarding the preparation and administration of oral medications through enteral access device for short-term use.
评估在质量改进项目中通过实施群体决策模型，能否提高参与经短期肠内途径口服给药准备和给药的专业人员对决策的依从性，并将第三个计划-实施-研究-改进循环与采用群体决策模型的第四个计划-实施-研究-改进循环进行比较。
本研究概述了一种使用卓越质量改进报告标准（SQUIRE）模型的定量研究方法。该研究于2018年6月至2019年4月进行。在数据收集时，共有16名护士和40名护理助理/技术员在临床医学病房工作。在巴西圣保罗州的一家医院，群体决策模型与计划-实施-研究-改进循环相结合，作为计划-实施-研究-改进循环的一部分，用于支持医院护理团队通过短期使用的肠内给药装置进行口服药物的准备和给药，包括设备清洗。
与之前未参与决策的计划-实施-研究-改进循环相比，研究结果表明，将计划-实施-研究-改进循环与群体决策模型方法相结合，显著提高了质量改进实践成功实施的可能性。这在研碎药片技术方面尤为明显，在没有群体决策模型的计划-实施-研究-改进循环中，依从性为5.3%，而在采用群体决策模型的计划-实施-研究-改进循环中，依从性提高到了100%。
计划-实施-研究-改进循环是管理团队的一种支持工具。然而，当最终决策采用自上而下的方法时，其有效性可能会受到限制。采用群体决策模型纳入参与阶段已显示出巨大潜力，可提高通过短期使用的肠内给药装置进行口服药物准备和给药的质量改进实践成功实施的前景。
