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In the context of "New Era" and "New Medicine", the teaching team of laboratory diagnostics proposed a new teaching method of PDCA (Plan, Do, Check, Action) cycle to innovate the instructional design and implementation of laboratory diagnosis on the base of traditional teaching model. Through optimizing the curriculum system, integrating superior resources, taking full advantage of information technology, mobilizing the virtual simulation laboratory, implementing moral education and multiple comprehensive evaluation results, the self-learning enthusiasm, innovation and development ability of students were improved significantly, accompanied with high humanistic care spirit. Moreover, the enthusiasm of participating in scientific research activities and professional competitions was enhanced obviously. Therefore, we believe that the PDCA cycle, with notable successes, deserves high promotion value and wide application.
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@#Objective To study the effect of PDCA cycle on the image quality of oral photography in patients with periodontal disease.Methods Totally 94 patients with periodontal disease admitted to our hospital from February to July 2022 were selected.47 patients who took oral photography images from February to April 2022 were included in the control group,and 47 patients who took oral photography images from May to July 2022 were included in the PDCA group.At the same time,9 nursing staff in the periodontal department of our hospital were selected.The patients in the control group were taken conventional photography,PDCA group used PDCA cycle on the basis of the control group.The image quality of the two groups of patients with periodontal disease and their satisfaction with the oral photography process were compared.The deduction of points for photography technology of nursing staff before and after the implementation of PDCA cycle were compared.Results The rate of reaching the standard of image quality in PDCA group was significantly higher than that in the control group(P<0.05).The satisfaction of PDCA group with oral photography was significantly higher than that of the control group(P<0.05).After the implementation of PDCA cycle,the deduction of points of material preparation,frontal,lateral,lingual,maxillofacial,maxillofacial,photography time and photography technology of nursing staff were significantly lower than those before the implementation(P<0.05).Conclusion PDCA circulation can effectively improve the rate of reaching the standard of oral photography image quality of patients with periodontal disease,increase their satisfaction with the photography process,and improve the nursing staff's photography technology score.
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Objective To explore the application of Plan-Do-Check-Act(PDCA)cycle management to continuously im-prove the service quality of outpatient pharmacy and enhance patient satisfaction.Methods To address the problem of long wait-ing time for patients in outpatient pharmacy,we applied PDCA cycle to investigate the factors affecting patients'waiting time in the process of medicine collection,analyze the current situation,determine the expected goals,formulate the service quality im-provement plan of outpatient pharmacy,implement the improvement plan,follow up and supervise,and summarize and analyse the problems regularly until it was solved.Results After implementing the PDCA cycle in the management,the service quality of outpatient pharmacy was improved,the waiting time was significantly shortened and the satisfaction of medical treatment was in-creased.Conclusion The application of PDCA cycle method is effective in improving the service quality of outpatient pharmacy.Therefore,it is recommended for broader implementation.
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OBJECTIVE To evaluate the effect of PDCA cycle on prophylactic use of antibiotics in laparoscopic cholecystectomy during perioperative period and to conduct pharmacoeconomic analysis. METHODS Using retrospective analysis method， 80 discharged patients of each group underwent laparoscopic cholecystectomy were randomly selected from Hefei Second People’s Hospital before PDCA cycle （from May to June 2019）， after the first round of PDCA cycle （from May to June 2020）， after the second round of PDCA cycle （from May to June 2021） according to real or basic reasons for irrational drug use. The rationality of prophylactic use of antibiotics for patients was evaluated. The general situation， antibiotic use， clinical efficacy and treatment cost of patients were compared before cycle and after the first and second rounds of PDCA cycle. Cost-effectiveness analysis method and sensitivity analysis method were adopted to evaluate pharmacoeconomic significance of PDCA cycle. RESULTS After two rounds of PDCA cycle， the irrational rate of antibiotics， cost ratio of antibiotics， the number of days of antibiotics use， DDDs， drug utilization index， the frequency of antibiotics use per capita， the total amount of antibiotics， the cost of antibiotics， the total amount of drugs， and the total cost of hospitalization all decreased significantly （P＜0.05）. The results of cost-effectiveness analysis indicated that the pharmacoeconomic effect was the best after two rounds of PDCA cycle； the results of sensitivity analysis were consistent with it， which confirmed the reliability of the research results. CONCLUSIONS PDCA CPA- cycle promotes the rational use of antibiotics of laparoscopic cholecystectomy during perioperative period， reduces the cost of antibiotics and relieves the economic burden of patients.
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Objective:To investigate the application of PDCA cycle management combined with "three-step" bedside teaching in respiratory nursing teaching.Methods:A total of 80 nursing students who studies in Department of Respiratory Medicine, Beijing Chaoyang Hospital Affiliated to Capital Medical University, were included as subjects, and they were divided into control group and observation group using a simple random number table, with 40 students in each group. The students in the control group received traditional teaching, while those in the observation group received PDCA cycle management combined with "three-step" bedside teaching. The two groups were compared in terms of the scores of theoretical knowledge, operation skills, and physical examination, comprehensive clinical nursing ability, and degree of satisfaction with teaching. SPSS 22.0 was used to perform the chi-square test and t-test. Results:The observation group had significantly higher scores of theoretical knowledge, operation skills, and physical examination than the control group ( P<0.05). Compared with the control group, the observation group had significantly higher scores of nursing consultation, physical examination, diagnosis, nursing measures, health consultation, humanistic care, organizational effectiveness, and overall evaluation ( P<0.05). The observation group had a significantly higher degree of satisfaction with teaching than the control group ( P<0.05). Conclusion:PDCA cycle management combined with "three-step" bedside teaching in respiratory nursing teaching can improve the assessment scores of theoretical knowledge, operation skills, and physical examination among nursing students, enhance their comprehensive clinical nursing abilities, and increase the degree of satisfaction.
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Objective:To explore the application of PDCA (plan, do, check, act) cycle theory in the teaching of eight-year clinical medical students for the course of Laboratory Diagnostics.Methods:From September 2021 to November 2022, the students majoring in clinical medicine of eight-year system who were studying the course of Laboratory Diagnostics at Peking Union Medical College were selected as the research objects. The teaching reform of the course of Laboratory Diagnostics was carried out according to the four stages of PDCA cycle theory, and the teaching effect was evaluated by the final examination results and questionnaire survey scores of the students.Results:The score of theoretical examination of eight-year students in 2018 was (86.7±4.68) points, which was higher than that of students in 2017 [(83.3±3.89) points], and the difference was statistically significant ( P<0.05). The questionnaire survey results of the two groups of students showed that the rating of experimental course was higher than that of theoretical course ( P<0.05). After the teaching reform based on PDCA cycle theory, the questionnaire survey scores of theoretical course [(3.83±0.25) points vs (2.94±0.28) points] and experimental course [(4.13±0.09) points vs (3.32±0.12) points] in students of 2018 were higher than those of 2017 (all P<0.001). Conclusion:PDCA cycle theory provides new methods and ideas for teaching management, which helps to improve the performance of clinical medical students of eight-year system and their recognition of the course.
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Public hospitals play a key role in emergency management of public health emergencies.The emergency man-agement capability of public hospitals directly affects the performance of medical services,public health service functions,and their sustainable development.Based on the division of crisis event lifecycle and emergency management stages,this paper analy-zes the inadequate preparation and early warning mechanisms for public health emergency management in public hospitals,as well as the lack of emergency response network and mechanism supply,and summarizes the ability difficulties of delayed evaluation and recovery,and poor circulation in various links.This article draws inspiration from the concept of comprehensive quality man-agement and builds a theoretical framework based on the PDCA cycle and the applicability of public health emergency manage-ment in public hospitals,based on the idea of"scenario-taskand capability-response methods".Based on this,strategies are proposed to enhance the public health emergency prevention and preparedness capabilities,emergency response and disposal ca-pabilities,and emergency regulation and recovery capabilities of public hospitals.
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Objective To explore the application of PDCA cycle management mode in public health emergencies in gen-eral hospitals.Methods The PDCA cycle management model was carried out.35 medical workers from Shawan People's Hos-pital of Panyu District,Guangzhou from January 2021 to December 2022 were included as research objects and divided according to different time points as cut-off points.The PDCA cycle management model was not implemented from January to December 2021.The PDCA cycle mode management will be implemented from January to December 2022.The treatment time,job burnout and emergency response ability of medical staff before and after PDCA cycle management were compared.Results After the im-plementation of PDCA cycle mode management,the pre-hospital examination,hospital admission,symptom examination and dis-ease diagnosis of medical staff were less than those before the implementation of PDCA cycle mode management,and the differ-ence was significant(P＜0.05).After the implementation of PDCA cycle mode management,the scores of emotional consump-tion and deindividuation tendency of medical staff were lower than those before the implementation of PDCA cycle mode manage-ment,while the scores of low sense of accomplishment after the implementation of PDCA cycle mode management were higher than those before the implementation of PDCA cycle mode management,with significant differences(P＜0.05).After the imple-mentation of PDCA cycle mode management,the emergency ability scores of medical staff were higher than those before the imple-mentation of PDCA cycle mode management,and the difference was significant(P＜0.05).Conclusion PDCA cycle manage-ment mode has a good application effect in public health emergencies in general hospitals,which is conducive to more efficient and successful treatment of public health emergencies.
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The problems during medical consumables selection were analyzed with a fishbone diagram.The selection process was optimized based on PDCA cycle,and a standardized selection plan for medical consumables was formulated by combining the practical experience of hospital management,and the practicability and feasibility of the selection plan was verified.References were provided for medical institutions to select cost-effective medical consumables.
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Objective:To study the effects of plan-do-check-action (PDCA) cycle in quality improvement of neonatal resuscitation.Methods:From 2016 to 2020, the clinical data of neonates born in our hospital were analyzed. Neonates born during 2016 to 2017 were pre-PDCA group and neonates born during 2018 to 2020 were post-PDCA group. PDCA quality improvement included step-by-step, high-frequency and low-dose training, strengthening teamwork and adding equipment.Results:A total of 7 728 live-birth neonates were delivered before PDCA with 319 cases (4.1%) of asphyxia. 10 174 live-birth neonates were delivered after PDCA with 422 cases (4.1%) of asphyxia. The asphyxia rates showed no significant difference between the two groups ( P>0.05). The incidences of severe asphyxia before and after PDCA were both 0.8% without significant difference ( P>0.05). The success rates of resuscitation for severe asphyxia before and after PDCA was 27.9% and 44.9%, respectively, and the differences were statistically significant ( P<0.05). The mortality rates within 7 d before and after PDCA were 0.5‰ and 0.1‰ respectively, without significant differences ( P>0.05). Conclusions:The implementation of PDCA cycle and step-by-step, high-frequency, low-dose neonatal resuscitation training can effectively improve the success rate of resuscitation in newborns with severe asphyxia.
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Objective:To investigate the application value of the PDCA cycle in increasing the rate of timely completion of a rapid frozen-section pathological report.Methods:The basic data of 1 926 rapid frozen section pathological reports not managed by the PDCA cycle in the Department of Pathology, Zhoushan Hospital, during January to August 2019 were collected. The number of pathological reports completed within 30 minutes and the rate of timely completion of pathological reports were calculated and compared with those calculated based on 1 051 pathological reports managed by the PDCA cycle during September to December 2019.Results:After management by the PDCA cycle, the rate of timely completion of frozen-section pathological reports was significantly increased from (84.51 ± 3.61)% to (91.87 ± 1.37)% ( t = 3.86, P < 0.05). Conclusion:Application of the PDCA cycle to pathology management can help monitor the completion of pathological reports on frozen sections. This facilitates determination of reasonable intervention measures and thereby increases the rate of timely completion of pathological reports on frozen sections.
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To evaluate effects of PDCA cycle in improving residency diagnosis and treatment ability of endocrine and metabolic diseases, this paper selected the problems of insufficient diagnosis and treatment ability in the results of the endocrinology examination paper as the research breakthrough point, and investigated 62 residents receiving standardized residency training to analyze main reasons of the problems such as "busy clinical work", "special clinical thinking" and "difficult to remember knowledge of endocrinology". The study implemented information-based teaching and daily self-education, followed the law of memory, strengthened the construction of teaching staff, improved teaching methods, etc., and effects of these methods were assessed after the teaching. It's found that the application of PDCA cycle can improve the residents' ability of clinical diagnosis and treatment in endocrine and metabolic diseases.
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Objective To observe the effect of applying PDCA cycle method to promote the management of key monitoring drug, and provide a basis for the management of key monitoring drug in medical institutions. Methods To compare the consumption of drugs and prescription reviews before and after the adoption of PDCA management in a hospital. The control group was the inpatients with traditional management method in 2019, and the observation group was the inpatients with PDCA method in 2020. Results After the implementation of PDCA cycle, the consumption amount of key monitoring drugs decreased significantly (P<0.001); The problems of irrational prescription such as drug use without indication, repeated drug use, inappropriate dosage and route of administration, and long course of treatment were effectively controlled (P<0.05). The qualified rate of prescription increased from 65.96% to 90.76% (χ2=27.010, P<0.001). The incidence of adverse reactions was significantly decreased (χ2 =37.044, P<0.001). Conclusion PDCA method aims at continuous closed-loop management of key monitoring drugs in medical institutions, which can control drug costs to the greatest extent, reduce the economic burden of patients, promote rational drug use, reduce the incidence of adverse reactions, and ensure the quality of medical care.
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Objective To understand the current situation of dispensing errors and effective prevention and control measures in outpatient pharmacies in domestic hospitals, in order to further improve the quality of drug dispensing. Methods The Chinese journal database was retrieved from 2015 to 2020 for the literature on the dispensing errors of outpatient pharmacies and the continuous improvement of the quality after the measures were taken in secondary and tertiary hospitals. Results Of the 146 literatures retrieved, 13 were included in the analysis (11 in tertiary hospitals and 2 in secondary hospitals). Before the improvement, the median of the drug dispensing error rate was 5.1‰, and after the improvement it was 1.1‰. Before and after the improvement, the types of drug dispensing errors were mainly quantity errors (52.5% vs. 51.3%), variety errors (28.3% vs. 28.7%), specifications and dosage forms errors (6.2% vs. 6.7%), and labeling errors (2.1% vs. 2.9%). The improvement measures taken for the reasons of dispensing errors have a high overlap rate, and they are concentrated in two aspects: personnel factors and drug factors. Conclusion The use of continuous quality improvement tools in hospital outpatient pharmacy to control and prevent dispensing errors is still a hotspot of current research. The composition of the types of errors after improvement has basically not changed. The implemen-tation of standardized operating procedures and other continuous improvement comprehensive measures can effectively reduce the incidence of dispensing errors, and contribute to the implementation of the “Expert Consensus on Medication Error Management in China”.
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In the COVID-19 outbreak, several general hospitals in Wuhan were transferred to designated hospitals. However, most of the designated hospitals had suffered from insufficient oxygen supply in different degrees. Taking a designated hospital as an example, this paper summarized the emergency management system of oxygen supply from the aspects of engineering transformation, process formulation and safety management through the PDCA cycle theory, discussed the management experience of oxygen supply under the epidemic situation, and explored the management mode of emergency normalization from the perspective of peacetime and wartime integration. The purpose was to provide reference for the management of medical oxygen supply in public health emergencies and normal operation.
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Objective To explore the effect of the intervention of clinical pharmacists on the rational use of piperacillin-tazobactam by using PDCA cycle, in order to provide reference for rational drug use. Methods The problems of piperacillin-tazobactam in our hospital was analyzed. PDCA cycle was used to manage the problems. Then, the data before and after PDCA cycle was compared and analyzed. Results After using PDCA cycle, the irrational use rate of piperacillin-tazobactam gradually decreased, from 9% in February 2018 to 2% in February 2019; the doses decreased from 4380 in February 2018 to 3346 in February 2019; and the frequency of usage decreased from 391 DDDs in February 2018 to 298 DDDs in February 2019. The effectiveness and continuous improvement of PDCA cycle in managing piperacillin-tazobactam were significant. Conclusion PDCA cycle can effectively improve the management effectiveness of piperacillin-tazobactam administration.
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OBJECTIVE: To investigate the use of PDCA mode for risk assessment and risk management of pharmacy intravenous admixture service. METHODS: A retrospective analysis was made on the errors recorded in the intravenous drug dispensing center from Monday 2019 to March 2019. The types and links of errors were counted and classified, and the causes were analyzed. Targeted preventive measures were implemented from April to June 2019 to observe the incidence of errors before and after prevention in intravenous drug dispensing centers. RESULTS: Through the PDCA cycle management intervention, the main errors in intravenous drug dispensing center are dispensing, labeling, reviewing, checking and issuing. The incidence of errors in each link after prevention is lower than that before prevention, and the difference is statistically significant (P<0.001). CONCLUSION: The PDCA cycle management and risk assessment are conducted. The paper analyzes the types and causes of common errors in intravenous drug dispensing center, so as to formulate corresponding preventive measures, which can reduce the risk factors of errors, reduce the incidence of errors, improve the quality of finished product infusion and the safety of intravenous drug use.
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OBJECTIVE： To promote rational use of proton pump inhibitors （PPIs） during perioperative period. METHODS： PDCA （Plan， Do， Check， Action） cycle management was used， the irrational use of PPIs of 300 medical records in neurosurgery department of our hospital were collected. The reasons were analyzed， management target was formulated and measures were implemented. The effects of management were evaluated through comparing the rate of irrational drug use and ratio of irrational type of PPIs in 300 medical records of neurosurgery department during perioperative period after management. RESULTS： Through collecting related data to confirm risk factors of stress ulcer， establishing rationality evaluation criteria for perioperative prophylactic use of PPIs， conducting rational drug use training among medical staff， drawing up various management systems and strengthening supervision and management， the rate of irrational use of PPIs was decreased significantly in our hospital； the number of irrational drug use cases decreased from 240 before management to 156 after management， among which the rate of prophylactic drug use without indication decreased from 37.33％ to 29.00％ （P＜0.05）； the irrational dosage rate decreased from 11.33％ to 6.33％ （P＜0.05）； the rate of irrational dosing frequency dropped from 12.67％ to 5.00％ （P＜0.01）. CONCLUSIONS： PDCA cycle management of our hospital can standardize the prophylactic use of PPIs in neurosurgery department during perioperative period and promote rational use of PPIs.
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OBJECTIVE： To promote the implementation of the pre-prescription review work， and to ensure the rational drug use of patients. METHODS： With the idea of PDCA （Plan， Do， Check， Action） cycle management， the phased improvement of three PDCA cycles was gradually implemented in the operation of the pre-prescription review system， aiming at the establishment of the working mode of the prescription review work， the improvement of the rules of knowledge base in the review system and the improvement of the ability of pharmacists to review prescriptions. The operation results of the system were evaluated by comparing the irrational prescription rate of outpatient pharmacies before and after the operation of pre-prescription review system. RESULTS： Through adopting the prescription review mode of “rigid” and “flexible” interception， regular revision of knowledge base rules， regular training and examination of prescription pharmacists， pre-prescription review system operated smoothly， and the pre-prescription review work was carried out in the process of continuous improvement. In the three PDCA cycles， the irrational rate of prescriptions decreased significantly， such as after the first PDCA cycle， the irrational rate of TCM outpatient prescriptions decreased from 22.0％ （1 393/6 332） in Jan. 2017 to 7.4％ （416/5 627） in Jun. 2017； after the second PDCA cycle， the irrational rate of outpatient prescriptions in hospital decreased from 4.87％ （5 244/107 691） in Mar. 2018 to 2.21％ （2 219/100 412） in Aug. 2018. After the third PDCA cycle， the percentage of over-treatment course prescriptions in total prescriptions decreased from 16.97％ （15 728/92 684） in Jun. 2018 to 5.55％ （5 394/97 275） in Sept. 2018. CONCLUSIONS： The pre-prescription review system can effectively intercept and interfere with irrational prescriptions， and PDCA cycle management can effectively promote the operation of the pre-prescription review work.
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s] Objective To understand the influence of PDCA cyclecombined with LBL/TBL teaching models on the problem-solving ability and clinical training of pharmacy interns so as to improve the teaching quality of hospital pharmacy practice. Methods A total of 126 hospital pharmacy interns were randomly divided into the control group (63 interns) and the experimental group (63 interns). The control group was taught with LBL/TBL teaching models, while the experimental group was taught with PDCA cycle combined with LBL/TBL teaching models . Questionnaires were used to investigate the problem-solving ability , the teaching effect of clinical training , and the satisfaction in the two groups after the clinical training. Results The scores of positive problem orientation and rational problem solving were higher in the experimental group than in the control group (P<0.05). The scores of negative problem orientation, avoidance style, impulsivity/carelessness style were lower in the experimental group than in the control group(P<0.05). The scores of theoretical knowledge ( 86 . 5 ± 8 . 5 ) and clinical skills ( 87 . 0 ± 7 . 2 ) were higher in the experimental group than in the control group (P<0.05). Besides, the investigation on the satisfaction to clinical training showed that the practical ability, teamwork consciousness and self-learning ability were better in the experimental group than in the control group (P<0.05). The total satisfaction of the experimental group was 92.2％, higher than that of the control group (83.5％) (P<0.05). Conclusion PDCA cycle combined with LBL/TBL teaching models can improve the problem-solving ability and the teaching effect of clinical training in pharmacy interns, which deserves wider application.