To Explore the Application of PDCA in Hemodialysis Center and Its Effect on the Maintenance of Internal Fistula

Clinical application and nursing experience of the plan-do-check-act cycle in daytime varicocelectomy

BACKGROUND

Varicocele is the most prevalent correctable cause of male infertility. Currently, surgical treatment is the primary method to enhance fertility.For many young varicocele patients who have postponed surgery due to time constraints, daytime surgery is especially crucial. Thus, this study aims to investigate the clinical and nursing application value of the Plan-Do-Check-Act (PDCA) cycle in daytime varicocelectomy.

METHODS

Retrospective collection of clinical data was conducted on 130 patients undergoing laparoscopic varicocelectomy in the Third Affiliated Hospital of Southern Medical University, Guangzhou,China.Among them, 65 patients who underwent daytime surgery were assigned to the observation group, while 65 patients who underwent routine hospital surgeries were assigned to the control group.The former also implemented PDCA cycle management.A comparison was made between the two groups regarding hospitalization time, hospitalization costs, and patient satisfaction.

RESULTS

The observation group exhibited a shorter hospitalization time and lower hospitalization costs compared to the control group, with higher patient satisfaction and pre-discharge visual analog scale (VAS) scores noted (P < 0.05).No significant difference was observed in the incidence of postoperative complications between the two groups during hospitalization (P > 0.05). The implementation of the PDCA cycle in the observation group has demonstrated its effectiveness, ensuring the smooth conduct of the daytime varicocelectomy.

CONCLUSION

In conclusion,daytime varicocelectomy can reduce hospitalization time,lower hospitalization costs, improve patient satisfaction. The PDCA Cycle enhances the rationality and efficacy of the daytime varicocelectomy procedure and is highly recommended. Furthermore, it offers valuable reference for the application of the PDCA Cycle in various other diseases and nursing management approaches.

TRIAL REGISTRATION

The Trial Registration Number: ChiCTR2300077465;Date of registration: November 9, 2023.

Analysis of the application effect of a rapid response team in emergency cesarean section

INTRODUCTION

Emergency cesarean section is one of the most critical methods in the treatment of high-risk emergency obstetric cases. The aim of this study was to explore the clinical effect of constructing a Rapid Response Team (RRT) in emergency cesarean section.

METHODS

This is a pre- and post-implementation study. The patients who underwent emergency cesarean section were retrospectively analyzed and divided into an experimental group and a control group. There were 52 patients (June-December 2020) in the control group who underwent routine emergency cesarean section without an RRT, and 51 patients (January-June 2021) in the experimental group who underwent emergency cesarean section with an RRT. The operation time indexes (DOI, decision-to-operating room interval; O-I, operating room-to-incision interval; DII, decision-to-incision interval; I-D, incision-to-delivery interval; DDI, decision-to-delivery interval), DDI pass rate, neonatal Apgar score and maternal complications in the two groups were compared. Moreover, the management time trends (DOI, DII, and DDI) in the experimental group were analyzed.

RESULTS

The DDI, DII, DOI, and O-I of the experimental group were shorter than those of the control group, and the differences were significant (p < 0.05). The DDI pass rate in the experimental group was higher than that in the control group, and the difference was significant (p < 0.01). The 1-min Apgar score of the experimental group was higher than that of the control group (p < 0.05). The key intervals of emergency cesarean section in the experimental group leveled off after approximately 3 to 4 months.

CONCLUSION

In the face of emergency situations, the implementation of an emergency cesarean section RRT can improve delivery intervals for emergency cesarean and would be conducive to maternal and infant safety.

Application effect of PDCA circulation on nursing quality management and risk control in digestive endoscopy room

To explore the application effect of plan, do, check, action (PDCA) cycle on nursing quality management and risk control in digestive endoscope room. Ninety patients who received digestive endoscopy care before undergoing PDCA circulation mode risk control from January 2022 to April 2022 were selected as the Common group. From May 2022 to December 2022, 156 patients who underwent digestive endoscopy care after undergoing PDCA cycle mode risk control were selected as the PDCA group. Compare the infection status of patients in the endoscope room and the qualification of the air in the endoscope room before and after PDCA circulation management. Compare the respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, and nursing satisfaction of patients in the Common group and the PDCA group. Compare the qualified rate of endoscopic cavity disinfection before and after PDCA cycle management, the qualified rate of endoscopic external disinfection, and the management score. Four patients in the Common group developed infection, with an infection rate of 4.44%. One case of infection occurred in the PDCA group, with an infection rate of 0.64%. The qualified rate of the endoscope room air in the Common group was 92.22%, while the qualified rate of the endoscope room air in the PDCA group was 98.72%. Compared with the Common group, the infection rate of patients in the PDCA group significantly decreased, and the qualified rate of air in the endoscope room significantly increased. The respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, nursing errors, and nursing complaint rates of patients in the PDCA group were significantly lower than those in the Common group, and nursing satisfaction was significantly higher than those in the Common group. The qualified rate of endoscopic cavity disinfection and endoscopic external disinfection in the PDCA group were significantly higher than those in the Common group. Compared with before management, the scores of post management, nursing safety, disinfection and isolation, instruments, theoretical tests, and operational tests of nursing personnel after management increased significantly. The PDCA cycle is well applied in nursing quality management and risk control in the digestive endoscope room.

Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis

Objective

To investigate the effects of arteriovenous fistulas (AVFs) and central venous catheters (CVCs) on the left ventricular function (LVF) and prognosis of maintenance hemodialysis (MHD) patients.

Methods

This retrospective cohort study included 270 patients (139 with AVF and 131 with CVC) undergoing dialysis with newly established vascular access in the blood purification center of Nanhua hospital, University of South China, from January 2019 to April 2021. Dialysis efficiencies, LVF indexes, and one-year prognoses were compared.

Results

At six and twelve months after the establishment of vascular access, the mean urea clearances (Kt/V) and urea reduction ratio (URR) between the AVF- and the CVC-group were similar (P>0.05). The mean LVF values between the two groups were also similar before the establishment of vascular access (P>0.05), but the mean values of left ventricular end diastolic diameter (LVEDd), interventricular septal thickness (IVSTd), and left ventricular posterior wall thickness (LVPWT) in the AVF-group were higher than those in the CVC-group one year later, and mean early (E) and late (A) diastolic mitral velocities, E/A, and ejection fraction (EF) were lower than those in the CVC-group (P<0.05). The incidence of left ventricular hypertrophy and systolic dysfunction in the AVF-group was higher than that in the CVC-group (P<0.05). The hospitalization rate of AVF-group (23.02%) was lower than that of the CVC-group (49.61%) (P<0.05).

Conclusion

Both AVF and CVC can achieve appropriate dialysis effects in MHD patients. AVF has a negative impact on cardiac function while CVC has a high hospitalization rate.