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

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. 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. 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). 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.