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Enhancing first-attempt success in radial artery cannulation: a PDCA-driven approach for anesthesiology residency
Meng Zhang1, Shuchuan Zhao2, Fangjing Bai1
1Department of Anesthesiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Objective:
This study aimed to evaluate the effectiveness of the Plan-Do-Check-Act (PDCA) cycle in improving the first-attempt success rate of radial artery cannulation among anesthesiology residents undergoing standardized training.
Methods:
Eighty-six residents from Sichuan Provincial People's Hospital, comprising 70 anesthesiology and 16 non-anesthesiology residents, were randomly divided into a control group and a PDCA group, each with 43 participants. Key outcomes assessed included first-attempt success rate, procedure duration, ultrasound utilization, preparation errors, and complication rates.
Results:
In anesthesiology residents, the PDCA group achieved a significantly higher first-attempt success rate (94%, 31/33) compared to the control group (43%, 16/37; P < 0.001). Among non-anesthesiology residents, the PDCA group also outperformed the control group, with success rates of 80% (8/10) vs. 33% (2/6; P = 0.048). Procedure duration was notably shorter in the PDCA group for both anesthesiology residents (median: 0.80 min, IQR: 0.50-2.30) and non-anesthesiology residents (median: 1.50 min, IQR: 0.70-3.00), compared to the control group (4.10 min, IQR: 3.10-5.90, and 3.70 min, IQR: 2.50-5.00; P < 0.001 and P = 0.026, respectively). Additionally, ultrasound usage was higher in the PDCA group, and assessment scores showed improvement, though the latter did not reach statistical significance.
Conclusion:
The PDCA cycle significantly enhances the first-attempt success rate and efficiency of radial artery cannulation while promoting greater adoption of ultrasound. These findings highlight its value in advancing standardized training for anesthesiology residents.
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