A practice-embedded, PDSA-guided implementation study of continuing professional development for stoma care in a...

Continuing professional development (CPD) in resource-constrained clinical settings is frequently challenged by time pressures, staffing constraints, and limited integration between education and routine practice. Practice-embedded quality improvement approaches may offer a pragmatic pathway for aligning workforce development with care delivery. This study describes the implementation of a nurse-led, PDSA-guided practice improvement program designed to strengthen stoma care for patients with colorectal cancer.

We conducted a single-site pragmatic implementation study using a quality improvement (QI) design. A Quality Stoma Practice Specific Program (QSPSP) was implemented in a tertiary medical center through three iterative Plan-Do-Study-Act (PDSA) cycles. The program incorporated specialist nursing leadership, standardized care processes, practice-based education activities, and interdisciplinary collaboration within routine workflows. Implementation and process indicators were assessed through structured audits and observational records. Patient-reported outcomes were explored using selected domains of the EORTC QLQ-C30 at post-discharge follow-up.

The QSPSP was integrated into routine nursing practice and was associated with improvements in care standardization, continuity of stoma care, infection control practices, and patient self-management education. Exploratory patient-reported outcome data from 27 participants indicated descriptive improvements in Emotional and Role Functioning domains at follow-up, while gains in Social Functioning were limited. Given the absence of baseline comparison and control conditions, these findings should be interpreted cautiously.

This study provides a descriptive account of a practice-embedded, PDSA-guided implementation initiative in a resource-constrained setting. While professional development processes were embedded within the intervention, independent measurement of learning was not conducted. The findings highlight the feasibility of integrating structured practice improvement activities within routine clinical work and suggest potential implications for aligning CPD with implementation efforts in similar contexts. Further research with comparative designs and longer follow-up is required to evaluate clinical and educational outcomes more robustly.