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A practice-embedded, PDSA-guided implementation study of continuing professional development for stoma care in a
Ran Bi1, Huixian Zhao2, Lijun Tang2
1Department of Oncology, Qinhuangdao First Hospital, Qinhuangdao, Hebei, China.
Frontiers in Medicine
|April 10, 2026
Summary
This study implemented a nurse-led stoma care program using quality improvement methods in a resource-constrained setting. The program improved stoma care processes and patient education, demonstrating feasibility for aligning continuing professional development with clinical practice.
Area of Science:
- Nursing Practice
- Quality Improvement
- Colorectal Cancer Care
Background:
- Continuing professional development (CPD) faces challenges in resource-constrained settings.
- Practice-embedded quality improvement (QI) offers a solution for aligning workforce development with care.
- This study focused on a nurse-led program to enhance stoma care for colorectal cancer patients.
Purpose of the Study:
- To describe the implementation of a nurse-led, PDSA-guided practice improvement program for stoma care.
- To assess the integration of the Quality Stoma Practice Specific Program (QSPSP) into routine clinical workflows.
- To explore the impact of the program on care processes and patient outcomes.
Main Methods:
- A single-site pragmatic implementation study using a QI design.
- Implementation of the QSPSP through three iterative Plan-Do-Study-Act (PDSA) cycles.
- Assessment of process indicators via audits and observational records; exploration of patient-reported outcomes (EORTC QLQ-C30).
Main Results:
- The QSPSP integrated into nursing practice, improving care standardization, continuity, infection control, and patient education.
- Exploratory data from 27 patients showed descriptive improvements in Emotional and Role Functioning domains.
- Limited gains were observed in Social Functioning; findings require cautious interpretation due to lack of control group.
Conclusions:
- The study demonstrates the feasibility of integrating QI activities into routine clinical work in resource-constrained settings.
- The findings suggest potential for aligning CPD with implementation efforts through practice-embedded initiatives.
- Further research with comparative designs is needed to robustly evaluate clinical and educational outcomes.
Keywords:
PDSAcontinuing professional developmentimplementation studynurse-led interventionpatient-reported outcomespractice-embedded quality improvementresource-constrained settingsworkplace learningMore Related Videos
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