Effectiveness of a multicomponent PDCA-based infusion safety management strategy in patients with pulmonary...

To evaluate the association between a multicomponent PDCA-based infusion safety management strategy and intraoperative peripheral intravenous (PIV) outcomes in adults with pulmonary tuberculosis.

This non-randomized historical-control study included 92 adults undergoing thoracic surgery: 46 historical controls receiving routine infusion management and 46 patients receiving a multicomponent intervention integrating PDCA-based quality improvement, staff training, standardized protocols, interdepartmental collaboration, audit and feedback, and two auxiliary devices. Baseline demographic and surgical characteristics were comparable between groups.

Compared with historical controls, the intervention group had lower rates of erythema/tenderness [8.7% vs. 69.6%; RR, 0.13 (95% CI, 0.05-0.33)], catheter dislodgement [2.2% vs. 28.3%; RR, 0.08 (95% CI, 0.01-0.56)], and catheter occlusion [4.3% vs. 43.5%; RR, 0.10 (95% CI, 0.02-0.40); all P ≤ 0.001]. Catheter dwell time was longer [5.0 vs. 3.0 days; Hodges-Lehmann difference, +2.0 days (95% CI, 1.0-2.0)], whereas hospital stay was shorter [11.0 vs. 19.0 days; difference, -7.0 days (95% CI, -10.0 to -5.0)]. Satisfaction scores were also higher [95.0 vs. 91.5; difference, +3.0 points (95% CI, 2.0-4.0); all P < 0.001].

The multicomponent PDCA-based strategy was associated with fewer PIV-related safety events, longer catheter dwell time, and higher satisfaction. However, because the intervention combined process changes with two devices and used a historical control, the observed differences cannot be attributed independently to PDCA or either device.