Effect of plan-do-check-act cycle in reducing contrast agent leakage in contrast-enhanced computed tomography

Abstract:

Objective：To investigate the clinical effect of plan-do-check-act（PDCA） cycle management procedure in the management of contrast agent leakage in contrast-enhanced computed tomography（CT）. Methods：A retrospective analysis was performed for the clinical data of patients who underwent contrast-enhanced CT in our hospital from March 2015 to February 2017. A total of 40 223 patients who underwent conventional nursing in contrast-enhanced CT from March 2015 to February 2016 were enrolled as control group，and 44 831 patients who underwent PDCA cycle management in contrast-enhanced CT from March 2016 to February 2017 were enrolled as observation group. The chi-square test was used to compare the incidence rate and degree of contrast agent leakage between the two groups. Results：A total of 76 patients experienced contrast agent leakage，resulting in an incidence rate of 0.08%，with 28 patients（0.06%） from the observation group and 48（0.11%） from the control group. Compared with conventional nursing，PDCA cycle management significantly reduced the incidence rate of contrast agent leakage（28/44 831 vs. 48/40 223， X2=7.638，P= 0.006）. In addition，PDCA cycle management significantly reduced moderate contrast agent leakage（7/44 831 vs. 16/40 223， X2= 4.579，P=0.032），but it did not reduce mild contrast agent leakage（19/44 831 vs. 27/40 223，X2 =2.402，P=0.121） and severe contrast agent leakage（2/44 831 vs. 5/40 223，X2=0.811，P=0.368）. Conclusion：PDCA cycle management for nursing intervention in contrast-en－hanced CT can reduce the incidence rate of contrast agent leakage and improve the quality of nursing.