EFFECT OF PLAN-DO-CHECK-ACT CYCLE ON CONTROLLING RISK OF MULTIDRUG-RESISTANT ORGANISM INFECTIONS AMONG PATIENTS IN INTENSIVE CARE UNIT, THE SECOND XIANGYA HOSPITAL, CENTRAL SOUTH UNIVERSITY, HUNAN, PR CHINA

Abstract

Patients in the intensive care unit (ICU) are at a high risk of developing multidrug-resistant organism (MDRO) infections because of their critical condition, frequent invasive procedures and inappropriate use of broad-spectrum antibiotics.  This study evaluated the effect of the Plan-Do-Check-Act (PDCA) cycle system on controlling the risk of MDRO infections in ICU patients.  Patients who tested negative for bacterial infection upon hospital admission were randomly assigned to control and PDCA groups (n = 64 per group) for routine MDRO prevention and control measures (the former group) and routine measures together with the PDCA cycle-based management (the latter group) during their ICU stay. Patients’ MDRO infection rate, antimicrobial use density, ICU length of stay, total hospitalization stay and ICU MDRO contamination were significantly reduced in the PDCA group compared to the control (p-value <0.050).  However, the 28-day mortality was not different between the two groups.  In addition, nurses’ hand hygiene behavior was significantly improved in the PDCA group compared to the control (n = 30 per group).  The results confirmed the utility of the PDCA cycle system for bacterial infection prevention and control in ICUs.  However, its long-term benefits need to be determined through expanding the cohort size and extending the intervention duration.