ArticleJournal of multidisciplinary healthcare2026
Impact of Plan-Do-Study-Act Cycle-Based Quality Improvement on Head-of-Bed Elevation Compliance, Cuff Pressure Management and Ventilator-Associated Pneumonia in Intensive Care Units: A Before-After Study.
Article in Journal of multidisciplinary healthcare, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aimed to evaluate the association between Plan-Do-Study-Act (PDSA) cycle-based quality improvement measures and the correct implementation rate of head-of-bed elevation, artificial airway cuff pressure compliance, and ventilator-associated pneumonia (VAP) incidence in mechanically ventilated patients, and to identify independent influencing factors of the two core care indicators. Methods: A total of 4305 patients receiving mechanical ventilation for ≥48 hours in the Emergency Intensive Care Unit (EICU) and Respiratory Intensive Care Unit (RICU) were enrolled, divided into the pre-implementation group (n=2163, Jan-Dec 2024) and the post-implementation group (n=2142, Jan-Dec 2025). The post-implementation group received comprehensive improvement measures based on the PDSA cycle, including standardized monitoring, normalized measuring tools and continuous quality control. The two indicators' compliance rates and VAP incidence were compared between groups. Univariate and multivariate Logistic regression analyses were used to identify influencing factors, and Spearman correlation analysis was performed to explore the relationship between indicator compliance and VAP incidence. Results: The post-implementation group had significantly higher compliance rates of both indicators and lower VAP incidence (all Conclusion: PDSA cycle-based comprehensive quality improvement measures were associated with improved compliance rates of head-of-bed elevation and artificial airway cuff pressure in mechanically ventilated patients, and lower VAP incidence. Standardized procedures and continuous quality monitoring are key to maintaining high compliance of these two core VAP prevention indicators.
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