Effects of the Plan-Do-Check-Act Nursing Model on Improving Treatment Adherence and Lowering Nosocomial Infection in Elderly Bronchopneumonia Patients: A Randomised Controlled Trial.

OBJECTIVE

This paper aimed at ascertaining whether a Plan-Do-Check-Act (PDCA) nursing model improves treatment adherence and reduces hospital-acquired infections (HAIs) in elderly patients with bronchopneumonia.

METHODS

Eighty-eight inpatients with senile bronchopneumonia were randomly assigned to two groups. The control group (n = 44) received standard therapy plus routine nursing; the observation group (n = 44) received the same care augmented by a PDCA-based nursing programme. Outcomes were assessed before and after nursing and included adherence ratings, clinical recovery indicators (length of stay; time to resolution of cough, sputum, pulmonary moist rales and dyspnoea), pulmonary function indices (FEV1, PEER, FVC), ward hygiene compliance metrics and HAI incidence.

RESULTS

Post-nursing, adherence in the observation group improved markedly and exceeded that of controls; patients rated as having good adherence increased from 15.91% to 56.82%, whereas the poor-adherence category fell from 50.00% to 2.27%. Times to disappearance of cough, sputum, moist rales, and dyspnoea, as well as length of stay, were all shorter than in the control group (all p < 0.05). Both groups showed gains in FEV1, PEER, and FVC after nursing (p < 0.05), with the observation group achieving significantly higher values at follow-up (p < 0.001). Ward-level compliance-equipment cleaning, staff hygiene, environmental/air quality, cleaning-disinfection quality and knowledge of infection prevention-was superior in the observation group (all p < 0.05). The HAI rate was lower with PDCA (3/44, 6.82%) than with routine care (11/44, 25.00%; p < 0.05).

CONCLUSION

Implementation of PDCA-based nursing in older adults with bronchopneumonia led to clinically meaningful benefits-accelerated symptom relief, enhanced adherence, measurable gains in lung function, improved ward hygiene compliance and reduced nosocomial infections.