Effectiveness of a multicomponent PDCA-based infusion safety management strategy in patients with pulmonary tuberculosis: a non-randomized historical-control study

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