Effects of the application of combined plan-do-check-action and enhanced recovery by nurses on patients undergoing cesarean section

Hua Cai(1), Ying Wang(2), Weichun Tang(3), Yan Lu(4), Juan Ji(5), Liping Chen(6),


(1) Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
(2) Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
(3) Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
(4) Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
(5) Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
(6) Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
Corresponding Author

Abstract


This study examined the effects of a combination of plan-do-check-action (PDCA) and enhanced recovery after surgery (ERAS) on patients undergoing cesarean section. One hundred and thirty patients undergoing caesarean section at the Second Affiliated Hospital of Nantong University comprised the study group. They were randomly divided into a control group (CG) and an intervention group (IG). The CG accepted routine management during the perioperative period, while the IG accepted a combination nursing of PDCA and ERAS. Relative to the CG, the IG presented lower visual analogue scale (VAS) scores at 4 h and 72 h after cesarean section, lower self-rating anxiety scale (SAS) scores and self-rating depression scale (SDS) scores, shorter time of anal exhaust, first urination along after leaving bed, lower total incidence rate of complications, and higher satisfaction rate of patients. We conclude that a combination nursing of PDCA and ERAS can alleviate postoperative pain, improve the psychological state, expedite postoperative recovery along with lessen the incidence of complications in patients undergoing cesarean section.

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Dexmedetomidine in Enhanced Recovery After

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Curr Pain Headache Rep. 2020; 24(5):21.

Tian Y, Li Q and Pan Y. Prospective study of the effect of

ERAS on postoperative recovery and complications in

patients with gastric cancer. Cancer Biol Med. 2021;

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Cui H, Sun Z, Ruan J, Yu Y and Fan C. Effect of enhanced

recovery after surgery (ERAS) pathway on the

postoperative outcomes of elbow arthrolysis: A

randomized controlled trial. Int J Surg. 2019; 68:78-

Teigen NC, Sahasrabudhe N, Doulaveris G, Xie X, Negassa

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after surgery at cesarean delivery to reduce

postoperative length of stay: a randomized controlled

trial. Am J Obstet Gynecol. 2020; 222(4):372.e1-

e10.

Antoine C andYoung BK. Cesarean section one hundred years

-2020: the Good, the Bad and the Ugly. J Perinat

Med. 2020; 49(1):5-16.

Landau R and Janvier AS. Are we finally tackling the issue of

pain during cesarean section? Anaesth Crit Care Pain

Med. 2021; 40(5):100938.

Engelman DT, Ben Ali W, Williams JB, Perrault LP, Reddy

VS, Arora RC, Roselli EE, Khoynezhad A, Gerdisch

M, Levy JH, Lobdell K, Fletcher N, Kirsch M, Nelson

G, Engelman RM, Gregory AJ and Boyle EM.

Guidelines for Perioperative Care in Cardiac Surgery:

Enhanced Recovery After Surgery Society

Recommendations. JAMA Surg. 2019; 154(8):755-

Saidian A and Nix JW. Enhanced Recovery After Surgery:

Urology. Surg Clin North Am. 2018; 98(6):1265-

Garin C. Enhanced recovery after surgery in pediatric

orthopedics (ERAS-PO). Orthop Traumatol Surg Res.

; 106(1s):S101-s107.

Elhassan A, Ahmed A, Awad H, Humeidan M, Urman RD,

Labrie-Brown CL, Cornett EM and Kaye AD.

Enhanced Recovery for Breast Reconstruction

Surgery. Curr Pain Headache Rep. 2019; 23(4):27.

Qiu H and Du W. Evaluation of the Effect of PDCA in

Hospital Health Management. J Healthc Eng. 2021;

:6778045.

Wei W, Wang S, Wang H and Quan H. The application of 6S

and PDCA management strategies in the nursing of

COVID-19 patients. Crit Care. 2020; 24(1):443.

Sung YT and Wu JS. The Visual Analogue Scale for Rating,

Ranking and Paired-Comparison (VAS-RRP): A new

technique for psychological measurement. Behav Res

Methods. 2018; 50(4):1694-1715.

Yue T, Li Q, Wang R, Liu Z, Guo M, Bai F, Zhang Z, Wang

W, Cheng Y and Wang H. Comparison of Hospital

Anxiety and Depression Scale (HADS) and Zung SelfRating Anxiety/Depression Scale (SAS/SDS) in

Evaluating Anxiety and Depression in Patients with

Psoriatic Arthritis. Dermatology. 2020; 236(2):170-

Meng J, Du J, Diao X and Zou Y. Effects of an evidencebased nursing intervention on prevention of anxiety

and depression in the postpartum period. Stress

Health. 2022; 38(3):435-442.

Lin Y, Yu Y, Zeng J, Zhao X and Wan C. Comparing the

reliability and validity of the SF-36 and SF-12 in

measuring quality of life among adolescents in China:

a large sample cross-sectional study. Health Qual Life

Outcomes. 2020; 18(1):360.

Lavender T, Hofmeyr GJ, Neilson JP, Kingdon C and Gyte

GM. Caesarean section for non-medical reasons at

term. Cochrane Database Syst Rev. 2012;

(3):Cd004660.

Hepp P, Hagenbeck C, Gilles J, Wolf OT, Goertz W, Janni

W, Balan P, Fleisch M, Fehm T and Schaal NK.

Effects of music intervention during caesarean

delivery on anxiety and stress of the mother a

controlled, randomised study. BMC Pregnancy

Childbirth. 2018; 18(1):435.

Kintu A, Abdulla S, Lubikire A, Nabukenya MT, Igaga E,

Bulamba F, Semakula D and Olufolabi AJ.

Postoperative pain after cesarean section: assessment

and management in a tertiary hospital in a low-income

country. BMC Health Serv Res. 2019; 19(1):68.

Li Y, Wang H, and Jiao J. The application of strong matrix

management and PDCA cycle in the management of

severe COVID-19 patients. Crit Care. 2020;

(1):157.

Zhou J, Xu H, Jiang M, Cao H, Jiang L, Xu T, Teng F

and Gu F. Effect of PDCA-based nursing management

model on the quality of life and complications of

patients with acute leukemia undergoing

chemotherapy. Am J Transl Res. 2021; 13(4):3246-

He YH andWang F. PDCA nursing in improving quality

management efficacy in endoscopic submucosal

dissection. World J Clin Cases. 2022; 10(27):9611-

Qiang H and Yuanshui S. Enhanced Recovery after Surgery

(ERAS) at cesarean delivery to reduce postoperative

length of stay: some details need to be improved. Am

J Obstet Gynecol. 2020; 222(5):512.

Kaye AD, Chernobylsky DJ, Thakur P, Siddaiah H, Kaye

RJ, Eng LK, Harbell MW, Lajaunie J and Cornett EM.

Dexmedetomidine in Enhanced Recovery After

Surgery (ERAS) Protocols for Postoperative Pain.

Curr Pain Headache Rep. 2020; 24(5):21.

Tian Y, Li Q and Pan Y. Prospective study of the effect of

ERAS on postoperative recovery and complications in

patients with gastric cancer. Cancer Biol Med. 2021;

(8):1274-81.

Cui H, Sun Z, Ruan J, Yu Y and Fan C. Effect of enhanced

recovery after surgery (ERAS) pathway on the

postoperative outcomes of elbow arthrolysis: A

randomized controlled trial. Int J Surg. 2019; 68:78-

Teigen NC, Sahasrabudhe N, Doulaveris G, Xie X, Negassa

A, Bernstein J and Bernstein PS. Enhanced recovery

after surgery at cesarean delivery to reduce

postoperative length of stay: a randomized controlled

trial. Am J Obstet Gynecol. 2020; 222(4):372.e1-

e10.


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