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

Date Published: 2026-10-06

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

Introduction:
The role of surgical intervention in the management of tuberculosis (TB) in China has undergone a strategic transformation—from marginalization to precise clinical positioning ( 1 – 3 ). In the early era of anti-tuberculosis pharmacotherapy during the 20th century, surgical approaches were largely overlooked. However, with the rising prevalence of drug-resistant tuberculosis (DR-TB) and the persistent clinical challenges posed by complex forms such as spinal TB, the value of surgical treatment has been reappraised…

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