TITLE:
Application of the PDCA Cycle for Quality Improvement of Radial Artery Puncture in Critically Ill Emergency Patients
AUTHORS:
Bo Hu, Dan Shou, Yatong Liu, Jindan Huang, Qian Luo, Xiaotong Duan, Liping Yang, Hong Shu, Xiaofang Zhu
KEYWORDS:
PDCA Cycle, Radial Artery Puncture, Ultrasound Guidance, Emergency Department, Critically Ill Patients, Quality Improvement
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.11,
November
5,
2026
ABSTRACT: Objective: To investigate the effect of a combined quality improvement intervention based on the Plan-Do-Check-Act (PDCA) cycle on radial artery puncture outcomes in critically ill emergency patients, and to establish a standardized training and quality improvement model adapted for the emergency setting. Methods: A retrospective before-after study was conducted. Data were extracted from the electronic medical records and nursing records of the emergency department. A total of 202 critically ill patients who underwent radial artery puncture in January 2024 were consecutively enrolled as the pre-intervention group, in which the traditional palpation method was used. Another 650 patients treated between April and July 2024, following implementation of a PDCA-based combined intervention (including ultrasound-guided training, standardized procedures, senior-nurse support, and post-procedural follow-up), were consecutively assigned to the post-intervention group. Each patient contributed only one procedure to the analysis. The first-attempt success rate, overall success rate, mean number of puncture attempts, complication rate, and procedure duration were compared between groups. Results: After the combined intervention, the first-attempt success rate increased from 51.48% to 75.69% (χ2 = 42.36, P χ2 = 102.87, P t = 15.23, P χ2 = 19.64, P P Conclusions: Application of a PDCA-based combined intervention for quality improvement of radial artery puncture in the emergency department increases the puncture success rate, reduces complications, shortens procedure time, and enhances the overall technical proficiency of nurses. Owing to the before-after study design, the individual contributions of ultrasound guidance, training, and senior-nurse support cannot be isolated. This model is worthy of promotion in emergency departments and similar critical care settings.