Home    中文  
 
  • Search
  • lucene Search
  • Citation
  • Fig/Tab
  • Adv Search
Just Accepted  |  Current Issue  |  Archive  |  Featured Articles  |  Most Read  |  Most Download  |  Most Cited
Ultrasound Quality Control

Application of PDSA cycle in quality control of ultrasound assessment of the fetal middle cerebral artery

  • Hongmei Dong ,
  • Xiaohang Zhang ,
  • Xi Wang ,
  • Yan Wang ,
  • Yu Zhang ,
  • Suzhen Ran
Expand
  • 1. Department of Ultrasound, Chongqing Health Center for Women and Children, Chongqing 401147, China

Received date: 2021-04-23

  Online published: 2021-07-16

Abstract

Objective

To explore the application of PDSA cycle in the quality control of ultrasonic detection of fetal middle cerebral artery (MCA) blood flow spectrum.

Methods

(Plan) Three hundred images of fetal MCA blood flow spectrum obtained in Chongqing Health Center for Women and Children from July 2019 to December 2019 were evaluated according to the quality control standard. The percentage of grade A images >95% was the goal of quality improvement. The formulation of improvement measures was based on the existing problems. (Do) The improvement measures were implemented from January to June 2020. (Study) Five hundred MCA blood flow spectrum images of the same period were evaluated. The image scores before and after quality control were analyzed. The proportions of grade A standard images before and after PDSA cycle were analyzed by chi-square test. (Action) Continuous improvement and follow-up feedback were used to determine the stage improvement results.

Results

MCA bloodstream spectrum grade A images accounted for 81.0% (243/300) before and 96.8% (484/500) after the implementation of PDSA cycle. The image quality was significantly improved after the implementation of PDSA cycle (χ2=24.793, P<0.01). Before improvement, the image deficiency items mainly included the angle between the acoustic beam and blood flow (19.35%), the absence of diastolic blood flow (18.75%), and the position of the sampling frame (14.29%). The main defects of the improved images were the angle between the acoustic beam and blood flow (22.83%), images of the Willis arterial ring (16.30%), and the size of the sampling volume (15.22%). The results showed that the training on the adjustment of the parameters of diastolic low speed blood flow measurement was effective, but the examinees did not pay attention to the blood flow image, measurement angle and sampling volume when the spectrum waveform was normal.

Conclusion

The application of PDSA cycle effectively improves the image quality of MCA blood flow spectrum, which is worthy of being used as a quality control tool in the process of establishing the quality control system of ultrasonic detection of single diseases.

Cite this article

Hongmei Dong , Xiaohang Zhang , Xi Wang , Yan Wang , Yu Zhang , Suzhen Ran . Application of PDSA cycle in quality control of ultrasound assessment of the fetal middle cerebral artery[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021 , 18(07) : 657 -663 . DOI: 10.3877/cma.j.issn.1672-6448.2021.07.008

References

1
姜玉新, 李建初, 王红燕, 等. 科学管理 勇于创新 严控质量: 超声质控常用方法及研究 [J/OL]. 中华医学超声杂志(电子版), 2020, 17(7): 597-601.
2
景柏华, 陈倩. 胎儿大脑中动脉血流检测的临床意义 [J]. 实用妇产科杂志, 2019, 35(12): 893-896.
3
Vollgraff Heidweiller-Schreurs CA, De Boer MA, Heymans MW, et al. Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis [J]. Ultrasound Obstet Gynecol, 2018, 51(3): 313-322.
4
Akolekar R, Ciobanu A, Zingler E, et al. Routine assessment of cerebroplacental ratio at 35-37 weeks' gestation in the prediction of adverse perinatal outcome [J]. Am J Obstet Gynecol, 2019, 221(1): 65. e1-65. e18.
5
Christoff P. Running PDSA cycles [J]. Curr Probl Pediatr Adolesc Health Care, 2018, 48(8): 198-201.
6
中国医师协会超声医师分会. 中国产科超声检查指南(2019版) [M]. 北京: 人民卫生出版社出版, 2019.
7
Ruiz-Martinez S,Volpe G, Vannuccini S, et al. An objective scoring method to evaluate image quality of middle cerebral artery Doppler [J]. J Matern Fetal Neonatal Med, 2020, 33(3): 421-426.
8
薛恩生. 超声医学专业质量管理控制指标专家共识(2018年版)解读及应用 [J/CD]. 中华医学超声杂志(电子版), 2019, 16(5): 327-328.
9
王红燕, 马莉, 谷杨, 等. 加强超声医学质量控制促进学科创新发展 [J/CD]. 中华医学超声杂志(电子版), 2019, 16(5): 321-326.
10
刘和时, 朱永胜. 血管多普勒超声预测不良妊娠结局 [J]. 中国医学影像技术, 2021, 37(1): 147-150.
11
Ciobanu A, Wright A, Syngelaki A, et al. Fetal Medicine Foundation reference ranges for umbilical artery and middle cerebral artery pulsatility index and cerebroplacental ratio [J]. Ultrasound Obstet Gynecol, 2019, 53(4): 465-472.
12
谢红宁. 胎儿生长发育受限的超声诊断与监测 [J]. 中国医学影像技术, 2019, 35(10): 1582-1585.
13
Rial-Crestelo M, Morales-Roselló J, Hernández-Andrade E, et al. Quality assessment of fetal middle cerebral and umbilical artery Doppler images using an objective scale within an international randomized controlled trial [J].Ultrasound Obstet Gynecol, 2020, 56(2): 182-186.
14
Taylor MJ, McNicholas C, Nicolay C, et al. Systematic review of the application of the plan-do-study-act method to improve quality in healthcare [J]. BMJ Qual Saf, 2014, 23(4): 290-298.
15
何小霞, 潘宝莹, 徐学虎, 等. 基于积极心理学的延续护理结合PDSA循环对肠造口患者自我效能感的影响 [J].中华现代护理杂志, 2016, 22(36): 5202-5206, 5207.
16
Hoyle ES, Hirani S, Ogden S, et al. Quality improvement programme to increase the rate of deferred cord clamping at preterm birth using the lifestart trolley [J]. Arch Dis Child Fetal Neonatal Ed, 2020, 105(6): 652-655.
17
Porter ED, Kelly JL, Fay KA, et al. Reducing unnecessary chest X-ray films after thoracic surgery: a quality improvement initiative [J]. Ann Thorac Surg, 2021, 111(3): 1012-1018.
Outlines

/

Copyright © Chinese Journal of Medical Ultrasound (Electronic Edition), All Rights Reserved.
Tel: 010-51322630、2632、2628 Fax: 010-51322630 E-mail: csbjb@cma.org.cn
Powered by Beijing Magtech Co. Ltd