Summary of Plan-Do-Study-Act (PDSA) cycles
| PDSA cycle | PDSA 1 (20 February 2018–27 February 2018) | PDSA 2 (6March 2018–25 March 2018) | PDSA 3 (17 April 2018–3 June 2018) | PDSA 4 (1 August 2018–17 November 2018) |
| Plan | Improve compliance to bundled care
| Improve compliance to scrub the hub by atleast 50% and improve usage of closed ports. | Sensitisation of ANTT for new staff | Sustain scrub the hub along with other components. |
| Do | Teaching sessions, display of SOP. Provision of closed ports, paper gloves in pharmacy; Availability of plastic trays | Teaching sessions with video demonstration of technique of scrub the hub. Record qualitative experience | Teaching of ANTT to new staff. Display of results of HCAI | Display of results of HCAI. 2 weekly training. ANTT made part of on-boarding unit education. Record qualitative experience |
| Study | Compliance to aseptic field use, glove use and key part protection 100%. Closed ports usage was 60%. Scrub the hub not started despite training. Most nurses were not sure of ‘Scrub the hub’ technique | Aseptic field usage and glove usage compliance sustained. Decline in protection of key parts (70%). Closed ports usage improved (90%). Scrub the hub improved (46%). Qualitative experience revealed forgetfulness and improved by reminder from fellow nurse | Protection of key parts compliance improved (100%). Scrub the hub improved (90%). | Scrub the hub duration sustained. Drying was less compliant (72%). Sickness level of the baby determined compliance. Other components sustained |
| Act | Adopt-aseptic field usage and glove usage. Continue implementation of other components especially ‘Scrub the hub’. | Entry of new staff reduced compliance to protection of key parts (barrier). Continue implementation of scrub the hub. | Aseptic field use, closed ports, glove use, Key part protection sustained. Test sustaining of scrub the hub in particular. Make ANTT part of ‘on-boarding’ unit education | Continue two weekly audits and sustain. |
ANTT, Aseptic Non-Touch Technique; HCAI, healthcare associated infection; SOP, standard operating procedure.