Abstract: 【Abstract】Objective To evaluate the effect of FOCUS-PDCA model in the management of intradialytic hypotension (IDH) in maintenance hemodialysis (MHD) patients. Methods Twenty-two patients with recurrent hypotension during hemodialysis from March to June in 2018 were selected. They were compared themselves before and after the intervention of FOCUS-PDCA for 3 months. The incidences of IDH and dropping out of the hemodialysis session 30 minutes earlier, laboratory indicators and self- rating anxiety scale (SAS) score at baseline and after the intervention of FOCUS-PDCA for 3 months were counted. Results The
major causes of IDH were dehydration volume/dry weight＞5%, anti-hypertensive drugs before hemodialysis, meals during hemodialysis and diabetes mellitus. IDH occurred in every period especially after three hours during hemodialysis. The incidences of IDH in 22 patients before and after the intervention of FOCUS-PDCA were 15.73% (45/286) and 6.14% (18/293) respectively (χ²=38.662, P=0.005). After the intervention, the incidence of dropping out of the hemodialysis session 30 minutes earlier decreased (χ²=10.741, P=0.027), Alb and kt/V increased (t=-2.134, P=0.038, t=-2.092, P=0.041), and SAS score decreased (t=4.473, P=0.008). Conclusion The procedures of IDH prevention and control reduced the incidence of IDH and improved the psychological and physiological status in MHD patients.

Key words: FOCUS-PDCA model, Intradialytic hypotension, Flow Chart, Hemodialysis