Abstract: 【Abstract】Objective To investigate the effect of PDCA (Plan, Do, Check and Action) cycle management on the improvement of mineral metabolism and nutritional indexes and cognition of the patients, in order to increase the hemodialysis quality management in maintenance hemodialysis (MHD) patients treated in the primary hospitals. Methods A total of 98 patients undergoing MHD in the Blood Purification Center of Wuxi Nineth People’s Hospital Affiliated to Soochow University were recruited and randomly divided into the routine health education group (n=46), and the PDCA cycle management group (n=52). The compliance rates of mineral metabolism and nutritional indexes, malnutrition-inflammation score (MIS), and knowledge of the patients about calcium and phosphorus metabolism and nutrition were compared before and after the intervention. Results After intervention for 18 months, the compliance rates of hemoglobin, serum phosphorus and parathyroid hormone were 71.15%, 59.62% and 53.85% respectively in the PDCA cycle management group, higher than those of 45.65%, 34.78% and 23.91% respectively in the routine health education group (c2=6.571, 6.031 and 9.138 respectively, P=0.010, 0.014 and 0.003 respectively). MIS score decreased significantly in the PDCA cycle management group (t=-2.926, P=0.005), but had no significant change in the routine health education group (t=1.284, P=0.206). MIS scores after the intervention were statistically different
between the two groups (t=-3.226, P=0.002). The scores of patients’knowledge about calcium and phosphorus metabolism and nutrition were improved in both groups (t=-11.395 and -16.299, P<0.001). After the intervention, the scores were significantly better in the PDCA cycle management group than in the routine health education group (t=4.906, P<0.001). Conclusion The PDCA cycle management mode can effectively improve the mineral metabolism and nutritional status, the awareness of selfmanagement, the quality of life and their prognosis in MHD patients treated in primary hospitals.

Key words: PDCA cycle management, Maintenance hemodialysis, Mineral metabolism, Malnutrition inflammation score, Clinical therapeutic effect