Abstract: 【Abstract】Aim To explore the clinical implication of PDCA cycle (P, plan; D, do; C, check; A, action) in the management of hyperphosphatemia for maintenance hemodialysis patients. Methods This was a single group and self-control study. A total of 136 patients were enrolled. All participants received regular health education on phosphorus restriction, and were additionally provided with one-to-one education on dietary phosphorus restriction based on self-developed health education tool by designated nurses for three months. The whole quality improvement process was managed by PDCA cycle, including investigation, root cause finding, target identification, intervention development and implementation, feedback and action. Participatory health education was adopted to guide the development of health education tool and reinforce the control of dietary phosphorus intake. The percentage of patients with hyperphosphatemia and patient satisfaction were evaluated. Results All participants completed the study. The percentage of patients with a serum phosphorus level equal to or above 1.78mmol/L was decreased significantly, from 57% to 44% (χ2＝4.250, P=0.039). Patients satisfaction on phosphorus management was achieved after the implementation of PDCA cycle (χ2＝9.285, P=0.002). Conclusions The implementation of PDCA cycle can reduce the ratio of patients with hyperphosphatemia, improve patient satisfaction, and help nurses gain a sense of personal and professional achievements.

Key words: PDCA cycle, hemodialysis, hyperphosphatemia