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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(06): s00451809417
DOI: 10.1055/s-0045-1809417
Original Article

Application value of the FOCUS-PDCA cycle in nursing care for dysphagia in patients with cerebral infarction: a meta-analysis

Authors

  • Xiaojing Lu 

    1   First Hospital of Qinhuangdao, Intensive Care Unit, Qinhuangdao Hebei, People's Republic of China.

  • Jiandong Zhang 

    2   First Hospital of Qinhuangdao, Department of Cardiovascular Surgery, Qinhuangdao Hebei, People's Republic of China.

  • Ranran Wang 

    3   First Hospital of Qinhuangdao, Emergency Intensive Care Unit Area 1, Qinhuangdao Hebei, People's Republic of China.

  • Xiujuan Liu 

    1   First Hospital of Qinhuangdao, Intensive Care Unit, Qinhuangdao Hebei, People's Republic of China.
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Abstract

Background

In recent years, there has been growing interest in applying quality improvement methodologies to healthcare processes. One such approach is the Find, Organize, Clarify, Understand, Select-Plan, Do, Check, and Act (FOCUS-PDCA) cycle.

Objective

To evaluate the effectiveness of the FOCUS-PDCA cycle in the management of dysphagia in patients with cerebral infarction.

Methods

We conducted a comprehensive literature search on the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, and Wanfang databases for articles published up to October 31st, 2024, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Randomized controlled trials and high-quality retrospective studies comparing the FOCUS-PDCA cycle with conventional care were included. The primary outcomes were swallowing function, quality of life, neurological and limb functions, and complication rates. Data were pooled using random-effects models, and heterogeneity was assessed using the I2 statistic.

Results

We included 6 studies involving 638 patients. The FOCUS-PDCA group showed significant improvements in swallowing function (standardized mean difference [SMD] = 1.65; 95%CI: 0.08–3.21), quality of life (SMD = 2.16; 95%CI: 0.54–3.79), and neurological and limb functions (SMD = 1.03; 95%CI: 0.07–2.00) compared with the conventional care group. The FOCUS-PDCA approach significantly reduced complication rates (risk ratio = 0.48; 95%CI: 0.32–0.68).

Conclusion

The FOCUS-PDCA cycle appears to be an effective strategy to improve outcomes in patients with cerebral infarction and dysphagia. However, more high-quality studies are needed to confirm these findings and guide clinical practice.

Keywords

Quality Improvement - Deglutition Disorders - Cerebral Infarction - Quality of Life

Authors' Contributions

Conceptualization: XL, JZ; Data curation: RW, XL; Formal analysis: XL, JZ; Investigation: RW, XL; Project administration: XL, JZ; Writing - original draft: XL, JZ; Writing - review & editing: XL, JZ, RW, XL. Contributed equally to the present study: XL, JZ.


Data Availability Statement

All data generated or analyzed during the present study are included in the article.


Editor-in-Chief: Hélio A. G. Teive 0000-0003-2305-1073.


Associate Editor: Adriana Bastos Conforto 0000-0001-7869-3490.




Publication History

Received: 11 December 2024

Accepted: 17 April 2025

Article published online:
17 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Xiaojing Lu, Jiandong Zhang, Ranran Wang, Xiujuan Liu. Application value of the FOCUS-PDCA cycle in nursing care for dysphagia in patients with cerebral infarction: a meta-analysis. Arq Neuropsiquiatr 2025; 83: s00451809417.
DOI: 10.1055/s-0045-1809417