Varicocele is the most prevalent correctable cause of male infertility. Currently, surgical treatment is the primary method to enhance fertility.For many young varicocele patients who have postponed surgery due to time constraints, daytime surgery is especially crucial. Thus, this study aims to investigate the clinical and nursing application value of the Plan-Do-Check-Act (PDCA) cycle in daytime varicocelectomy.Retrospective collection of clinical data was conducted on 130 patients undergoing laparoscopic varicocelectomy in the Third Affiliated Hospital of Southern Medical University, Guangzhou,China.Among them, 65 patients who underwent daytime surgery were assigned to the observation group, while 65 patients who underwent routine hospital surgeries were assigned to the control group.The former also implemented PDCA cycle management.A comparison was made between the two groups regarding hospitalization time, hospitalization costs, and patient satisfaction.The observation group exhibited a shorter hospitalization time and lower hospitalization costs compared to the control group, with higher patient satisfaction and pre-discharge visual analog scale (VAS) scores noted (P < 0.05).No significant difference was observed in the incidence of postoperative complications between the two groups during hospitalization (P > 0.05). The implementation of the PDCA cycle in the observation group has demonstrated its effectiveness, ensuring the smooth conduct of the daytime varicocelectomy.In conclusion,daytime varicocelectomy can reduce hospitalization time,lower hospitalization costs, improve patient satisfaction. The PDCA Cycle enhances the rationality and efficacy of the daytime varicocelectomy procedure and is highly recommended. Furthermore, it offers valuable reference for the application of the PDCA Cycle in various other diseases and nursing management approaches.The Trial Registration Number: ChiCTR2300077465;Date of registration: November 9, 2023. 

Clinical application and nursing experience of the plan-do-check-act cycle in daytime varicocelectomy

Application of the PDCA cycle for implementing the WHO Safe Childbirth Checklist in women with vaginal deliveries

Objective To discuss the application value of the plan–do–check–act (PDCA) cycle in shortening the decision to delivery interval (DDI) time. Methods A total of 106 DDI cases from the Ningbo Women and Children’s Hospital (China) from January 2019 to December 2020 were selected as the subjects of this study. The causes for the prolongation of DDI were analyzed and protocols were developed. Through continuous summaries and improvement, a standardized process was established to direct clinical application, ie, the PDCA cycle. Results The DDI was shortened from 14.26 min in 2019 to 12.18 min in 2020 and the neonatal asphyxia rate significantly decreased from 34.69% in 2019 to 12.50% in 2020 (P < 0.05). Conclusion The PDCA cycle management mode effectively shortened the DDI time and reduced the neonatal asphyxia rate, without increasing adverse maternal outcomes.

Application of the Plan–Do–Check–Act Cycle in Shortening the Decision to Delivery Interval Time

Ovarian hyperstimulation syndrome (OHSS) is a type of clinical syndrome including enlargement of ovaries, increased capillary permeability, a shift of protein-rich fluid from the intravascular system to the third space and blood concentration (Gomez et al. 2010, Fiedler and Ezcurra 2012, Balint et al. 2020). The main symptoms of the disorder are abdominal pain, distension, nausea, dyspnoea, ascites, pleural effusion, oliguria, enlargement of ovaries with multiple follicles and luteal cysts inside (Chai et al. 2020). For severe cases, OHSS can cause low blood volume shock, acute respiratory distress syndrome, renal failure and even death (Fiedler and Ezcurra 2012, Hansen et al. 2014). OHSS is usually considered as a serious iatrogenic complication of controlled ovarian stimulation (COS), patients with polycystic ovarian syndrome (PCOS) receiving treatment for infertility with COS are at high risk for OHSS (Tso et al. 2020). Early onset OHSS occurs within nine days after oocyte retrieval, triggered by administration of exogenous human chorionic gonadotropin (HCG) for follicular maturation, and usually resolves spontaneously within 7–14 days if no pregnancy occurs (Grossman et al. 2010, Fiedler and Ezcurra 2012, Jinghua et al. 2018). Late onset OHSS appears 10 days after oocyte retrieval (Jinghua et al. 2018) as a result of continuous stimulation by endogenous HCG from trophoblast of the embryo transplanted, however, symptoms of OHSS gradually resolve within 1–2 months in most cases (Haimov-Kochman et al. 2004, Grossman et al. 2010, Humaidan et al. 2016, Jinghua et al. 2018). However, spontaneous form of OHSS in the absence of COS have been reported in the literature, and have nearly always presented between 8 and 15 weeks of pregnancy (Kasum et al. 2013, Sridev and Barathan 2013, Nwafor and Nsikak 2020, Oliveira E. Souza et al. 2021), and also in the non-pregnant (Chai et al. 2020) or postpartum women (He et al. 2008) but has been considered rare in late pregnancy. Categorised as severe in the hypertensive disorders of pregnancy (HDP) (Wilkerson and Ogunbodede 2019), preeclampsia is defined as a newly onset hypertension after 20 weeks of gestation and proteinuria or as evidence of end-organ dysfunction such as thrombocytopenia, renal insufficiency, impaired liver function, cardiac dysfunction, pulmonary edoema, haemolysis, or cerebral or visual symptoms (Leeman 2016, Committee on Practice Bulletins-Obstetrics 2017, Wilkerson and Ogunbodede 2019, Marwan and Maged 2020). Preeclampsia affects up to 1.5% 16.7% of pregnancies worldwide and results in 60,000 maternal deaths (Ma’ayeh et al. 2020). However, preeclampsia complicated with spontaneous OHSS is rare. Herein, we report a case of a pregnant patient who presented with spontaneous OHSS complicated with preeclampsia in the third trimester. She had a favourable outcome upon close surveillance.

Spontaneous ovarian hyper-stimulation syndrome complicated with preeclampsia in the third trimester: a case report

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Application of the Plan–Do–Check–Act Cycle in Shortening the Decision to Delivery Interval Time

Spontaneous ovarian hyper-stimulation syndrome complicated with preeclampsia in the third trimester: a case report