{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:39:05Z","timestamp":1792463945193,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T00:00:00Z","timestamp":1761436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T00:00:00Z","timestamp":1761436800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Caring Sciences"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This paper aimed at ascertaining whether a Plan\u2010Do\u2010Check\u2010Act (PDCA) nursing model improves treatment adherence and reduces hospital\u2010acquired infections (HAIs) in elderly patients with bronchopneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010eight inpatients with senile bronchopneumonia were randomly assigned to two groups. The control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200944) received standard therapy plus routine nursing; the observation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200944) received the same care augmented by a PDCA\u2010based nursing programme. Outcomes were assessed before and after nursing and included adherence ratings, clinical recovery indicators (length of stay; time to resolution of cough, sputum, pulmonary moist rales and dyspnoea), pulmonary function indices (FEV1, PEER, FVC), ward hygiene compliance metrics and HAI incidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Post\u2010nursing, adherence in the observation group improved markedly and exceeded that of controls; patients rated as having good adherence increased from 15.91% to 56.82%, whereas the poor\u2010adherence category fell from 50.00% to 2.27%. Times to disappearance of cough, sputum, moist rales, and dyspnoea, as well as length of stay, were all shorter than in the control group (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Both groups showed gains in FEV1, PEER, and FVC after nursing (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), with the observation group achieving significantly higher values at follow\u2010up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Ward\u2010level compliance\u2014equipment cleaning, staff hygiene, environmental\/air quality, cleaning\u2010disinfection quality and knowledge of infection prevention\u2014was superior in the observation group (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The HAI rate was lower with PDCA (3\/44, 6.82%) than with routine care (11\/44, 25.00%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation of PDCA\u2010based nursing in older adults with bronchopneumonia led to clinically meaningful benefits\u2014accelerated symptom relief, enhanced adherence, measurable gains in lung function, improved ward hygiene compliance and reduced nosocomial infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scs.70145","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T04:28:58Z","timestamp":1761539338000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of the Plan\u2010Do\u2010Check\u2010Act Nursing Model on Improving Treatment Adherence and Lowering Nosocomial Infection in Elderly Bronchopneumonia Patients: A Randomised Controlled Trial"],"prefix":"10.1111","volume":"39","author":[{"given":"Wenjing","family":"Zhang","sequence":"first","affiliation":[{"name":"Respiratory and Critical Care Medicine Lianyungang Tumor Hospital  Lianyungang Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[{"name":"Operating Room Lianyungang Tumor Hospital  Lianyungang Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Yuan","sequence":"additional","affiliation":[{"name":"Respiratory and Critical Care Medicine Lianyungang Tumor Hospital  Lianyungang Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoya","family":"Liu","sequence":"additional","affiliation":[{"name":"Respiratory and Critical Care Medicine Lianyungang Tumor Hospital  Lianyungang Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2691-601X","authenticated-orcid":false,"given":"Huaining","family":"Hu","sequence":"additional","affiliation":[{"name":"Nursing Department Lianyungang Second People's Hospital  Lianyungang Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00259-0"},{"issue":"12","key":"e_1_2_9_3_1","article-title":"Physiotherapy Approach for Treating Bronchopneumonia: A Case Report","volume":"15","author":"Zade 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