PDSA Cycle for Nursing Quality Improvement

Key Points

• PDSA is an iterative quality-improvement cycle used to test and refine practice changes.
• Four steps are Plan, Do, Study, and Act.
• Baseline and post-change data comparison drives decisions.
• Cycles repeat until a reliable, sustainable improvement is achieved.

Equipment

• Defined improvement target and measurable indicators
• Baseline data collection template
• Post-intervention audit/trending tool

Procedure Steps

1. Plan: Define the problem, desired outcome, metrics, and small-scale intervention.
2. Collect baseline performance data before implementing the change.
3. Do: Run the intervention in a controlled test period.
4. Capture process and outcome data during the test.
5. Study: Compare observed results with expected targets.
6. Identify barriers, unintended effects, and fidelity gaps.
7. Act: Decide to adopt, adapt, or abandon the tested change.
8. Launch the next PDSA cycle with revised plan parameters as needed.
9. Continue sequential cycles until improvement is stable and reproducible.

Common Errors

• Skipping baseline data → cannot prove change effect.
• Testing too many variables at once → unclear causal interpretation.
• Acting without Study analysis → repeated ineffective cycles.
• Stopping after one successful test → poor long-term sustainment.

Related

• quality-improvement-nurse-role-and-qapi - Organizational context for QI cycle deployment.
• quality-assurance-and-donabedian-model-in-nursing-evaluation - Framework for evaluating improvement dimensions.
• documenting-risk-management-and-intervention-evaluation - Documentation inputs used in cycle analysis.