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ORIGINAL RESEARCH article
Front. Surg.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1564760
Enhancing first-attempt success in radial artery cannulation: A PDCA-driven approach for anesthesiology residency training
Provisionally accepted
Meng Zhang 1
Shuchuan Zhao 1 Fangjing Bai 1 Shanshan Yu 1
Huixian Zhou 2
Si-Yuan Song 3,4* Guangmin Xu 1*- 1 Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China
- 2 Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States
- 3 Department of Neurology, Baylor College of Medicine, Houston, United States
- 4 Baylor College of Medicine, Houston, Texas, United States
Objective: This study aimed to evaluate the effectiveness of the Plan-Do-Check-Act (PDCA) cycle in improving the first-attempt success rate of radial artery cannulation among anesthesiology residents undergoing standardized training.Methods: Eighty-six residents from Sichuan Provincial People's Hospital, comprising 70 anesthesiology and 16 non-anesthesiology residents, were randomly divided into a control group and a PDCA group, each with 43 participants. Key outcomes assessed included first-attempt success rate, procedure duration, ultrasound utilization, preparation errors, and complication rates.In anesthesiology residents, the PDCA group achieved a significantly higher first-attempt success rate (94%, 31/33) compared to the control group (43%, 16/37; P < 0.001). Among non-anesthesiology residents, the PDCA group also outperformed the control group, with success rates of 80% (8/10) versus 33% (2/6; P = 0.048).Procedure duration was notably shorter in the PDCA group for both anesthesiology residents (median: 0.80 min, IQR: 0.50-2.30) and non-anesthesiology residents (median: 1.50 min, IQR: 0.70-3.00), compared to the control group (4.10 min, IQR: 3.10-5.90, and 3.70 min, IQR: 2.50-5.00; P < 0.001 and P = 0.026, respectively). Additionally, ultrasound usage was higher in the PDCA group, and assessment scores showed improvement, though the latter did not reach statistical significance.The PDCA cycle significantly enhances the first-attempt success rate and efficiency of radial artery cannulation while promoting greater adoption of ultrasound. These findings highlight its value in advancing standardized training for anesthesiology residents.
Keywords: Plan-Do-Check-Act, Teaching method, Standardized training, radial artery cannulation, Anesthesiology
Received: 22 Jan 2025; Accepted: 21 Feb 2025.
Copyright: © 2025 Zhang, Zhao, Bai, Yu, Zhou, Song and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Si-Yuan Song, Department of Neurology, Baylor College of Medicine, Houston, United States
Guangmin Xu, Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China
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