Application of the Plan-Do-Check-Act Management Model to Violence Risk Management in a Psychiatric Ward: Impact on Patient Safety and Nurse–Patient Relationships

{"Junhua":[0],"Li,1,*":[1],"Huiming":[2],"Niu,2,*":[3],"Xiaojuan":[4],"Liu,3":[5],"Zhijie":[6],"Lei,4":[7],"Hongfang":[8],"Li,4":[9],"Ying":[10],"Cheng,4":[11],"Hongjuan":[12],"Du,4":[13],"Yalan":[14,88],"Wang11Department":[15],"of":[16,30,33,47,50,64,67,80,91,111,191,337],"Ward":[17,51,92],"4,":[18,93],"Tian":[19,36,53,69,94],"Shui":[20,37,54,70,95],"City":[21,38,55,71,96],"Third":[22,39,56,72,97,225],"People’s":[23,28,40,45,57,62,73,78,98,109,226],"Hospital,":[24,41,58,74,99,227],"Tianshui,":[25,42,59,75,106],"Gansu,":[26,43,60,76,107],"741020,":[27,44,61,77,108],"Republic":[29,46,63,79,110],"China;":[31,48,65],"2Department":[32],"Psychosomatic":[34],"Ward,":[35],"3Department":[49],"5,":[52],"4Department":[66],"Nursing,":[68],"China*These":[81],"authors":[82],"contributed":[83],"equally":[84],"to":[85,125,187,240,254,283,388],"this":[86],"workCorrespondence:":[87],"Wang,":[89],"Department":[90],"No.":[100],"17,":[101],"Jingbiao":[102],"Road,":[103],"Qinzhou":[104],"District,":[105],"China,":[112],"Tel":[113],"+86":[114],"18419952054,":[115],"Email":[116],"[email protected]:":[117],"Violence":[118],"in":[119,174,197,208,252,353,362,381],"psychiatric":[120,175,382,402],"wards":[121],"poses":[122],"significant":[123],"risks":[124],"patients,":[126,294],"staff":[127],"and":[128,142,201,220,238,277,334,343,377,396],"the":[129,151,189,192,291,297,315,354],"therapeutic":[130,144],"environment.":[131],"Patients":[132],"with":[133,205,210,234,347],"schizophrenia":[134,235],"frequently":[135],"exhibit":[136],"violent":[137,199,374],"behaviours":[138],"that":[139,392],"compromise":[140],"safety":[141,405],"disrupt":[143],"relationships.":[145],"Although":[146],"reactive":[147],"crisis":[148],"management":[149,178,195,251,370,391],"remains":[150],"norm,":[152],"systematic,":[153],"proactive":[154],"strategies":[155],"for":[156],"violence":[157,176,273,389],"prevention":[158],"are":[159],"scarce.":[160],"The":[161,268,367],"Plan-Do-Check-Act":[162],"(PDCA)":[163],"cycle":[164,194,250,313,369],"provides":[165],"a":[166,242,258,385],"structured":[167],"quality":[168],"improvement":[169],"framework,":[170],"yet":[171],"its":[172],"effectiveness":[173,190],"risk":[177,390],"has":[179],"not":[180],"been":[181],"well":[182],"established.Objective:":[183],"This":[184],"study":[185,214,299],"aimed":[186],"evaluate":[188],"PDCA":[193,249,312,368],"model":[196,371],"reducing":[198],"incidents":[200],"improving":[202],"patient":[203,278,379,404],"satisfaction":[204,279,350,380],"nursing":[206],"care":[207,266,399],"inpatients":[209],"schizophrenia.Methods:":[211],"A":[212],"quasi-experimental":[213],"was":[215],"conducted":[216],"between":[217],"April":[218,221],"2021":[219],"2022":[222],"at":[223],"Tianshui":[224],"Gansu":[228],"Province,":[229],"China.":[230],"Four":[231],"hundred":[232],"patients":[233],"were":[236,281],"enrolled":[237,293],"allocated":[239],"either":[241],"research":[243,316,355],"group":[244,260,317,356],"(n":[245,261],"=":[246,262,303,308,365],"200),":[247,263],"receiving":[248,264],"addition":[253],"standard":[255,265],"care,":[256],"or":[257],"control":[259,305],"alone.":[267],"Modified":[269],"Overt":[270],"Aggression":[271],"Scale,":[272],"behaviour":[274,375],"recording":[275],"forms":[276],"surveys":[280],"used":[282],"assess":[284],"outcomes":[285],"over":[286],"an":[287],"8-week":[288,298],"period.Results:":[289],"Of":[290],"400":[292],"331":[295],"completed":[296],"(research":[300],"group:":[301,306],"n":[302,307],"162;":[304],"169).":[309],"After":[310],"implementing":[311],"management,":[314],"demonstrated":[318],"significantly":[319,352],"lower":[320],"aggression":[321],"scale":[322],"scores":[323],"(7.54":[324],"±":[325,329],"2.07":[326],"vs":[327,360],"10.53":[328],"3.99,":[330],"p":[331,364],"<":[332],"0.001)":[333],"reduced":[335],"frequencies":[336],"verbal":[338],"aggression,":[339],"property":[340],"damage,":[341],"self-harm":[342],"physical":[344],"assault":[345],"compared":[346],"controls.":[348],"Patient":[349],"increased":[351],"(60.5%":[357],"\\"very":[358],"satisfied”":[359],"51.5%":[361],"controls,":[363],"0.015).Conclusion:":[366],"effectively":[372],"reduces":[373],"incidence":[376],"enhances":[378],"wards,":[383],"offering":[384],"systematic":[386],"approach":[387],"strengthens":[393],"nurse–patient":[394],"relationships":[395],"improves":[397],"overall":[398],"quality.Keywords:":[400],"schizophrenia,":[401],"nursing,":[403]}

Authors

Publication Details

Journal
Dove Medical Press (Taylor and Francis Group)
Published
2026-09-16
Primary Topic
Workplace Violence and Bullying
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
article

Application of the Plan-Do-Check-Act Management Model to Violence Risk Management in a Psychiatric Ward: Impact on Patient Safety and Nurse–Patient Relationships

Hongfang Li, Junhua Li, Yalan Wang, Zhijie Lei et al.
Dove Medical Press (Taylor and Francis Group)
Workplace Violence and Bullying
article

Application of the Plan-Do-Check-Act Management Model to Violence Risk Management in a Psychiatric Ward: Impact on Patient Safety and Nurse–Patient Relationships

Hongfang Li, Junhua Li, Yalan Wang, Zhijie Lei, Huiming Niu, Ying Cheng, Hongjuan Du, Xiaojuan Liu
article en

Abstract

Junhua Li,1,* Huiming Niu,2,* Xiaojuan Liu,3 Zhijie Lei,4 Hongfang Li,4 Ying Cheng,4 Hongjuan Du,4 Yalan Wang11Department of Ward 4, Tian Shui City Third People’s Hospital, Tianshui, Gansu, 741020, People’s Republic of China; 2Department of Psychosomatic Ward, Tian Shui City Third People’s Hospital, Tianshui, Gansu, 741020, People’s Republic of China; 3Department of Ward 5, Tian Shui City Third People’s Hospital, Tianshui, Gansu, 741020, People’s Republic of China; 4Department of Nursing, Tian Shui City Third People’s Hospital, Tianshui, Gansu, 741020, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yalan Wang, Department of Ward 4, Tian Shui City Third People’s Hospital, No. 17, Jingbiao Road, Qinzhou District, Tianshui, Gansu, 741020, People’s Republic of China, Tel +86 18419952054, Email [email protected]: Violence in psychiatric wards poses significant risks to patients, staff and the therapeutic environment. Patients with schizophrenia frequently exhibit violent behaviours that compromise safety and disrupt therapeutic relationships. Although reactive crisis management remains the norm, systematic, proactive strategies for violence prevention are scarce. The Plan-Do-Check-Act (PDCA) cycle provides a structured quality improvement framework, yet its effectiveness in psychiatric violence risk management has not been well established.Objective: This study aimed to evaluate the effectiveness of the PDCA cycle management model in reducing violent incidents and improving patient satisfaction with nursing care in inpatients with schizophrenia.Methods: A quasi-experimental study was conducted between April 2021 and April 2022 at Tianshui Third People’s Hospital, Gansu Province, China. Four hundred patients with schizophrenia were enrolled and allocated to either a research group (n = 200), receiving PDCA cycle management in addition to standard care, or a control group (n = 200), receiving standard care alone. The Modified Overt Aggression Scale, violence behaviour recording forms and patient satisfaction surveys were used to assess outcomes over an 8-week period.Results: Of the 400 enrolled patients, 331 completed the 8-week study (research group: n = 162; control group: n = 169). After implementing PDCA cycle management, the research group demonstrated significantly lower aggression scale scores (7.54 ± 2.07 vs 10.53 ± 3.99, p < 0.001) and reduced frequencies of verbal aggression, property damage, self-harm and physical assault compared with controls. Patient satisfaction increased significantly in the research group (60.5% "very satisfied” vs 51.5% in controls, p = 0.015).Conclusion: The PDCA cycle management model effectively reduces violent behaviour incidence and enhances patient satisfaction in psychiatric wards, offering a systematic approach to violence risk management that strengthens nurse–patient relationships and improves overall care quality.Keywords: schizophrenia, psychiatric nursing, patient safety

Dove Medical Press (Taylor and Francis Group)
Gender equality
Openalex Percentile: Top 4%
Workplace Violence and Bullying
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.