Standardization of Subcutaneous Injection of Prefilled Anticoagulants Through Lean Six Sigma Management: A Before-After Study.

Aim: The aim of this study was to investigate the impact of the Lean Six Sigma management approach on the standardization of nurses' prefilled anticoagulant subcutaneous injection practices, with a focus on improving anticoagulation outcomes, reducing patient complications, and enhancing overall patient satisfaction.

Background: The lack of standards for prefilled anticoagulant injection has resulted in a high complication rate, decreased patient satisfaction, and diminished service quality. This study investigated the impact of the Lean Six Sigma management approach on the standardization of nurses' prefilled anticoagulant subcutaneous injection practices.

Methods: This study compared pre-implementation and post-implementation data from Lean Six Sigma. A baseline investigation was conducted to determine the type and incidence of complications caused by anticoagulant injection. The nurses' injection process was observed and analyzed to determine problems with the injection technology and the reasons for the reduction in injection quality. Solutions were developed to address these root causes, including formulating a standard process for the subcutaneous injection of preperfusion anticoagulant; recording teaching videos; formulating the standard operating procedure (SOP) while refining, quantifying, and optimizing the operation steps as much as possible; and making an injection site rotation card. Comparative assessments were conducted pre-training and post-training, focusing on nurses' knowledge, standardization of operations, duration of procedures, patient complication rates, and satisfaction with nursing care.

Result: Post-training, there was a significant increase in nurses' knowledge and standardization of injection procedures. In addition, there was a notable reduction in the duration of the procedure and patient complications and an increase in patient satisfaction (P<0.01 or P<0.05).

Conclusion: Implementing the Lean Six Sigma management approach effectively standardized nursing procedures for prefilled anticoagulant subcutaneous injections, improved anticoagulation outcomes, minimized patient complications, reduced injection time, and elevated the overall quality of clinical nursing and patient satisfaction.