# Application of bundle management strategies in reducing local sterile abscesses following leuprolide acetate microsphere injections

## TL;DR

Using a set of management strategies significantly reduced the occurrence of local sterile abscesses after a specific type of injection in children with early puberty.

## Contribution

The study demonstrates that a bundle management approach effectively lowers abscess rates in clinical practice.

## Key findings

- The incidence of sterile abscesses dropped from 5.1% to 0.6% in patients after implementing bundle strategies.
- Bundle management improved nurses' skills and patient treatment adherence.
- The reduction in abscesses was statistically significant (P < 0.001).

## Abstract

To investigate the effect of bundle management strategies on reducing the incidence of local sterile abscesses following leuprolide acetate microsphere injections.

A single-center, intervention evaluation with a historical control study was conducted. Female children treated with leuprolide acetate microspheres for central precocious puberty (CPP) at the Pediatric Outpatient Department of Peking University Third Hospital from January 2016 to December 2024 were included as study participants. Patients from January 2016 to December 2018 served as the control group (277 individuals, 5,023 injections), during which high-risk factors for sterile abscesses were identified and bundle improvement strategies were formulated for continuous quality improvement. Patients from January 2019 to December 2024 were assigned to the intervention group (994 individuals, 13,498 injections). The control group received conventional management protocols, while the intervention group implemented a bundle management scheme encompassing medical and nursing staff training, standardized procedures, use of standardized tools, health education, and follow-up management. The incidence of local sterile abscesses was compared between the two groups.

After implementation of the bundle management strategies, the incidence of sterile abscesses in the control group was 5.1% (14/277) by patient count and 3.2‰ (16/5,023) by injection count, which decreased to 0.6% (6/994) and 0.4‰ (6/13,498) in the intervention group, respectively, with statistically significant intergroup differences (P < 0.001 for both).

Implementation of bundle management strategies significantly reduces the incidence of local sterile abscesses after leuprolide acetate microsphere injections, enhances nurses' standardized operational proficiency and professional competence, alleviates patient suffering, improves treatment adherence, and warrants clinical adoption.