Objective: To evaluate the effect of a stepwise health education model based on the Plan-Do-Check-Act (PDCA) cycle on improving discharge readiness of elderly diabetic patients with oral hypoglycemic drugs, and to provide evidence for optimizing discharge management of chronic diseases. Methods: A prospective quasi-experimental study was conducted among 240 elderly inpatients with diabetes mellitus admitted between June 2023 and May 2024. Participants were assigned to a study group (n = 120) or a control group (n = 120). The study group received PDCA-oriented stepwise health education, while the control group received conventional education. Results: The study group demonstrated significantly higher discharge readiness scores than the control group (p < 0.001). Eighty percent of patients in the study group achieved excellent medication knowledge, 3.2 times higher than the control group (p < 0.001). Nursing satisfaction was also higher in the study group (90.0% vs. 35.0%, p < 0.001). Within three months after discharge, 81.7% of patients in the study group maintained correct medication behavior, compared with only 15.0% in the control group. Additionally, qualitative interviews indicated that 88.3% of study participants expressed positive feedback toward the hierarchical education model. Conclusions: The PDCA-based stepwise health education model significantly improved discharge readiness, medication knowledge, and patient satisfaction, while reducing medication errors within three months after discharge. By integrating dynamic monitoring, hierarchical optimization, and continuous improvement, this model promotes precise and individualized health education, offering theoretical and practical support for chronic disease discharge management.
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