降低中醫病人毫針處置入出針數不符發生率

Decreasing the Incidence of Discrepancy of the Number of Fine Needles between Insertion and Removal for Patients Undergoing Chinese Medicine Interventions

周雅惠(Ya-Hui Zhou) ； 李秀茹(Hsiu-Ju Lee) ； 林淑瓊(Shuv-Chung Lin) ； 李采芬(Tsae-fen Lee) ； 黃慈心(Tzu-Shin Huang)

《新臺北護理期刊》 13卷2期 (2011/11) Pp. 63-72

https://doi.org/10.6540/NTJN.2011.2.007

摘要

毫針處置已廣被應用於中醫臨床實務中，但若遺留針在病人身上會造成病人與醫護人員針扎之傷害。目的：本專案旨在（1）降低中醫毫針處置入出針數不符發生率從20%至0%；（2）提升護理人員對毫針入出針記錄認知率從80%至100%；及（3）提高護理人員入出針紀錄的執行率從50%至100%。方法：本專案藉由分析毫針處置作業流程、實際觀察中醫住院病人接受毫針處置過程、問卷調查護理人員執行毫針處置之認知和執行狀況，來確立問題與導因，並依決策矩陣分析解決辦法之可行性、經濟性、及效益性。本專案所訂定改善措施包含：（1）修訂協助毫針標準作業規範；（2）修訂入針及出針記錄工具：「針灸處置紀錄表」；（3）創新建構「毫針人形圖記錄表」；及（4）舉辦毫針處置專科在職教育，本專案並進一步依目的來評價其成果。結果：本結果顯示中醫毫針處置入出針數不符發生率從20%降低至1.9%，護理人員對毫針入出針記錄認知率從80%提高至100%，及護理人員入出針紀錄的執行率從50%提高至100%。結論：中醫毫針入出針不符發生率從20%降至1.9%，雖未達所訂定目標（0%），但改善幅度已達90.5%。期望本專案之改善經驗及創新建構針灸紀錄表能作應用至他院中醫住院或門診毫針處置之參考。

關鍵字

毫針處置 ； 入出針不符 ； 中醫護理

並列摘要

Background: The fine-needle interventions have become popular in clinical practice of Chinese medicine. Yet, remaining fine needles on patients caused injuries of needles ticking among patients and nursing staffs.Purposes: Three aims were (1) to decrease the incidence of discrepancy of the number of fine needles between insertion and removal from 20% to 0%; (2) to increase the nurses' cognitive rate of fine-needle insertion and removal from 80% to 100%; and (3) to enhance the nurses' performing rate of fine-needle insertion and removal records from 50% to 100%.Methods: The project was analyzed by operating procedures of fine-needle interventions, observing the whole process of patients receiving fine-needle interventions, and investigating nurses' cognitive rate and performing rate of fine-needle insertion and removal using questionnaires to set the problems and causes. According to the analysis of a decision matrix by feasibility, economical, and efficacy, this project defined strategies, including revision of assisting the fine-needle operating standard, revision of recoding tools for acupuncture, creation of a recording table with fine-needle human bodies, and execution of in-service education training for the unit. In addition, the project evaluated outcomes by the designated goals.Results: The results showed the incidence of discrepancy of the number of fine needles between insertion and removal decreased from 20% to 1.9%. Also the nurses' cognitive rate and performing rate of inserting and removing fine-needle records increased from 80% to 100%, and from 50% to 100%, respectively.Conclusion: The incidence of discrepancy of the number of fine needles between insertion and removal has been lowered from 20% to 1.9%. Although it did not reach the designated goal (0%), the improving magnitude has achieved 90.5%. We hope our experience and creating records can be applied to outpatients and hospitalized patients of other hospitals receiving Chinese-medicine interventions with fine needles.

並列關鍵字

fine-needle intervention ； discrepancy of the number of fine needles between insertion and removal ； Chinese medicine nursing