提升復健科病人接受中醫毫針刺治療之安全性

Improving Patient Safety: Acupuncture Therapy Administered in the Rehabilitation Department

背景：為了使復健科的病人迅速恢復健康，時常會採用中西醫合併治療方式。以針灸（毫針刺）進行筋絡疏通為復健科病人最常見的中醫治療措施。雖然一般臨床護理人員都具備有良好西醫護理知識與技能，但是對於中醫藥概念及中醫護理訓練尚缺不足，因此執行中醫針灸護理時，偶而會發生漏取針或暈針致死等危害病人安全的意外事件。目的：提升復健科病人接受中醫毫針刺治療之安全性。解決方案：制定中醫毫針刺護理作業標準、護理記錄單、執行複查及臨床在職訓練等措施介入。結果：認知程度由平均得分9.6分（63.8%）提升至14.5分（96.6%）；技術操作正確性由93分（58.1%）提升至144分（90.0%）；異常事件由6件（0.9%；2008年1月至2009年1月）下降至0件（2009年4月1日至4月30日）。結論：經推動標準作業程序、護理記錄單、執行複查等介入措施可提升病人治療之安全性。

Background: Therapies that combine Chinese and western medicine is applied particularly often on patients in rehabilitation departments to reduce disease and illness recovery times. Acupuncture (fine needle piercing) is a widely applied traditional Chinese therapeutic approach. However, accidents including leaving needles in the patient's body and patient fainting due to carelessness or inadequate nursing training have raised concerns about the efficacy of acupuncture.Purpose: This article was written to recommend ways to improve the safety of acupuncture applied to patients in rehabilitation departments.Resolution: The authors developed standard operating procedures, nursing records, double-checking requirements, and on-the-job training courses.Result: After implementation of recommended resolutions, nursing staff cognition rose from 9.6 (63.8%) to 14.5 points (96.6%); the Traditional Chinese Medicine (TCM) nursing skill accuracy rate rose from 93 (58.1%) to 144 points (90.0%); and accident incidents fell from 6 (0.9%; 2008.1-2009.1) to 0 (2009.4.1-4.30).Conclusion: Implementing resolution recommendations effectively enhance patient safety.