降低針灸治療毫針掉落發生率之改善專案

The Improving Project to Decrease the Rate of Filiform Needle Drop Out When Taking Acupuncture Treatment

本專案旨在降低針灸治療毫針掉落發生率，專案動機係由毫針掉落衍生醫療抱怨、醫護人員及照顧者針扎風險高所引發。分析毫針掉落原因為電針導線夾過重、醫師採淺刺治療方式、病人服布料無彈性無法固定、棉被面積龐大易滑落、電針導線夾置放位置作業規範不明確及病人不自主移動等。經改良電針導線夾、規劃以皮內針施行淺刺、增設收放式開合夾固定病人服、修訂電針法護理作業規範及增設大浴巾於針灸時使用等措施後，中醫病房病人接受中醫針灸治療毫針掉落發生率由3.8%降至0.14%，改善幅度達96.3%，冀望此專案之改善經驗可提供針灸照護之參考，並降低因針灸治療毫針掉落造成之潛在針扎風險。 The proposal aimed to reduce the incidence of filiform needles drop when taking acupuncture treatment. The motivation was that the filiform needles drop leads to medical complaints and increases the risk of needlestick injuries (NSIs) for medical staff and caregiver. Analysis results revealed several reasons for filiform needles drop, including the alligator clip for electroacupuncture was too heavy, the doctors applied shallow needling therapy, the patient's clothes can not be fixed due to lack of elasticity, quilts were too large and could slip easily, the operation procedure for alligator clip placement was not clear, and patients moved involuntarily. Through improving the alligator clip for electroacupuncture, using intradermal needle when taking shallow needling therapy, adding retractable clip to fix the patient's clothes, revising the operation procedure of electroacupuncture care, and adding bath towel when taking acupuncture treatment, the incidence of filiform needles drop in the Chinese medicine ward reduced from 3.8% to 0.14% and the improvement rate reached 96.3%. The protocol can serve as a reference for acupuncture care and reduce the potential risk of NSIs caused by filiform needles drop when taking acupuncture treatment.