提升中醫醫護人員暈針處置流程完整率

Improvement of The Needle Sickness Management Procedures For Traditional Chinese Medicine Care Team

緣起：暈針案例發生比例不高，一旦發生時需緊急處置或急診就醫，當醫護同仁不熟悉處置流程下容易緊張與造成緊急處置步驟延誤，為了維護病人針灸治療過程安全，增進醫療人員專業及應變能力，降低醫療事故風險，引起本案改善動機。目標設定：醫師暈針處置流程完整率目標設定85%；護理暈針處置流程完整率目標設定95%。材料與方法：1.新創暈針處置“叫拔B＂口訣，讓同仁在第一時間可以馬上輸出記憶簡化暈針處置流程；2.升級意識評估，納入ISBAR交班；3.製成E-learning教學影片，線上數位學習無界限；4.每年舉辦實務演練，強化同仁的危機處理。結果：醫護暈針處置流程完整率醫師端提升至93.6%；護理師端由提升至100%。員工專業能力提昇，團隊合作正向提升改善工作表現；門診就醫滿意度調查正面提升，大幅降低病人暈針發生次數；在醫院管理層面上，中醫部門的病人安全控制表現良好。

Background: During traditional Chinese medicine (TCM) acupuncture treatments, patients may experience needle sickness and need to be transferred to the emergency room for medical treatment or first aid. Due to the low incidence rate, healthcare providers may lack sufficient response capability. The motivation includes enhancing the emergency response capabilities of medical personnel, reducing the risk of medical accidents, and patient safety as well. In this project, we set different goals for the healthcare providers and evaluated additional benefits on several aspects. Afterward, we reviewed the overall quality of TCM acupuncture treatments with the Quality and Safety Department of the hospital. Objective: To achieve a completion rate over 85% for physicians’needle sickness management procedures, and a completion rate over 95% for nurses' needle sickness management procedures. Methods: 1.A new mnemonic for needle sickness management,“Call, Pull, B,”was created, so that healthcare providers could immediately output the memories of needle sickness management procedures. 2.To upgrade awareness assessment and incorporate it into ISBAR handover. 3.To create E-learning teaching videos and link them with QR Cords. It allows healthcare providers to conveniently learn online. 4.To conduct practical exercises every year to strengthen crisis management capabilities of the team members. Results: The completion rate of needle sickness management procedures increased to 93.6% for the physicians, and 100% for the nurses. The emergency situations of needle sickness have significantly decreased, and the patients’satisfactions have increased as well. In terms of hospital management, the TCM department performed well in patient safety control.