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Su-June She1 Yu-Wen Lu2 Chia-Ling Chiang1 Yu-Ching Chen1
Ho-Yu Lee3 Shu-Chun Liu2*
1Nursing Dept., Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
2Chinese Medicine Dept., Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
3Nursing Dept., Kushan Changtai Healthcare Management Co. Ltd, Changhua, Taiwan
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World Health Organization (WHO) declared 64 acupuncture indications,showing that acupuncture has become much more valued and popular internationally as one of alternative therapies. The most common incident of acupuncture is the event of missing needle which is prone to cause needlestick injuries and damage the safety of medical workers and patients. Reducing the incident of missing needle is crucial for safety. This study aimed to investigate the causes of high missing needle rate (up to 0.96%) in the chronic ward of a regional hospital, among which there were 2 cases resulting in retained needle in patient’s back and needlestick injuries of medical staff, and to find a way to improve it.
The acupuncture procedures in the ward were analyzed through brainstorming, field observations, interviews, questionnaire survey, medical chart review and acupuncture safety examination, etc. Problems were identified including ineffective implementation of Chinese Medicine prescriptions, unfamiliar with acupuncture treatment, no well-defined acupuncture SOP, no acupuncture needle disposal container, and no sign or display indicating under treatment. Improvement strategies were formulated through 4 evaluating indicators: feasibility, benefit,importance, & economical efficiency. With Team Resource Management (TRM),a re-engineering process was conducted to revise the acupuncture SOP and Chinese Medicine prescription form and implement needling check while time out, fixed needling time, on job training of flipped teaching, hook calculator and sign installation. After the implementation of the ermeasures, the missing needle rate dropped from 0.96% to 0%. The significant improvement shown in the study is believed to be a framework for reference to solve the problem of the missing needle, which could assure the safety of medical workers and patients and improve the healthcare quality.
Keywords：acupuncture, the safety of patients, process re-engineering, team resource management
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231.4 以流程再造降低慢性病房中醫針灸遺漏針發生率－某區域醫院為例
