中医药研究论丛

222.1 住院会诊针灸遗漏针探讨
TJ TCM.22(2) : 1-10, 2019
住院会诊针灸遗漏针探讨
The Investigation of Retained Needle after Acupuncture Treatment of Inpatient Care
徐培倩1 陈肜瑄2 林舜谷3,4 任东辉2 王宏铭1*
1 台北马偕纪念医院中医部,台北,台湾
2 奇美医疗财团法人奇美医院中医部,台南,台湾
3 台北市立联合医院仁爱院区中医科,台北,台湾
4 国立阳明大学公共卫生研究所,台北,台湾
【摘要】
目的:漏拨针是中医医疗常见之危险事件,可能引起医疗纠纷、危及病人和医护人员之安全,本研究之目的在於探讨可能导致会诊遗漏针之因素。
方法:本次调查某南部医学中心中医部 98 年至105 年病房会诊之遗漏针事件,统计发生次数以及穴位、诊断等资料。
结果:本研究发现遗漏针最常发生在上肢部位。发现者以病房护理师最多。发生月份以六月、八月、九月、十月为最多。最常发生遗漏针的穴位是百会、曲池、後溪及肩穴。发生遗漏针的患者以脑血管疾病的病人最多。
结论:遗漏针较容易发生在容易被衣物、躯体、头发等物体挡住的地方,我们建议取针完後应再次搜索患者身体,由头至脚依序搜索,检查有无遗漏针之可能,尤其是容易遭视线挡住之处,是防止遗漏针发生十分重要的一个步骤,此外,改善职前教育品质、建立标准作业流程、确立多重确认机制、充分和病房医疗人员和患者沟通、定期召开检讨会议,以及考虑用固定出针人员或是不留针的治疗方式,才能将遗漏针事件降至最低,以减少遗漏针事件。
【关键词】遗漏针、针灸、医疗纠纷、病安事件
Pei-Chien Hsu1 Tung-Hsuan Chen2 Shun-Ku-Lin3,4 Dong-Hui Jen2 Hung-Ming Wang1*
1Department of Chinese Medicine, MacKay Memorial Hospital, Taipei, Taiwan
2Department of Chinese Medicine, Chi Mei Medical Center, Tainan, Taiwan
3Department of Traditional Chinese Medicine, Taipei City Hospital, Renai Branch, aipei,Taiwan
4Institute of Public Health, National Yangming University, Taipei, Taiwan
【Summary】
Objective: Retained needles after acupuncture is a common adverse event after acupuncture. It may cause medical disputes and endanger the safety of patients and health practitioners. The present study aims to explore the location, timing, and diagnosis of retained needles after acupuncture.
Methods: We counted the number of retained needles during January 1, 2009, to December 31, 2016, in a medical center in Tainan city, and analyzed the acupoints, primary diagnosis, persons who first discovered the failed removing needle, and occurred month.
Results: The most common areas of retained needles events were the upper limbs. Most discoverers were a nurse. June, August, September, and October were the most common months of retained needles events. Above all the acupoints, most retained needles events occurred at DU20, LI11, SI3, LI15. Most of the events occurred in stroke patients.
Conclusions: We suggest that improving the quality of pre-service education,establishing standard operating procedures and multiple confirmation mechanisms could reduce the incidence rate of retained needles after acupuncture. We also encourage health practitioners to maintain excellent communication with inpatients.
【Keywords】Retained needle, acupuncture, medical disputes, patient safety incident