康复科患者艾灸相关烫伤及质量改进研究

Study on Quality Improvement of Moxibustion Related Scald in Rehabilitation Department

目的:探讨康复科患者艾灸相关性烫伤的影响因素,通过持续质量管理、改进,评价这些措施对预防患者发生艾灸相关烫伤是否有效。方法:回顾性分析2015~2020年我科接受灸法治疗患者的临床资料,统计灸法使用情况及艾灸相关烫伤的发生率,并分析导致患者烫伤的相关因素,并将2019年、2020年的数据与2015~2018年的数据比较,比较经过质量管控、改进后,患者出现艾灸相关烫伤的发生率、烫伤病种的变化情况。结果:2015~2018年我科发生艾灸相关烫伤110例,发生艾灸相关烫伤前五位的病种为脑卒中、脑外伤、脊髓损伤、糖尿病、痴呆。2019年艾灸相关烫伤的发生13例,2020年艾灸相关烫伤的发生8例,烫伤发生率持续下降(P<0.05)。发生烫伤前五位病种变化不大,但发生烫伤的次数也有显著下降。结论:认知功能下降、感觉减退是导致艾灸相关烫伤的主要原因,患者个人的认知,家属的陪护对艾灸相关烫伤也有一定影响;同时,使用安全的艾灸器具,提高医务人员的责任心,加强治疗过程中的巡回监管,也是预防并降低艾灸相关烫伤的重要组成部分。

Objective:To explore the influencing factors of moxibustion related scald in patients in rehabilitation department,and to evaluate whether these measures are effective in preventing moxibustion related scald through continuous quality management and improvement.Methods:The clinical data of patients treated with moxibustion in our department from 2015 to 2020 were retrospectively analyzed.The use of moxibustion and the incidence of moxibustion related scald were statistically analyzed,and the related factors leading to scald were analyzed.The data of 2019 and 2020 were compared with the data of 2015~2018 to compare the incidence of moxibustion related scald and the changes in the types of scald diseases after quality control and improvement.Results:From 2015 to 2018,110 cases of moxibustion related scald occurred in our department,and the top five diseases of moxibustion related scald were stroke,brain injury,spinal cord injury,diabetes and dementia.In 2019,13 cases of moxibustion related scald occurred,and 8 cases of moxibustion related scald occurred in 2020.The incidence of scald injuries continues to decline.0.05.There was no significant change in the first five kinds of scald,but the number of scald also decreased significantly.Conclusion:The decline of cognitive function and sensation is the main cause of moxibustion related scald.The patient's personal cognition and the accompanying of family members also have a certain influence on moxibustion related scald.At the same time,the use of safe moxibustion appliances,improve the responsibility of medical personnel and strengthen the touring supervision in the treatment process are also an important part of the prevention and reduction of moxibustion related scald.