The Research On Acupuncture And Moxibustion Combined Therapy Based On FOCUS-PDCA On The Incidence Of Aspiration Pneumonia In Stroke Inpatients

OBJECTIVE:Objective to explore the application of comprehensive acupuncture and moxibustion therapy based on FOCUS-PDCA quality improvement tool as the intervention mean on the incidence of aspiration pneumonia in stroke inpatients.METHOD:This study applies the FOCUS-PDCA quality improvement tool,through Find-Organize-Clarify-Understand-Select-Plan-Do-Check-Act of nine steps,based on the high incidence of aspiration pneumonia in stroke inpatients,a continuous quality improvement project team established to comprehensively analyze risk factors associated with aspiration pneumonia in stroke inpatients,developing a screening table for risk factors associated with aspiration pneumonia in stroke inpatients.All cases that met the study criteria in The Third Ward of Acupuncture Department of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,were retrospectively screened from October 2019 to January 2020 to clear and definite the situation of inpatients with aspiration pneumonia before improvement.According to the screening results,Plato was applied to find out the main factors,selecting the parts that need to be improved,making the improvement plans,and optimizing the diagnosis and treatment process.All cases meeting the study criteria from October2020 to January 2021 will be screened for admission,and on the basis of the screening results comprehensive acupuncture and moxibustion therapy will be administered according to the new diagnosis and treatment process.Method adopts history comparison case-control study,collecting the data of two groups before and after improvement by applying the FOCUS-PDCA quality improvement tool,and the baseline data of two groups as well as the incidence of aspiration pneumonia were statistically analyzed by using SPSS26.0 statistical analysis software software.According to the results,the deficiencies will be excavated and improved,and the period February 2021 will be taken as the continuous improvement stage to continue the improvement.RESULT:(1)There were no statistically significant differences in gender,age,smoking,alcohol consumption,presence or absence of disturbance of consciousness and dysphagia,or NIHSS scores at admission between the historical contemporaneous control group and the group managed with FOCUS-PDCA(P>0.05),and there was consistency at baseline between the two groups.(2)The incidence of aspiration pneumonia,(P=0.046<0.05),was statistically different between the historical contemporaneous control group and the group managed with FOCUS-PDCA,and the incidence of aspiration pneumonia in stroke inpatients was 2.8% in the FOCUS-PDCA management group which was lower than the historical contemporaneous control group(6.8%).That is to say comprehensive acupuncture and moxibustion therapy based on FOCUS-PDCA could reduce the incidence of aspiration pneumonia in stroke inpatients.CONCLUSION:(1)Comprehensive acupuncture and moxibustion therapy based on FOCUS-PDCA was effective in reducing the incidence of aspiration pneumonia in stroke inpatients.(2)Screening the relevant risk factors of aspiration pneumonia in stroke inpatients through admission,carrying out active and targeted treatment,nursing,and publicity and education for the risk factors is helpful for the management of aspiration pneumonia in stroke inpatients,and provides standardized prevention,diagnosis and treatment strategies,thus provide better quality services and ensuring the quality and safety of medical treatment.