Abstract
Needle retention, where acupuncture needles are left in the patient following treatment, is a serious adverse event that can lead to infections, bleeding, and tissue damage. While rare, its potential complications render it a critical concern in acupuncture practice. Current research suggests that inadequate procedural safeguards contribute to the incidence of needle retention, yet there is limited investigation into the role of standard operating procedures (SOPs) in reducing such events. This study aimed to evaluate and compare the effects of 2 different SOPs on the incidence of needle retention in acupuncture treatment. We developed a new acupuncture procedure based on SOPs for acupuncture commonly used in hospitals in Taiwan. The main advancements included replacing paper confirmation checklists with online instant messaging systems, staff meetings before treatment, and repeated confirmations after treatment. We implemented 2 SOPs for inpatients in Taipei City Hospital from 2018 to 2021. The incidence of needle retention was calculated, and a logistic regression model was applied to estimate the odds ratio (95% confidence interval) for needle retention risk between the acupuncture SOPs. This study included 13,920 acupuncture treatments, of which 7653 followed the original SOP and 6267 followed the new SOP. The incidence of needle retention was 6.8 versus 2.2 per thousand acupuncture treatments for the original versus new SOPs, respectively. Compared with the original SOP, the new version showed a 0.41 adjusted odds ratio (95% confidence interval, 0.15-0.72; P = .032) of needle retention after adjusting for age, gender, body mass index, Barthel scale, and acupuncture treatment times. Ameliorating the SOPs could reduce the risk of needle retention after acupuncture. This study showed that a new acupuncture SOP, incorporating technology and better communication, significantly reduced needle retention incidents, enhancing patient safety and care quality.