1. Acupuncture
By Katie Hicks

2. Introduction
Acupuncture has been practiced in China and other Asian countries for thousands of years.
Acupuncture is one of several forms for Traditional Chinese Medicine
Became better known in the U.S. in the early 1970’s after a reported wrote about doctors in China using needles to ease his post-operative pain.

3. Qi (pronounced “chee”)
In English, Qi means “energy”
An invisible, flowing force responsible for life
Qi is the force in nature that operates as air and weather
Responsible for the functioning of the Organ-energy systems

4. Meridians
Meridians (also called channels and vessels) are networks of pathways providing routes along which Qi energy flows
14-20 main channels connecting the body in a weblike interconnecting matrix of at least 2,000 acupuncture points

5. Meridians
Disease occurs when an internal imbalance of Qi flow occurs due to blocked meridians
TCM acupuncturist identifies the nature of the imbalance and then selects acupuncture points along the meridians

6. Acupuncture
Typically 5 to 15 needles are inserted by the acupuncturist at depths varying from superficial to 5 cm
Needles remain in place anywhere from five minutes to over an hour

7. “Petupuncture”

8. Additional Forms of Acupuncture
Electroacupuncture
Moxibustion (heat)
Pressure
Laser-generated light

9. Adverse Events Associated with Acupuncture
Infection
Pneumothorax
Organ puncture
Cardiac tamponade
Broken or forgotten needles
Fatigue
Nausea
Headache

10. Review of Literature
Effects of acupuncture to treat fibromyalgia: A preliminary randomized controlled trial
16 participants
Group A received a total of 5 electroacupuncture treatments (one per week) followed by weekly clinical exams for 5 weeks.
Group B received 10 electroacupuncture treatments (one per week)
Study demonstrated a statistically significant difference between the two groups
Limitations: small sample size

11. Review of Literature
Effects of Acupuncture During Labor and Delivery in a U.S. Hospital Setting: A Case-Control Pilot Study
45 participants received acupuncture during labor compared with 127 matched historical controls
Incidence of C-section, amount of parenteral opioids used, use of epidural analgesia, and duration of labor were evaluated.
Patient and nursing staff satisfaction and acceptance were assessed by post-partum questionnaires.
Study show statistically significant decrease in C-section rate in the acupuncture group, no acupuncture-related adverse events, and a high subjective perception of improvement by patients and nurses
Limitations include no control for a possible placebo effect, relatively small sample size, and participants allowed any choice of pain medication

12. Review of Literature
Electroacupuncture for Primary Insomnia: A Randomized Controlled Trial
Purposed that electroacupuncture would be superior to placebo acupuncture in the short-term treatment of primary insomnia
randomized, single-blind parallel-group study design to compare the effects of electroacupuncture and placebo acupuncture
group were treated 3 times per week for 3 consecutive weeks
Both groups were connected to the same electric stimulator, however the placebo group received no current
study showed statistically significant improvements in subjective and objective measures of sleep efficiency in the electroacupuncture group

13. Review of Literature Acupuncture for Essential Hypertension
Meta-analysis that looked at the efficacy of acupuncture in treatment of essential hypertension
Data from 20 articles met the inclusion criteria
Total of 1528 patients from the 20 trials were included in this review
Blood pressure was significantly lower with acupuncture plus antihypertensive drugs than with sham acupuncture plus hypertensive drugs
Limitations included failure to the trials to specify many factors, such as allocation, randomization, and follow-up
The frequency of acupuncture sessions varied from study to study

14. ROL Conclusion PROs CONs Generally safe Well tolerated by most clients
Appears to improve well-being in many people who have tried it
CONs
very few sound studies out there on which to build evidence-based practice
Most studies had relatively small sample sizes
Randomized controlled studies difficult to perform due to many variables (ineffective blinding, inadequate treatment “dose”, incomplete understanding of how acupuncture really works

15. Incorporation Into Advanced Nursing Practice
Attendance at an acupuncture course of approximately two years in length is recommended
Kansas State Board of Nursing (KSBN) requires that as long as an ARNP has “protocols” regarding acupuncture, he/she may practice under ARNP license
Kansas does not currently require acupuncturists to be certified

16. Incorporating Acupuncture into Advance Nursing Practice
Acupuncture can be recommended to patients with a variety of common syndromes as an adjunctive or even primary treatment option
Further research is needed on the efficacy and cost-effectiveness of acupuncture

17. Questions