• 한국콘텐츠학회논문지
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• 제21권10호
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• pp.630-644
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• 2021

본 연구는 인공호흡기 관련 폐렴 예방을 위한 근거기반 간호실무지침을 개발하고자 수행되었다. 한국보건의료연구원의 하이브리드 방법에 따라 근거기반 간호실무지침을 개발하고 유효성을 검증한 방법론적 연구이다. 주제와 핵심 질문은 문헌 검토와 전문가 인터뷰를 통해 도출하였고, 핵심 질문과 관련된 권고안은 체계적 검색과 선정에 의한 기존 가이드라인을 분석하여 수렴하였으며, 미해결 핵심 질문과 관련된 권고안은 체계적고찰과 메타 분석을 통해 새로 개발하였다. 개발된 권고안은 RAND에 의한 유효성 검증과 간호실무지침 초안은 AGREE II에 의한 방법론적 질평가를 수행하였다. 9개 범주의 44개 권고안으로 구성된 최종 간호실무지침의 임상타당성은 중환자실 간호사 122명을 대상으로 평가하였다. 최종 개발된 인공호흡기 관련 폐렴 예방을 위한 근거기반 간호실무지침은 방법론적 타당성과 내용타당도가 검증되었고 우리 간호실무 환경에 적합하여 중환자 간호실무의 질적 향상에 기여할 수 있을 것으로 기대된다.

• 한국콘텐츠학회논문지
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• 제17권7호
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• pp.344-357
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• 2017

본 연구는 근거기반 실무지침에 대한 간호학 교과서의 반영 현황을 분석하기 위한 것이다. 연구대상은 2012년 3월부터 2017년 3월까지 출간된 기본간호학 교과서 14개로써 이론서 7개와 실습서 7개로 구성되었고, 근거기반 실무지침은 5개의 도뇨관련 요로감염예방 실무지침으로부터 포괄적으로 수렴하여 91개 권고문항으로 구성되었다. 근거기반 실무지침에 대한 기본간호학 이론서와 실습서의 총 반영률은 각각 23.0%와 15.2%이었다. 이론서에 반영률이 가장 높은 영역은 도뇨관 유지 영역이었고 실습서는 도뇨관 삽입 영역이었다. 반영률이 50%이상인 개별 권고문항은 총 91개 중 16개이었고 이중 도뇨관 유지에 관한 권고문항이 8개(50.0%)로 확인되었다. 마지막으로 교과서에 반영은 되었지만 상반되게 기술된 개별 권고문항은 총 9개 이었고, 요실금 관리를 위한 도뇨, 도뇨관의 정기적 교환, 도뇨관 제거 전 방광훈련과 회음부 간호의 순이었다. 향후 기본간호학 교과서를 개정할 때 오류내용이 우선 교정되어야 하고 근거기반 실무지침 권고내용에 대한 반영을 확대하기 위한 노력이 필요하다.

• 임상간호연구
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• 제25권1호
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• pp.1-14
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• 2019

Purpose: This study was done to develop a evidence-based guideline for pain assessment and management in Korea by adapting previously developed pain guidelines. Methods: The guideline adaptation process was conducted using 24 steps according to the guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed pain management guideline consisted of 9 domains and 234 recommendations. The number of recommendations in each domain was: 13 general instruction items, 51 pain assessments, 14 pain interventions, 66 pharmacological interventions for acute pain, 41 pharmacological interventions for chronic cancer pain, 35 pharmacological interventions for chronic noncancer pain, 21 non-pharmacological interventions, 2 documentations, 10 nursing education items, for pain. Conclusion: The findings suggest that the new pain management guideline can be used to address pain in hospital settings.

• 대한간호학회지
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• 제50권6호
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• pp.863-875
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• 2020

Purpose: This study was conducted to develop and test the effects of a program for practice application of intravenous infusion evidence based nursing practice (EBP) guidelines in small and medium-sized hospitals. Methods: A mixed method research design was used, combining non-equivalent control group pre-post test design with qualitative study analysis. The subjects consisted of 55 nurses. The practice application program was developed based on the Advancing Research and Clinical practice through close Collaboration (ARCC) model. Data were collected for analysis in the following areas: nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, importance about intravenous infusion, and performance about intravenous infusion, with data assessed using valid and reliable instruments. Patient outcomes were collected from the hospital's medical records. Data were analyzed using t-test, χ2-test, and Shapiro-Wilk test, with qualitative content analysis used for interview data. Results: Following the intervention, nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, and performance of intravenous infusion and perceptions of its importance showed significant improvement in the experimental group. Phlebitis rates decreased in the experimental group compared to the control group. Conclusion: This program is effective to improve nurse's perception and practice of evidence based nursing. Therefore we recommend to use this program at same levels of hospitals.

• 임상간호연구
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• 제22권2호
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• pp.118-131
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• 2016

Purpose: This study was conducted to develop a useful evidence-based guideline for preventing venous thromboembolism(VTE) in Korea adapting previously developed VTE guidelines. Methods: The guideline adaptation process was performed using 24 steps according to the nursing practice guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed VTE prevention guideline was consisted of 16 domains and 163 recommendations. The number of recommendations in each domain were: 4 general issues, 4 risk factors, 2 intervention at occurrence of VTE, 14 mechanical interventions, 30 pharmacological interventions, 19 VTE prevention for medical patient, 10 stroke patient, 16 cancer patient, 14 pregnancy, 6 for long distance traveller, 5 for abdominal surgery, 10 thoractic surgery, 10 orthopedic surgery, 5 neurosurgery, 4 other surgical patient, 2 urological surgery, 1 ENT surgery, 1 plastic surgery, 3 day surgery, 3 education of VTE prevention. Fourteen point three percent, 61.1%, and 24.6% of the recommendations were graded A, B, and C, respectively. Conclusion: The findings suggest that the new VTE prevention guideline can be more efficiently used to prevent VTE in hospital settings.

• 임상간호연구
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• 제21권3호
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• pp.355-365
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• 2015

Purpose: The purpose of this study was to evaluate nursing protocols for superficial cryotherapy in different medical institutions. Methods: The study was conducted with a cross-sectional descriptive design. The medical institutions including general hospitals, hospitals, and geriatric hospitals were randomly selected. A total of 435 nurses from 126 institutions completed a questionnaire. Data were collected from December 2014 to June 2015. Results: Forty-two institutions (39.5%) had nursing protocol for cryotherapy. The nurses reported that durations of cold application were 2 minutes to 5 hours. Frequently used cold therapy devices in order of frequency were frozen gel packs, ice packs, and frozen IV fluid bags. There were variances in the duration of cold application according to the types of institution ($x^2=7.78$, p=.020) and nursing units ($x^2=26.42$, p<.001). In addition, intervals of cold application were different according to the nursing units (x=12.23, p=.032). There were differences in cold application instruments by regional groups (x=70.38, p<.001). Most of the nurses (95.6%) responded that national nursing protocol for superficial cryotherapy were needed. Conclusion: There were difficulties in providing consistent nursing interventions because of the practical differences and absence of evidence-based guidelines for cryotherapy. The researchers recommend that basic studies with various instruments be conducted and proper nursing protocols be developed for cryotherapy.

• 임상간호연구
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• 제21권2호
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• pp.154-168
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• 2015

Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

• 임상간호연구
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• 제29권2호
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• pp.149-162
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• 2023

Purpose: This study was to investigate the belief in evidence-based practice, awareness of importance and performance of intravenous infusion and pressure ulcer evidence-based practice guidelines among nurses in a tertiary general hospital. Methods: The subjects of this study were 217 nurses working in a tertiary general hospital. Data collection was performed between February 11 and February 25, 2022. Data analysis was conducted descriptive statistics, t-test, hierarchical regression analysis, and Importance-Performance Analysis. Results: The mean score of belief for evidence-based practice among novice nurses was 3.34 out of 5, while preceptor nurses scored a mean of 3.41 out of 5. There was no significant difference in belief scores between novice nurses and preceptor nurses (t=-1.21, p=.227). The factors influencing the performance of evidence-based practice guidelines for intravenous infusion were belief in evidence-based practice (β=.14, p=.009) and importance of intravenous infusion (β=.51, p<.001), and the factors influencing the performance of evidence-based practice guidelines for pressure ulcer were belief in evidence-based practice (β=.15, p=.002) and importance of pressure ulcer (β=.65, p<.001). Importance-Performance Analysis of the evidence-based practice guidelines of two groups were used to identify common and different items. Conclusion: To improve the performance of evidence-based practice guidelines, it is necessary to enhance the evidence-based practice belief and importance of evidence-based practice guidelines. In particular, evidence-based practice should be provided to improve nursing quality through education on items of low-importance and low-performance and items of high-importance but low-performance guidelines identified through Importance-Performance Analysis.

• 임상간호연구
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• 제20권2호
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• pp.147-161
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• 2014

Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

• 임상간호연구
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• 제27권2호
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• pp.187-198
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• 2021

Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.