• 임상간호연구
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• 제22권3호
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• pp.294-304
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• 2016

Purpose: This study was done to develop an evidence-based external ventricular drainage (EVD) nursing practice guideline in order to provide standardized nursing and prevent EVD related complications. Methods: We used the standardized methodology for nursing practice guideline adaptation developed by Korean Hospital Nurses Association for the guideline adaptation process in this study. Results: The newly developed EVD nursing practice guideline was adapted to the American Association of Neuroscience Nurses (AANN)'s clinical practice guideline which is 'Care of the patient undergoing intra-cranial pressure monitoring/external ventricular drainage of lumbar drainage.' There were 61 recommendations documented in the preliminary guideline all evaluated by 9 experts based on acceptability and applicability. The final practice guideline was composed of 3 domains with 57 recommendations. The three domains of nursing were the insertion, maintenance, and removal of the EVD. The number of recommendations in each domain was 8 in EVD insertions, 39 in EVD maintenance, and 10 in EVD removals. Of the 57 recommendations 3.5% were level 1, 31.5% were level 2, and 65% were level 3. Conclusion: The standardized practice guideline can improve nurses' performance and accuracy. It can also be used as the foundation for effective communication between all medical staff.

• 임상간호연구
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• 제20권3호
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• pp.337-347
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• 2014

Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

• 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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• 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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• 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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• 제17권2호
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• pp.176-191
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• 2011

Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.

• 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.

• 재활간호학회지
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• 제19권2호
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• pp.118-127
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• 2016

Purpose: This study was to develop an evidence-based clinical practice protocol of physical restraints by adaptation process for patients with a geriatric hospital. Methods: Protocol adaptation process was conducted in accordance with manual for guideline adaptation version 1.0 by ADAPTE collaboration. Results: The adapted physical restraint protocol was consisted of 3 domains and 37 recommendations. The number of recommendations in each domain were: 7 nursing assessment, 19 nursing intervention, and 11 nursing evaluation. More than half (56.8%) of the recommendations were rated as grade B, 37.8% as grade C, and 5.4% were rated as grade D. Conclusion: The adapted physical restraint protocol is expected to contribute as an evidence-based clinical practice protocol for healthcare workers in geriatric hospitals for reducing and improving efficiency of appropriate physical restraints use.

• 고전문학과교육
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• 제33호
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• pp.5-44
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• 2016

이 연구에서는 만화가 고우영(1939-2005)을 고전에 대환 자신의 이해와 해석을 동시대인들에게 확산시킨 창조적 수용자라고 보고, 일련의 고전소설을 개작한 그의 작업 중 흥부전의 개작인 <놀부뎐>(1988)을 대상으로 서사변용 양상을 살피고 이를 가능하게 한 흥부전의 수용문화를 고찰하였다. 특히 고우영의 작품은 '어떻게 하면 과거의 문학을 현재의 고전으로서 살아있게 할 수 있는가?'하는 질문에 좋은 참조가 된다. 기존의 흥부전과 다른 특징을 드러내는 데 초점을 맞추어 사건 구성과 인물형상화, 시공간적 배경에서 작품의 서사 변용 양상을 살펴보았다. 우선이 작품은 흥부와 놀부가 태어나게 된 사연으로부터 시작하여 가족 관계 속에서 둘의 성격 형성 과정을 서사화하는 '앞이야기 이어붙이기' 방식을 취하고 있다. 이는 이 작품이 성격과 성향이 다른 형제 간의 갈등을 서사의 중심 문제로 취하고 있음을 말해 준다. 한편, 결말 처리에 있어서는 모호성과 다양한 해석 가능성을 보여주는데 이는 권선징악의 주제를 구현하던 흥부전에 대한 대화적 답변이라 할 수 있다. 인물형상화 면에서는 새로운 인물의 삽입과 기존 인물에 대한 재해석이 어떻게 이루어지는지 분석하였다. 새로운 인물인 놀순이와 연생원은 각기 자기 사연과 개성을 가진 인물로 등장하여 놀부와 흥부의 성격 형성과 인생행로에 영향을 미치면서, 형제의 서로 다른 성격을 매개적으로 드러내었다. 또한 긍정적인 요소와 부정적인 요소를 함께 갖춘 흥부와 놀부의 성격형상화를 통해 <놀부뎐>은 기존의 흥부전이 보여주는 선악관, 인간관에 대해 의문을 드러내며 겉모습으로 사람의 선악을 쉽게 판단하는 세태를 비판할 수 있었다. <놀부뎐>의 시공간을 이해할 때, 작품의 시공간적 배경은 흥부와 놀부가 살고 있는 서사세계와 작자와 독자가 살고 있는 당대가 혼융되어 있다고 할 수 있다. 흥부, 놀부의 외면은 전승되는 서사세계에서 가져왔으되, 그들이 사유 방식과 감성 구조는 현대적인 것이며, 이를 표현하기 위해서 이질적인 시공간에 속한 사물과 이와 연관된 사건들이 필요했던 것이다. 이런 시공간의 혼융은 흥부전이 옛날이야기가 아니라 동시대에 진행되는 현재의 이야기로 받아들이게 하면서 <놀부뎐>이 현재의 삶을 빗댄 이야기임을 재확인하게 한다.

• 임상간호연구
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• 제19권1호
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• pp.128-142
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• 2013

Purpose: This study was conducted to adapt the previously developed intravenous infusion guidelines with good quality for development of the evidence-based intravenous infusion nursing practice guideline in Korea. Methods: Guideline adaptation process was conducted according to guideline adaptation manual version 2.0 developed by NECA (Kim, Kim et al., 2011) which consisted of three main phases, 9 modules including a total of 24 steps. Results: Adapted intravenous infusion nursing practice guideline was consisted of 19 domains and 180 recommendations. The domains and number of recommendations in each domain were: general guide, 4; assessment, 1; vascular access device selection, 4;site selection, 14;site preparation, 5;site care, 29; maintaining patency, 11; blood sampling via vascular access, 4; vascular access device exchange and removal, 9; add-on device selection, 27; infusion related complications, 63; education, 7; and documentation and report, 2. There were 11.9% of A, 28.4% of B, 58.7% of C in grade of recommendations. Conclusion: Adapted intravenous infusion nursing practice guideline is expected to contribute providing an evidence based practice guides for intravenous infusion. The guideline is recommended to be disseminated to nurses nationwide to improve the efficiency of intravenous infusion practice.