• 제목/요약/키워드: 임상실무지침

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수용개작을 통한 뇌실외배액 간호 실무지침 개발 (Development of Nursing Practice Guideline for External Ventricular Drainage by Adaptation Process)

  • 정원경;이영희
    • 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.

혈액투석 환자의 기능부전 도관관리 실무지침개발 (Development of a Practice Guideline for Catheter Dysfunction in Hemodialysis Patients)

  • 이경미;김미연;홍진영;조용애;양원지
    • 임상간호연구
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    • 제22권2호
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    • pp.238-247
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    • 2016
  • Purpose: This study was done to develop an evidence-based practice guideline for catheter dysfunction in hemodialysis patients. Methods: Development of the guideline process was done according to the De Novo development version 1.0 by NECA which consists of 12 steps. Results: The developed guideline consisted of 5 domains and 14 recommendations. The number of recommendations for each domain were: 3 on catheter dysfunction assessment, 1 on conservative management of catheter dysfunction, 7 on drug management of catheter dysfunction, 1 on catheter function test and 2 on maintenance management. Of the recommendations, 7.15% were marked as A grade, 52.85% of B grade, and 50% of C grade. Conclusion: Findings in this study indicate that this guideline can be added to the evidence-based practice guidelines for fundamentals of practice and that this guideline can be disseminated to nurses nationwide in order to improve the care of hemodialysis patients with catheter dysfunction.

수용개작방법을 활용한 전신마취 수술 후 폐합병증 예방 간호실무지침 개발 (Development of the Nursing Practice Guidelines for Preventing Postoperative Pulmonary Complications using the Guideline Adaptation Process)

  • 최진주;김현정;강혜민;추희영;김경숙
    • 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.

근거기반 욕창간호 실무지침 개정 (Updates of Evidence-Based Nursing Practice Guidelines for Pressure Injury)

  • 김정윤;박경희;박옥경;박주희;이윤진;황지현
    • 임상간호연구
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    • 제29권1호
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    • pp.12-23
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    • 2023
  • Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.

상급종합병원 신규간호사와 프리셉터 간호사의 근거기반실무에 대한 신념, 간호실무지침에 대한 중요도와 수행도 (Belief in Evidence-Based Practice, Awareness of Importance and Performance of Nursing Practice Guidelines among Novice Nurses and Preceptors in a Tertiary General Hospital)

  • 서주희;은영
    • 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.

요양병원 간호사와 간호조무사의 암성 통증관리에 대한 지식 및 수행 (Knowledge and Performance of Cancer Pain Management of Nurses and Nurses' aides in Long-term Care Hospitals)

  • 정선진;김계하
    • 한국콘텐츠학회논문지
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    • 제14권10호
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    • pp.649-660
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    • 2014
  • 최근 급증하고 있는 요양병원 간호사와 간호조무사의 암성 통증관리에 대한 지식과 수행 정도를 평가하고자 본 연구는 실시되었다. 광주와 전라남도의 7곳의 요양병원에서 간호사 84명과 간호조무사 72명을 표출하여 자료를 수집하였다. SPSS/WIN 21.0 프로그램을 사용하여 기술통계, 독립 t-검정, one-way ANOVA, 피어슨 상관 계수, 단계적 다중회귀분석을 실시하였다. 분석 결과, 대상자의 지식은 30점 만점에 16.84점으로 나타났고, 수행의 평균평점은 4점 만점에 2.88점이었다. 대상자들의 지식은 교육 수준, 직업, 암성 통증관리지침 존재 여부 인식에 따라 차이가 있었다. 수행에서는 교육 수준, 직종, 병상 수, 암성 통증관리지침 존재 여부 인식, 암성통증 임상실무지침서 비치 여부에 따라 차이가 관찰되었다. 지식은 수행과 정적 상관관계를 보였으며, 수행에 영향을 미치는 요인은 지식, 병상 수, 암성통증 임상실무지침서 비치 여부였다. 향후 요양병원 간호사와 간호조무사의 암성 통증관리에 대한 교육 프로그램을 실시할 때 이러한 변수들을 고려해야 할 것이다.

상급종합병원과 종합병원의 근거기반 임상간호실무지침의 활용도 (Utilization of Evidence-Based Clinical Nursing Practice Guidelines in Tertiary Hospitals and General Hospitals)

  • 은영;전미양;구미옥;조용애;김정연;권정순;김경숙
    • 임상간호연구
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    • 제27권3호
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    • pp.233-244
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    • 2021
  • Purpose: The purpose of this study was to investigate the actual utilization of clinical practice guidelines developed by Hospital Nurses Association. Methods: The subjects were 70 nurses who were in charge of guideline distributions in 70 advanced general hospital and general hospitals with 500 beds or more nationwide. Data were collected between June and August, 2020 by mail (return rate: 88.6%). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 24.0. Results: Among the clinical practice guidelines developed by Hospital Nurses Association, 72.9~90.1% were placed with book and electronic file in nursing department and 24.3~35.8% were placed with book and electronic file in each nursing unit at hospital. The average number of utilized clinical practice guidelines were 3.96±3.88, and average score of guideline utilization was score 2.85±0.79 which means 'use sometimes'. Conclusion: To improve the distribution and utilization of the clinical practice guidelines, it is necessary to enhance the recognition of values of evidence based nursing practice targeting head of nursing department and to stimulate the distribution and utilization of the clinical practice guidelines using diverse education programs for staff nurses.

요양시설노인을 위한 구강간호 임상실무지침 수용개작 (Adapting Oral Health Care Guidelines for Nursing Home Residents in South Korea)

  • 박명숙;최스미;한정희
    • 재활간호학회지
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    • 제18권1호
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    • pp.1-10
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    • 2015
  • Purpose: This study attempted to adapt evidence-based oral health care guidelines for nursing home residents in South Korea. Methods: The manual for guideline adaptation, version 2.0, developed by the Korean National Evidence-based Healthcare Collaborating Agency was applied. On the basis of a comprehensive literature review of current research and multidisciplinary panel discussion on adapting such guidelines, we developed evidence- based guidelines for oral health at nursing homes. Results: The guidelines have three domains: oral assessment, oral hygiene care, and support and facilities. Oral assessment includes recommendations on the frequency of and tools for conducting oral health assessment. Oral hygiene care involves recommendations for care of natural teeth, denture care, xerostomia, and behavioral problems. Support and facilities refer to six components of the support system provided by facilities to encourage oral hygiene care among nursing home residents. Conclusion: These adapted guidelines could be an effective method to improve oral hygiene among nursing home residents.

입원환자의 급성 악화 신속대응 가이드라인 개발 (Development of Guidelines for Raid Response to Acute Deteriorating of Hospitalized Patients)

  • 이하늬;박정숙
    • 한국콘텐츠학회논문지
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    • 제22권10호
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    • pp.359-373
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    • 2022
  • 본 연구는 입원환자들의 급성 악화 시 신속한 대응을 위한 근거 기반 가이드라인을 개발하고자 수행되었다. 가이드라인 개발을 위해 기존의 가이드라인을 검색하였고, 총 13편이 선정되어 가이드라인에 대한 Appraisal of guidelines for research and evaluation (AGREE II) 도구를 활용한 질 평가, 최신성 평가, 권고 내용 비교표를 통한 내용 및 권고안의 근거평가, 권고의 수용성 및 적용성 평가를 수행하였다. 본 가이드라인은 신속대응체계의 개념 모형에 따라 관리, 인식, 활성화, 대응, 평가에 대한 권고로 구성되어 있다. 전문가 16명에게 가이드라인 초안의 적절성, 적용 가능성, 효과성에 대한 평가와 적용 여부에 대한 검토를 통해 최종적인 평가 결과를 반영하여 130개의 권고를 확정하였다. 가이드라인의 실무 적용성 평가를 위해 임상 현장에서 신속대응 업무를 수행하는 간호사를 대상으로 실무 적용성을 파악한 결과, 가이드라인에 대한 전체 실무 적용성 평균은 5점 만점에 4.41±0.78점으로 지침 내용에 대한 실제 임상 업무에서의 적용성이 높은 것으로 나타났다.

e-navigation SQA/HCD 통합 가이드라인을 위한 국제 논의 동향 (The International Conference Report for e-navigation SQA and HCD Guideline)

  • 김효승;정지은;임상우;이서정
    • 한국항해항만학회:학술대회논문집
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    • 한국항해항만학회 2015년도 추계학술대회
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    • pp.7-8
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    • 2015
  • 2015년 6월 MSC 95차 위원회에서 e-navigation 소프트웨어 품질 보증 및 인간 중심 설계 가이드라인이 회람문서로 정식 등재되었다. 이후 가이드라인을 산업계에 적용하기 위하여 실무 적용 지침을 개발 중에 있다. 본 지침은 소프트웨어 전체 개발주기에 따른 구체적인 활동을 제시하고 각 활동에 필요한 기본적인 산출물의 양식을 제공한다. 2015년 4월 부산에서 개최된 e-navigation SQA 및 HCD 가이드라인 국제 워크숍에서는 가이드라인의 발전과 향후 적용 방안에 대해 논의하였다. 또한, IMO SQA에 대한 산업계의 다양한 의견을 수집하고, SQA와 HCD를 통합하여 산업계에 적용하는 방향을 논의하였다. 본 논문에서는 워크숍에서 논의된 가이드라인의 향후 발전 방안에 대해 소개한다.

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