• Title/Summary/Keyword: 진료지침

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The Effects and Variances of the Critical Pathway of Laparoscopic Colon Resection in Colon Cancer Patients (일 병원의 대장절제술 환자를 위한 표준진료지침의 임상적용 효과와 변이분석)

  • Jung, Hye-Jeong;Choi, Mo-Na;Kim, So-Sun;Kim, Nam-Kyu;Lee, Kang-Young
    • Asian Oncology Nursing
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    • v.12 no.3
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    • pp.204-212
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    • 2012
  • Purpose: To investigate the effectiveness and variance of a critical pathway (CP) for laparoscopic colon resection in colon cancer patients, and nurses'satisfaction with the CP. Methods: A CP for laparoscopic colon resection was applied to the CP-group that included 50 patients, who underwent elective colon resection between March and May, 2011. The non-CP group included 51 patients who had the same operation without the CP applied from March to May, 2010. Results: The means of length of hospital stay were 11.7 and 7.3 days (p<.001) and the lengths of postoperative hospital stay were 8.6 and 5.1 days (p<.001) in the non-CP group and CP group, respectively. There was no significant difference between two groups for total healthcare costs, pain score, complications, or emergency room visits within 30 days after discharge. By examining variances of the CP, there were 162 variances and the most frequent cause was patient's condition. Nurses'satisfaction with the use of CP was favorable and the mean score of satisfaction was 3.76 on the 5 point Likert scale. Conclusion: There are clear benefits to use of CP, resulting in standardized and effective patient care. In conclusion, analysis of variance data can assist in evaluating and revising CP for optimal care and reducing variances.

Comparison of Pain Management between before and after the Application of Guidelines in Cancer Emergency Room (암성통증관리지침 적용 전후 긴급진료실 내원 환자의 통증관리 비교)

  • Won, Young-Hwa;Kim, Yeon-Hee;Park, Jeong-Yun
    • Asian Oncology Nursing
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    • v.12 no.3
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    • pp.230-236
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    • 2012
  • Purpose: This study was to investigate the effect of the application of cancer pain management guidelines on pain management among patients in Cancer Emergency Room. Methods: This study was a retrospective descriptive study. Before application, data were collected by analyzing the Electronic Medical Record in Cancer Emergency Room in September, 2011, and after application in February, 2012. The subjects of this study consisted of 231 patients (pre-application group 83, post-application group 148), who stayed over 24 hours and complained of pain higher than Numeric Rating Scale score 4. The post-test was conducted after educating the nurses about the application of the pain management guidelines in the Electronic Medical Record. Results: This survey showed that, as the cancer pain management guidelines were applied for cancer patients with above moderate pain, the pain intensity decreased, the number of patients reaching the treatment goal score increased. Furthermore, the estimated time to reach the treatment goal decreased significantly. Conclusion: Pain intensity of the cancer patients was decreased through regular pain assessments by nurses and the medication of analgesics according to the cancer pain management guidelines. Therefore, it is necessary to develop the pain management program and to provide the physicians and nurses with intensive education about the pain management guidelines for systematic and effective pain management.

Suggestions for developing Korean Medicine Clinical Practice Guideline for Allergic Rhinitis - Based on 2018 Chinese Clinical Practice Guideline (알레르기 비염 한의표준임상진료지침 방향 제언 - 2018 중국 임상진료지침을 바탕으로)

  • Kang, Jeong-In;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.4
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    • pp.130-140
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    • 2019
  • Objective : The purpose of this study is to examine the treatment of allergic rhinitis introduced in the Chinese guideline, and to find out the direction of evidence-establishment and applicability in developing Korean Medicine clinical practice guideline for allergic rhinitis. Method : We studied Traditional Chinese Medicine treatment of allergic rhinitis introduced in the 2018 Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. The treatment are classified into three categories; herbal medicines, acupuncture and the others. And we compared this guidelines with other guidelines for how they differ in description of the database, evidence of level, and strength of recommendation. Results : Herbal medicines are presented based on syndrome differentiation. The basic acupoints for allergic rhinitis are introduced as follows; Fengchi(GB20), Yingxiang(LI20), Feishu(BL13) and Taiyuan(LU9). And in comparison with other guidelines for allergic rhinitis, the Chinese guideline showed lack of description in the database, evidence of level, and strength of recommendation, though they used evidence-based models. Conclusions : Clinical practice guideline projects are also underway in Korea for benefit expansion and improving quality of medical services. It is important to develop guidelines which should be evidence-based and reflect Korean medical environment.

Guideline for the Management of Neonates Born to Mothers With COVID-19 (코로나19 감염 산모에서 출생한 신생아 관리 지침)

  • Jae Hong Choi ;Soo-Han Choi ;Do-Hyun Kim ;Yong-Sung Choi ;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.125-130
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    • 2022
  • For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference.

Construction and Feedback of an Information System by Analyzing Physicians' Information-Seeking Behavior (의사들의 정보추구행태를 반영한 의학정보시스템 개발 및 평가)

  • Kim, Na Won;Lee, Jee Yeon
    • Journal of the Korean Society for information Management
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    • v.33 no.1
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    • pp.161-180
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    • 2016
  • Physicians have information needs related to academic research and clinical practice but encounter difficulties seeking appropriate medical resources and information. The goal of this study is to develop a search system to support Korean physicians' information needs. To access sources to meet the identified need, in-depth interviews were conducted, and MediSearching, a new search system, was developed accordingly. To verify its usefulness and to obtain users' suggestions, interviews were conducted and feedback was solicited via collected test searches. The initial set of interviews indicated that physicians' information needs and search behaviors differed by type of hospital and clinical department. Physicians in university hospitals with a greater need for research materials searched for academic articles, whereas physicians in specialty hospitals or primary care clinics with a stronger need for materials related to clinical practice asked their colleagues for information. Consequently, MediSearching was designed to satisfy both groups' needs, and the test search provided useful search results compared with existing services. Korean physicians have previously had to repeat their search process on separate sites that provide different services according to type of information and search method. MediSearching may reduce this inconvenience and add documents in various formats and languages.

ANALYSIS ON THE OUTPATIENT ANESTHESIA AT DENTAL CLINIC FOR DISABLED IN SEOUL NATIONAL UNIVERSITY DENTAL HOSPITAL (서울대학교 치과병원 장애인진료실의 외래환자마취 실태 분석)

  • Park, Chang-Joo;Jung, Jun-Min;Kim, Hyun-Jeong;Jang, Ki-Taeg;Lee, Sang-Hun;Yum, Kwang-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.19-25
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    • 2004
  • Dentally disabled person means one who have difficulty in cooperating voluntarily with a dentist for routine dental care. Seoul National University Dental Hospital (SNUDH) Dental Clinic for Disabled has worked for them under outpatient anesthesia concept. The aim of this study was to determine the anesthetic characteristics of the patients attending for dental treatment at SNUDH Dental Clinic for Disabled in order to establish better future treatment plans. The data were drawn from the patients who visited SNUDH Dental Clinic for Disabled from January 1999 to October 2002. Total 93 dental treatments for 83 patients were enrolled in this study. Most patients had mental retardation and the conservative treatments were carried out under general anesthesia. Thiopental and vecuronium were mostly used for induction agent and neuromuscular blocker, respectively. Enflurane, with oxygen and nitrous oxide, was mostly used to maintain the anesthesia. Mean total anesthetic time was $164.4{\pm}57.2$ minutes and mean duration at the post-anesthetic care unit was $106.2{\pm}50.5$ min. Serious postoperative complications were not observed. These results showed our successful anesthetic outcomes without any severe side effect or complication and the needs of more outpatient centers for dental care for disabled.

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An Overview on the Traditional Chinese Medicine Treatment Guidelines for Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) (중증급성호흡기증후군(SARS) 및 중동호흡기증후군(MERS)의 중의 진료지침에 대한 고찰)

  • Ryu, Han-sung;Oh, Hye-kyung;Lee, Jee-young;Yoon, Seong-woo
    • The Journal of Internal Korean Medicine
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    • v.36 no.3
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    • pp.335-347
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    • 2015
  • Objectives This study aims to overview traditional Chinese medicine (TCM) treatment guidelines for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) in order to facilitate the use of Korean medicine (KM) treatment in pandemic diseases. Methods We compared the characteristics between SARS and MERS, and overviewed the Traditional Chinese Medicine treatment guidelines for SARS and MERS. We assessed the efficacy of simultaneous administration of herbal medicine and Western medicine on SARS by studying Cochranes 2012's Systematic Review Studies. Results and Conclusions Based on wen bing (warm diseases) of KM as well as TCM, KM treatment can be an alternative for pandemic diseases such as SARS and MERS considering the Korean's characteristic environment.

A Preliminary Study for the Development of Clinical Practice Guidelines of Korean Medicine for Bladder Cancer (방광암(膀胱癌)의 한의학적 진료지침 개발을 위한 기초 연구)

  • Park, Tae-yeol;Yoo, Hwa-seong;Lee, Sang-hun
    • The Journal of Internal Korean Medicine
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    • v.37 no.6
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    • pp.911-928
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    • 2016
  • Objectives: This study presents Korean medicine clinical practice guidelines for bladder cancer, of which the 5-year survival rate has still been about 75% since the 1990s despite the rapid development of medical science. Methods: A consensus was reached by an expert committee composed of professors and researchers who specialize in Korean medicine on the basis of a literature review that included other countries' clinical guidelines and a textbook. Results: Traditional Chinese medicine clinical practice guidelines were published for the first time in 2014. In Korea, the medical system is different from China in that Korea has completely dualized Korean and Western medicine and a low availability of proprietary herbal medicines. Therefore, these Korean medicine clinical practice guidelines for treating bladder cancer based on the previously published guidelines of Chinese medicine will help first-line Korean medicine doctors. Conclusions: Further studies related to Korean medicine are necessary to develop more advanced Korean medicine clinical practice guidelines for treating bladder cancer.

2018 심방세동 카테터 절제술 대한민국 진료지침: PART I

  • Park, Hyeong-Seop;Jeong, Dong-Seop;Yu, Hui-Tae;Park, Hui-Nam;Sim, Jae-Min;Kim, Ju-Yeon;Kim, Jun;Lee, Jeong-Myeong;Kim, Gi-Hun;No, Seung-Yeong;Jo, Yeong-Jin;Kim, Yeong-Hun;Yoon, Namsik
    • International Journal of Arrhythmia
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    • v.19 no.3
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    • pp.186-234
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    • 2018
  • Catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure. Management of patients with AF has traditionally consisted of three main components: (1) anticoagulation for stroke prevention; (2) rate control; and (3) rhythm control. With the emergence of large amounts of data, which have both defined and called attention to the interaction between modifiable risk factors and the development of AF and outcomes of AF management, we believe it is time to include risk factor modification as the fourth pillar of AF management. Catheter and surgical ablation of AF are highly complex procedures, therefore a decision to perform catheter or surgical AF ablation should only be made after a patient carefully considers the risks, benefits, and alternatives to the procedure.

2018 심방세동 카테터 절제술 대한민국 진료지침: PART III

  • Lee, Jeong-Myeong;Jeong, Dong-Seop;Yu, Hui-Tae;Park, Hyeong-Seop;Sim, Jae-Min;Kim, Ju-Yeon;Kim, Jun;Yun, Nam-Sik;O, Se-Il;No, Seung-Yeong;Jo, Yeong-Jin;Kim, Ki-Hun
    • International Journal of Arrhythmia
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    • v.19 no.3
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    • pp.285-339
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    • 2018
  • Catheter ablation of atrial fibrillation (AF) is one of the most complex interventional electrophysiological procedures. The success of AF ablation is based in large part on freedom from AF recurrence based on electrocardiography (ECG) monitoring. Arrhythmia monitoring can be performed with the use of noncontinuous or continuous ECG monitoring tools. AF ablation is an invasive procedure that entails risks, most of which are present during the acute procedural period. However, complications can also occur in the weeks or months following ablation. Recognizing common symptoms after AF ablation and distinguishing those that require urgent evaluation and referral to an electrophysiologist is an important part of follow-up after AF ablation. This section reviews the complications associated with catheter ablation procedures performed to treat AF. The types and incidence of complications are presented, their mechanisms are explored, and the optimal approach to prevention and treatment is discussed. Finally, surgical and hybrid AF ablation technology and the indications for concomitant open or closed surgical ablation of AF, stand-alone and hybrid surgical ablation of AF are covered in this section.