• Title/Summary/Keyword: CARE guideline

Search Result 421, Processing Time 0.03 seconds

Development of Evidence-Based Guideline for Fever Management of Critical Adult Patients with Brain Injury (성인 뇌 손상 발열 중환자를 위한 체온 중재 지침 개발)

  • Lee, Jung Min;Cho, Yong Ae;Yoon, Ji Hyun;Choi, Hye Ok;Kim, Nam Cho
    • Journal of Korean Clinical Nursing Research
    • /
    • v.22 no.3
    • /
    • pp.265-275
    • /
    • 2016
  • Purpose: The purpose of this study was to develop an evidence-based guideline for fever management for critically ill adult patients after a brain injury. Methods: Development of the guideline process was done according to the De Novo development Korean Medical Guideline Information Center (KoMGI) and consists of 12 steps. Results: This developed guideline included 3 domains and 19 recommendations. The number of recommendations for each domain was 7 on measuring temperature, 9 on managing fever, and 3 on managing shivering. The level of evidence was as follows: 58% were at level I, and 42% at level II. Of the recommendations, 58% were graded as A, 37% as B, and 5% as C. Conclusion: These findings indicate that this guideline can be used as a guide for nursing in critically ill adult patients with brain injury. This guideline can also contribute to improvements in the quality of nursing care for critically ill adult patients with brain injury.

Clinical Practice Guideline of Acute Respiratory Distress Syndrome

  • Cho, Young-Jae;Moon, Jae Young;Shin, Ein-Soon;Kim, Je Hyeong;Jung, Hoon;Park, So Young;Kim, Ho Cheol;Sim, Yun Su;Rhee, Chin Kook;Lim, Jaemin;Lee, Seok Jeong;Lee, Won-Yeon;Lee, Hyun Jeong;Kwak, Sang Hyun;Kang, Eun Kyeong;Chung, Kyung Soo;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
    • /
    • v.79 no.4
    • /
    • pp.214-233
    • /
    • 2016
  • There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

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

  • Lee, Kyung Mi;Kim, Mi Yeun;Hong, Jin Young;Cho, Yong Ae;Yang, Won Ji
    • Journal of Korean Clinical Nursing Research
    • /
    • v.22 no.2
    • /
    • pp.238-247
    • /
    • 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.

Medico Legal Aspects of Clinical Practice Guideline (표준 치료 지침서(Clinical Practice Guideline)의 의료법학적 의의)

  • Bae, Hyun-A
    • The Korean Society of Law and Medicine
    • /
    • v.9 no.2
    • /
    • pp.181-207
    • /
    • 2008
  • With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

  • PDF

Assesment of The Quality of Reporting in Case Reports in Journal of Sasang Constitutional Medicine from Year 2015 to 2018 : Using CARE Guidelines (2015년부터 2018년까지 사상체질의학회지에 보고된 증례에 대한 보고의 질 평가 : CARE지침을 바탕으로)

  • Kim, Ji Hwan;Lee, Hye Lim;Lee, Ju Ah;Lee, Myeong Soo
    • Journal of Sasang Constitutional Medicine
    • /
    • v.30 no.2
    • /
    • pp.28-41
    • /
    • 2018
  • Objectives The purpose of this study is to evaluate the quality of case reports about Sasang Constitutional Medicine(SCM). Methods Case reports published from March, 2015 to March, 2018 in Journal of SCM were identified by searching from Oriental Medicine Advanced Searching Integrated System(OASIS). We assessed the quality of reporting of them based on CAse REport (CARE) guideline. Results A total of 39 case reports were finally included for the assessment. Overall quality of reporting was acceptable because case report even less reporting items mentioned 70.4% of them. However, the quality level was uneven because the maximum report rate was 77.8 %, the minimum 44.4 %, and the median 66.7 % when rigorously assessed. More than 50% of 39 case reports did not report 6 items about intervention adherence and tolerability, Diagnostic challenges, patient's perspective on interventions, informed consent, timeline, and adverse events, and did not sufficiently report 4 items about inclusion of terms such as case reports or SCM in keyword, symptoms of patient in abstract, information such as occupation relevant with psychosocial history, and the rationale for conclusions. Conclusions Efforts to improve the quality of reporting in SCM, and to develop case reporting guidelines appropriate for SCM are required.

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

  • Jeong, Sunjin;Kim, Kyeha
    • The Journal of the Korea Contents Association
    • /
    • v.14 no.10
    • /
    • pp.649-660
    • /
    • 2014
  • The purpose of this study was to assess knowledge and performance of cancer pain management of nurses and nurses' aides in long-term care hospitals. Subjects were 84 nurses and 72 nurses' aides recruited from seven long-term care hospitals in Gwangju city and Jeonranam-do. SPSS/WIN 21.0 was used for data analysis by descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. The mean scores of knowledge of cancer pain management were 16.84, and the score for performance was 2.88. There were significant differences in the knowledge of cancer pain management according to education level, job, and cancer pain management guidelines. Significant differences in performance of cancer pain management were observed according to education level, job, number of beds, cognition of cancer pain management guidelines, and clinical practice guideline for cancer pain management. Knowledge, number of beds, and clinical practice guideline for cancer pain management affected in performance of cancer pain management. Education program for cancer pain management and clinical practice guideline for cancer pain management are needed to improve performance of cancer pain management of nurses and nurses' aides in long-term care hospitals.

Development of Evidence-based Nursing Practice Guidelines for Febrile Children in Emergency Room (응급실 내원 발열 소아환자의 열관리를 위한 근거중심 간호실무 가이드라인 개발)

  • Jeong, Min-Jin;Shin, Hyun-A;Kim, Yun-Hee;Lee, Jee-Hyang;Lee, Seung-Ja;Song, Mi-Ra
    • Child Health Nursing Research
    • /
    • v.18 no.4
    • /
    • pp.214-221
    • /
    • 2012
  • Purpose: The purpose of this study was to develop evidence-based nursing practice guidelines for the care of febrile children in the emergency room and to evaluate the guidelines by applying them to practice. Methods: This study was conducted using a methodological design. referring to the Scottish intercollegiate guideline network, draft of guidelines were developed based on the recommendations found from the critical literature analysis. Then, the draft was modified by an expert group and a pilot application. The final draft was evaluated by the expert group using appraisal of guidelines for research and evaluation. Finally, the final guideline and algorithm were completed. Results: The guideline includes 39 recommendations for the care of febrile children in the emergency room. Conclusion: The clinical guidelines developed through this research can be utilized as systematic and scientific guidelines for the care of febrile children in the emergency room. In addition, the research results will contribute to improving care services.

A Survey on Patient's Experience and Perception on Health Care Utilization for Developing of a Korean Medicine Clinical Practice Guideline for Puerperal Wind Disorder (산후풍 한의표준임상진료지침을 위한 환자의 의료 이용 경험 및 인식도 조사)

  • Kwon, Na-Yoen;Kim, Dong-Il;Yoon, Young-Jin;Park, Jang-Kyung
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.35 no.2
    • /
    • pp.54-69
    • /
    • 2022
  • Objectives: The purpose of this study is to reflect the patient's perspective in the process of developing Korean medicine clinical practice guideline (CPG) of puerperal wind disorder by survey. Methods: Five hundred fifty patients were surveyed from November 3rd, 2021 to November 8th, 2021 by internet. This study is an exploratory cross-sectional survey study, and descriptive statistics and frequency analysis were conducted on respondents' general characteristics, postpartum symptoms, the history of using treatment institution for puerperal wind disorder, satisfaction of medical institutions and perception of postpartum care. Results: Survey results showed that 92.0% of respondents experienced symptoms after childbirth, and 56.2% of the symptoms were arthralgia, followed by obesity with 41.8%. Among puerperal wind disorder patients, 34.2% had treatment history, and 54.3% received Korean medical treatment. Treatment satisfaction was confirmed to be higher in Korean medical treatment. The necessity of postpartum care was recognized at 95.7% of respondents, and the performance rate of traditional Korean postpartum care was also high. Conclusions: Based on a realistic patient-centered basis, it is a study that can lay the foundation for standardizing Korean medicine treatment and strengthening coverage in the future.

Comparative Review of Design Guidelines of Hospice Facilities for Establishing Standards (호스피스 시설기준 수립을 위한 디자인 가이드라인 비교연구)

  • Lee, Sukyung;Yoon, Hungjin
    • Journal of The Korea Institute of Healthcare Architecture
    • /
    • v.25 no.1
    • /
    • pp.51-60
    • /
    • 2019
  • Purpose: This study aims to analyze design guidelines for hospice facilities in the US, UK, and Canada focused on design considerations and space requirements, and utilizes them as baseline data for establishing standards for Korean hospice facilities. Methods: Comparative review was carried out to investigate hospice care models, design consideration, and room sizes and requirements for design guideline of hospice facilities in United States, UK and Canada identified on electronic database and review articles, and to examine major characteristics and tendencies of hospice facilities. Results: The hospice care models characteristics in design guidelines is generally largely divided into hospital-based hospice facility, Nursing home-based hospice facility, and daycare hospice. The design considerations in hospice facilities focused on medical efficiency, flexibility, barrier-free environment, person-centered care, and stability. There is also a need for single resident room, rooms for the patient's family, and isolation room for infection control. Implications: it is recommended to establish standards for the installation and operation of required and recommended rooms and considerations when establishing the standards of hospice facilities in Korea. This Study is limited to a simple comparative analysis of the framework of guideline.