• 한국의료질향상학회지
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• 제4권1호
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• 대한간호학회지
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• 제50권4호
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• pp.583-598
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• 2020

Purpose: This study was to investigate the operational status of the midwifery birthing centers (MBCs) and midwives' job status (Phase 1) and to develop midwifery practice guidelines (MPG) (Phase 2) in Korea. Methods: In the first phase, the subjects were 15 midwives who operated 11 of 14 MBCs that were opened as of August 2018. The questionnaire consisted of items to measure the operational status of the MBC and midwives' job status. In the second phase, the MPG was developed from literature review, interviews with five midwives opening their MBCs, surveys with 74 midwives, and a validity evaluation conducted by seven experts. Results: The distribution of operating MBCs was five in Gyunggi-do, two each in Seoul and Incheon, one each in Busan, Chungcheongbuk-do, Gyeongsangbuk-do, Gyeongsangnam-do and Jeju-do. The mean age of midwives was 54.3 and all were female. In 2017, a total of 762 births including 81 homebirths were performed by midwives. The job performance was highest in the order of neonatal care 3.81, childbirth care 3.56, and postpartal care 3.53, respectively. The MPG included seven areas of prenatal care, childbirth care, postpartal care, neonatal care, primary health care, law/ethics, and administration, with 56 tasks and 166 task elements. Conclusion: This study provides the valid basic data for the operational status of the MBC and the midwives' job status. The MPG describes the midwife's job and may be used as basic data for preparing policies for the development of midwifery practice in Korea.

• 한방재활의학과학회지
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• 제29권3호
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• pp.75-85
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• 2019

Objectives This study was perfomed to assess the adherance to CARE (CAse REport) guideline of case reports in the Journal of Korean Medicine Rehabilitation Methods We searched the case reports published in the Journal of Korean Medicine Rehabilitation from January 2016 to April 2019 in the database of oriental medicine advanced searching integrated system (OASIS). Then we evaluated the quality of the searched case reports based on the CARE guideline. Results Totally 31 papers were selected after the screening the case reports by the inclusion and exclusion criteria. The report rate of the sub-items of the CARE guideline was 78.26% at the maximum, 60.87% at the maximum, and 70.97% on the average. The following items were reported only in less than 50% of them; 'Timeline', 'Diagnostic challenges', 'Diagnostic reasoning including other diagnoses considered' 'Prognostic characteristics', 'Follow-up and Outcomes', 'Patient Perspective', 'Informed Consent' Conclusions This study is expected to contribute to the overall improvement of the level of case reports in the Journal of Korean Medicine Rehabilitation.

• 동의신경정신과학회지
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• 제33권2호
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• pp.143-156
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• 2022

Objectives: The purpose of this study was to evaluate the quality of reporting for case reports published in Journal of Oriental Neuropsychiatry from year 2018 to 2021 compared with year 2013 to 2017 in order to recommend ways to improve the quality of case reports published in the future. Methods: To evaluate the quality of case reports identified by electronic searching in Oriental medicine Advanced Searching Integrated System (OASIS) and by hand searching from archives on peer review system of Journal of Oriental Neuropsychiatry using CAse REport (CARE) guideline. The researcher assessed the quality of reporting based on the CARE guideline as 'Sufficient', 'Not-Sufficient', 'Not-Applicable', and 'Not-Reported' for case reports published from 2018 to 2021 in Journal of Oriental Neuropsychiatry. In addition, it was compared with previous case reports published from 2013 to 2017. Results: Finally, 17 case reports were included for the assessment. General quality of reporting for case reports published from year 2018 to 2021 was improved compared with that of previous case reports published in 2018. The maximum value (46.4%→60.7%, 14.3% increase), the minimum value (22.2%→32.1%, 9.9% increase), and the median value (39.3%→50.0%, 10.7% increase) of the report rate evaluated as 'Sufficient' were generally improved. The maximum value (53.6%→50.0%, 3.6% decrease), minimum value (25.9%→21.4%, 4.5% decrease), and median value (35.7%→32.1%, 3.6% decrease) of the report rate evaluated as 'Not-Sufficient', the maximum value of the report rate evaluated as 'Not-reported' (40.7%→25.9%, 14.8% decrease), the minimum value (14.7%→10.7% decrease), and the intermediate value (14.7% decrease) were also generally improved. Four items (8b, 8d, 10c, and 13) were evaluated as 'Not-Reported'. These items seem to be items that need urgent improvement along with 8c, which showed a significant decrease in reporting rate. Conclusions: There are needs to improve the quality of case reports in Journal of Oriental Neuropsychiatry by comparing case reports published from year 2013 to 2017 with case reports published from year 2018 to 2021. To improve the quality of case reporting, sufficient education at the academic level should be provided on thesis preparation methods. It is also necessary to develop a tool for evaluating the quality of case reporting that reflects characteristics of Korean Medicine.

• 임상간호연구
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• 제24권2호
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• pp.209-226
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• 2018

Purpose: This purpose of this study was to develop evidence-based practice guideline for isolation in health care settings to prevent transmission of infectious diseases utilizing guideline adaption process. Methods: The process of guideline adaptation was performed according to the Korean hospital nurses association's guideline adaptation manual which consisted of three main phases, 9 modules, and 24 steps. Results: The adapted isolation guideline consisted of introduction, overview of isolation guideline, summary of recommendations, recommendations, references, and appendices. The guideline includes 224 recommendations in 4 sections which are organizational administration, standard precautions, transmission-based precautions, and education/counselling. Conclusion: The adapted isolation guideline is recommended to be disseminated and utilized by nurses and clinicians nationwide to improve the isolation practices for infected or colonized patients with communicable diseases and to decrease the transmission of infections in the healthcare settings.

• 한국의료질향상학회지
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• 제3권2호
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• pp.70-85
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• 1997

Background : 6.1% of red blood cells and whole blood issued to the operating room was not transfused to the patients and discarded in Seoul National University Hospital in 1994. Objectives : We planned to set up an effective management program of blood in the operating room and we investigated whether this program could reduce the disposal rate of blood. Methods : We made a guideline of blood management in the operating room through a workshop. The guideline was revised after a preliminary application. The revised guideline was applied for 5 months from May to September in 1996. The disposal rate was compared before and after the installation of the new program. Results : 5,336 units of blood were issued to the operating room for 5 months. Disposal rate of red blood cells and whole blood was markedly reduced from 6.2% in May to 2.1% in September(p<0.05). The average disposal rate was 3.7% during the five months. Conclusion : We were able to reduce the disposal of unused blood in the operating room through the development and the application of a new blood management program.

• 임상간호연구
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• 제26권1호
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• pp.75-85
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• 2020

Purpose: The purpose of this study is to develop a nursing salary guideline for Korean hospitals. Methods: Literature review and a mobile survey were conducted regarding staff nurses' salary. Regression analysis and simulation model were applied to develop the nurses' salary guideline. Results: The United Kingdom, Australia, and Germany have standard salary guidelines which demonstrated the standard salary of nurses. These were determined mainly by nursing experience and expertise. The results of the mobile survey indicated that the maximum to minimum ratio of the salary was as high as 4.5 among staff nurses working in Korean hospitals. Two models (exponential and linear) for a standard nursing salary guideline were developed and the simulation results demonstrated an improved salary structure for staff nurses. Conclusion: This developed salary guideline for staff nurses is recommended to be applied in Korean hospitals which provide total nursing care services.

• Journal of Hospice and Palliative Care
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• 제13권2호
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• pp.69-75
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• 2010

Hospice is defined by the National Hospice and Palliative Care Organization (NHPCO, USA) and WHO, as a program of care that provides comprehensive medical, nursing and support services to dying patients and their family. Despite its broad definition, however, hospice care in Korea has been focused mostly on terminal cancer patients. Thus hospice eligibility for patients with advanced cancer is relatively easier to predict than those with other fatal chronic illnesses such as heart, lung, renal or liver diseases, and dementia. This makes it more difficult for patients and families to prepare for death and gain full benefits of hospice care. This article introduces the medical guidelines for selected non-cancer patients who are expected to live for only six months, this making it possible for patients, who are nearing the end of life, to avoid unwarranted suffering.

• 가정∙방문간호학회지
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• 제28권2호
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• pp.164-177
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• 2021

Purpose: The purpose of this study was to develop effective management indicators for improving efficiencies of visiting nursing centers. Method: This was a methodological research study to develop the key performance indicators based on balanced score cards for long-term care visiting nursing centers. The main methods used in this study were literature review, focus group interview, and content validity index. The data analysis was used frequency, percentage, mean, and standard deviation. Results: The common vision of the long-term care visiting nursing centers was identified as "The healthy visiting nursing center to serve high quality cares." Eight action strategies and 15 key performance indicators to achieve this vision were developed. Conclusion: Based on the results of this study, we suggest that the developed balanced score cards will be used as an effective managerial guideline to improve performances of long-term care visiting nursing centers.

• 대한한방부인과학회지
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• 제19권4호
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• pp.117-130
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• 2006

Purpose : We studied to analyze the cognition and realities of postpartum care and to aid the spread of oriental medicine in postpartum care and to get a basic guideline of postpartum care home and K.M.D.'s role model of postpartum care. Methods : We has made questions about the cognition and realities of postpartum care to 2 groups they are puerperants in postpartum care home at Gangdong-gu or Songpa-gu and maiden girls from December 2005 to April 2006. And then we analyzed collected data by using statistics analysis program, SPSS. Results : Almost of 2 group felt sympathy for importance of postpartum care. Puerperants pay postpartum care for without regard to economic state. Essential factors to choice a postpartum care home were sanitary condition and professionalism at taking care of infant and puerperant. 60.4% of puerperants in postpartum care home wanted segregation of infant and puerperant. The reason is for taking rest and lack of confidence at taking care infant. 69.2% of puerperants Would like to taking Herb-medicine for postpartum care. Only 13.4% of puerperants need postpartum care home is operated by K.M.D. Conclusion : It is hard to open postpartum care home by K.M.D. independently. But Puerperants has well-expectation in postpartum care by Korean medicine.