• Title/Summary/Keyword: Clinical Practice Guidelines

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A Study on the In-Patients' Experiences of Informed Consent (사전동의(Informed Consent)에 관한 입원환자의 경험)

  • Yoo, Myung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.2
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    • pp.255-264
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    • 2006
  • Purpose: This study was carried out to understand the in-patients' experiences related on informed consent for examination, treatment or surgery. Method: The study was conducted with 578 patients who were admitted to the departments of internal medicine and surgery for examination, treatment or surgery requiring informed consent from November 1 to 30, 2004 at three general hospitals in Daegu, Busan and Gyeongsangbuk-do. The data was analyzed by using SPSS 11.5 for Windows. Results: Although the one who explains during the process of informed consent should be doctors, 6.6% was informed by nurses or others. In addition, the majority has been told for complications and risk while relatively fewer patients were informed for necessity, method and costs of the procedure, and no one ever heard of other alternatives or the right to terminate the procedure at any time. While 40% of patients were not the final decision-makers of examination, treatment or surgery, 11.9% of patients answered their opinions were not considered during the final decision-making process. Conclusion: The study suggest that the ethically appropriate informed consent has not been achieved in the clinical practice, and therefore it is necessary to develop the specific behavioral guidelines and nursing ethics education program for nurses in order to settle down the desirable informed consent at the dimension of nursing management.

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United Kingdom pediatric dentistry specialist views on the administration of articaine in children

  • Ezzeldin, Maryam;Hanks, Gemma;Collard, Mechelle
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.303-312
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    • 2020
  • Background: Lidocaine is the gold standard local anesthetic (LA) for UK pediatric dental treatment. Recent reports suggest frequent Articaine use in Europe and Canada, with evidence indicating more profound anesthesia. The aim of this study was to examine pediatric dentistry specialist experiences and practices relating to Articaine administration in the UK. Methods: A literature review was followed by a survey using an anonymous 15-item electronic questionnaire, which was sent to 200 registered British Society of Pediatric Dentistry (BSPD) specialists. Descriptive analyses, Z score, chi-squared test, Fisher's exact test, and Spearman's correlation test were performed. Results: Sixty-one (30.5%) participants responded, and 12 (19.7%) indicated Articaine as their first line anesthetic. Articaine was used daily or weekly by 38 (62.3%) respondents, depending on the clinical context. Articaine was commonly used to avoid inferior alveolar nerve blocks and gain more profound anesthesia in abscessed or hypomineralized teeth. Participants reported significantly more adverse effects with lidocaine (Fisher's exact test, P < 0.0001) than with Articaine. Articaine was most often administered in children aged > 4 years via infiltration techniques. Only 15 (24.6%) respondents reported awareness of guidelines for Articaine use in pediatric patients. Conclusions: Articaine use in pediatric dentistry is common; however, evidence supporting its practice is limited. Several specialists follow conventions based on anecdotal evidence. Formulating guidance to aid decision-making when treating pediatric patients under LA would be beneficial.

Common viral infections in kidney transplant recipients

  • Vanichanan, Jakapat;Udomkarnjananun, Suwasin;Avihingsanon, Yingyos;Jutivorakool, Kamonwan
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.323-337
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    • 2018
  • Infectious complications have been considered as a major cause of morbidity and mortality after kidney transplantation, especially in the Asian population. Therefore, prevention, early detection, and prompt treatment of such infections are crucial in kidney transplant recipients. Among all infectious complications, viruses are considered to be the most common agents because of their abundance, infectivity, and latency ability. Herpes simplex virus, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, hepatitis B virus, BK polyomavirus, and adenovirus are well-known etiologic agents of viral infections in kidney transplant patients worldwide because of their wide range of distribution. As DNA viruses, they are able to reactivate after affected patients receive immunosuppressive agents. These DNA viruses can cause systemic diseases or allograft dysfunction, especially in the first six months after transplantation. Pretransplant evaluation and immunization as well as appropriate prophylaxis and preemptive approaches after transplant have been established in the guidelines and are used effectively to reduce the incidence of these viral infections. This review will describe the etiology, diagnosis, prevention, and treatment of viral infections that commonly affect kidney transplant recipients.

Healthcare Considerations for Special Populations during the COVID-19 Pandemic: A Review

  • Kim, Jeung-Im;Im, YeoJin;Song, Ju-Eun;Jang, Sun Joo
    • Journal of Korean Academy of Nursing
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    • v.51 no.5
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    • pp.511-524
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    • 2021
  • The coronavirus disease 2019 (COVID-19) has emerged as a threat to human health and public safety. People of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 infection. However, the clinical manifestations of this infection differ by age. This study purposes to describe healthcare considerations for special populations, such as children, pregnant and lactating women, and older adults, who may have unique healthcare needs, in the pandemic situation. To realize the research purpose, we conducted a review of the practice guidelines of public documents and qualified studies that were published online/offline during a specific period. The review identified current knowledge on care for newborns, children in schools, pregnant women (from antenatal to postpartum care), and older adults suffering from high-risk conditions. Subsequently, we summarize vaccination guidance for special populations and, finally, discuss the issues currently affecting special populations. Therefore, this current knowledge on care for special populations helps nurses to provide accurate information on vaccinations aimed at preventing COVID-19 and protecting the masses from infection. Currently, the scarcity of information on COVID-19 variants necessitates further research on measures to reduce pandemic spread.

History of Radiation Therapy Technology

  • Huh, Hyun Do;Kim, Seonghoon
    • Progress in Medical Physics
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    • v.31 no.3
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    • pp.124-134
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    • 2020
  • Here we review the evolutionary history of radiation therapy technology through the festschrift of articles in celebration of the 30th anniversary of Korean Society of Medical Physics (KSMP). Radiation therapy technology used in clinical practice has evolved over a long period of time. Various areas of science, such as medical physics, mechanical engineering, and computer engineering, have contributed to the continual development of new devices and techniques. The scope of this review was restricted to two areas; i.e., output energy production and functional development, because it is not possible to include all development processes of this technology due to space limitations. The former includes the technological transition process from the initial technique applied to the first model to the latest technique currently used in a variety of machines. The latter has had a direct effect on treatment outcomes and safety, which changed the paradigm of radiation therapy, leading to new guidelines on dose prescriptions, innovation of dose verification tools, new measurement methods and calculation systems for radiation doses, changes in the criteria for errors, and medical law changes in all countries. Various complex developments are covered in this review. To the best of our knowledge, there have been few reviews on this topic and we consider it very meaningful to provide a review in the festschrift in celebration of the 30th anniversary of the KSMP.

Acute aortoiliac thrombosis in minimal change disease

  • Soyoung Lee;Hwarim Kang;Jongho Shin;Kyeong Min Kim
    • Journal of Medicine and Life Science
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    • v.19 no.3
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    • pp.125-129
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    • 2022
  • Patients with nephrotic syndrome (NS) are generally known to be at greater risk for thrombosis, with arterial thrombosis-related complications being relatively rare compared to venous thrombosis-related complications. This report describes a 46-year-old male with historically proven minimal change disease (MCD) complicated by acute aortoiliac thrombosis. He had been diagnosed with MCD 8 months previously and was treated successfully with steroids. He was prescribed a second course of high-dose steroids (prednisolone 1 mg/kg/day) due to a relapse of MCD at the outpatient clinic 8 days before the emergency department visit. The patient presented with severe pain in both lower limbs and was diagnosed with aortoiliac thrombosis that developed during high-dose steroid treatment. He subsequently underwent surgical thromboembolectomy. Hypoalbuminemia has the strongest association with the risk of thromboembolism. According to international clinical practice guidelines, anticoagulant therapy is recommended when serum albumin is ≤2-2.5 g/dL. However, as serum albumin levels may be relatively high in the early phase of NS, as in this case report, an individualized anticoagulation strategy for each patient should be considered, regardless of serum albumin levels.

A Trend Analysis on the Qualitative Research of Dental Hygiene in Korea (2000~2023)

  • An-Na Yeo;Yang-Keum Han
    • Journal of dental hygiene science
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    • v.24 no.3
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    • pp.160-170
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    • 2024
  • Background: This study aimed to analyze trends in qualitative research within the field of dental hygiene, focusing on papers published in Korean journals from 2000 to 2023. As dental hygienists play a crucial role in preventive oral health, understanding the breadth and depth of qualitative research in this field is essential for advancing practice and education. Methods: This descriptive survey research study analyzed 23 qualitative studies using the Consolidated Criteria for Reporting Qualitative Research (COREQ) as a framework. Studies were selected through a comprehensive search of Korean databases. The analysis covered research topics, participant types, methodological approaches, and adherence to COREQ domains, including "Research Team and Reflexivity," "Study Design," and "Analysis and Findings." Results: The analysis revealed that most studies employed a phenomenological methodology (36.4%). Additionally, 87.0% of the studies mentioned Institutional Review Board (IRB) approval and only 8.7% utilized qualitative data analysis software. The studies primarily focused on oral care for the elderly, communication, and the experiences of dental hygienists. Furthermore, 95.7% of the studies included participant quotations, but only 56.5% checked data saturation. Conclusion: This study highlights the need for a more diverse methodological approach in dental hygiene research. Journals should also emphasize strict adherence to IRB guidelines and encourage the use of qualitative data analysis software to enhance the rigor of research. By strengthening the systematic foundation of qualitative research in dental hygiene, the field can better address clinical challenges and expand the understanding of dental hygienists' work environments.

Comparative Study of ISO Standards for an Effective Implementation of the Domestic Medical Device GMP System (ISO 국제표준의 비교 연구를 통한 국내 의료기기 GMP 제도의 효과적인 운영 방안)

  • Jung, Young A;Kim, Young Jin
    • Journal of Korean Society for Quality Management
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    • v.46 no.2
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    • pp.211-224
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    • 2018
  • Purpose: It can easily be understood that more rules and regulations need to be imposed on the medical device industry due to its impact on public health and hygiene. Domestic medical device manufacturers are thus required to comply with the requirements specified in the good manufacturing practice (GMP) system, and it is essential to abide by the international standards as well to sustain their global competitiveness. The main purpose of this study is to review the guidelines of the medical device GMP system in Korea and propose future directions for further enhancement of the GMP system. Methods: Specific requirements prescribed in international standards, such as ISO 9001:2015, ISO 13485:2016, ISO 14971:2012, and ISO 14155:2011, are analyzed and compared with the domestic GMP system. Results: It has been observed that the generic international standard related to quality management system, ISO 9001:2015, lays out the foundations for the development of quality management system relevant to medical device industry, ISO 13485:2003, with which the domestic GMP system is fully compatible. Further, several important aspects of risk management and clinical trials of medical devices are also recognized and included in the domestic medical device GMP system. Conclusion: Even though specific requirements of individual ISO standards are slightly different from each other, their overall structure and framework may contribute to the development and enhancement of globally competitive GMP system of the domestic medical device industry.

Nutritional education for management of osteodystrophy (NEMO) trial: Design and patient characteristics, Lebanon

  • Karavetian, Mirey;Abboud, Saade;Elzein, Hafez;Haydar, Sarah;de Vries, Nanne
    • Nutrition Research and Practice
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    • v.8 no.1
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    • pp.103-111
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    • 2014
  • This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake ($58.86%{\pm}33.87%$ of needs) yet adequate dietary P intake ($795.52{\pm}366.94$ mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.

Development of Indwelling Urinary Catheterization Guideline by Adaptation Process (수용개작방법을 활용한 유치도뇨 간호실무지침 개발)

  • Jeong, Ihn Sook;Jeong, Jae Sim;Seo, Hyun Ju;Lim, Eun Young;Hong, Eun-Young;Park, Kyung Hee;Jung, Young Sun;Choi, Eun Kyoung;Park, Hee Youn;Park, Sun-A
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.1
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    • pp.31-42
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    • 2015
  • Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.