• Title/Summary/Keyword: Clinical Practice Guidelines

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Development of Nursing Practice Guidelines on Enteral Tube Feeding using the Guideline Adaptation Process (간호분야 실무지침의 수용개작 방법론에 따른 경장영양 실무지침의 개발)

  • Cho, Yong Ae;Eun, Young;Gu, Mee Ock;Cho, Myung Sook;Park, Myung Wha;Kim, Kyung Sook;Kim, Jeong Yeun
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.2
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    • pp.147-161
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    • 2014
  • Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

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.

Clinical Practice Guidelines on Pediatric Gastroesophageal Reflux Disease: A Systematic Quality Appraisal of International Guidelines

  • Harris, Jacob;Chorath, Kevin;Balar, Eesha;Xu, Katherine;Naik, Anusha;Moreira, Alvaro;Rajasekaran, Karthik
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.109-120
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    • 2022
  • Purpose: While regurgitation is a common and often benign phenomenon in infants and younger children, it can also be a presenting symptom of gastroesophageal reflux disease (GERD). If untreated, GERD can lead to dangerous or lifelong complications. Clinical practice guidelines (CPGs) have been published to inform clinical diagnosis and management of pediatric GERD, but to date there has been no comprehensive review of guideline quality or methodological rigor. Methods: A systematic literature search was performed, and a total of eight CPGs pertaining to pediatric GERD were identified. These CPGs were evaluated using the Appraisal of Guidelines for Research and Evaluation instrument. Results: Three CPGs were found to be "high" quality, with 5 of 6 domains scoring >60%, one "average" quality, with 4 of 6 domains meeting that threshold, and the remaining four "low" quality. Conclusion: Areas of strength among the CPGs included "Scope and Purpose" and "Clarity and Presentation," as they tended to be well-written and easily understood. Areas in need of improvement were "Stakeholder Involvement," "Rigor of Development," and "Applicability," suggesting these CPGs may not be appropriate for all patients or providers. This analysis found that while strong CPGs pertaining to the diagnosis and treatment of pediatric GERD exist, many published guidelines lack methodological rigor and broad applicability.

Clinical Practice Guidelines of Korean Medicine for Gastric Cancer (위암 치료에 대한 한방 임상 가이드라인)

  • Kim, Hyo-Rin;Jeong, Hye-Ryon;Baek, Dong-Gi;Won, Jin-Hee;Moon, Goo
    • Journal of Korean Traditional Oncology
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    • v.19 no.1
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    • pp.1-24
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    • 2014
  • Objectives : The purpose of this study was to present the clinical guidelines for gastric cancer. Methods : The literature on Western and Oriental medical treatment of gastric cancer were collected, analyzed and summarized from the Google Scholar, KIOM OASIS and PUBMED from 1993 to 2014. Results : Gastric cancer is the second most common cancer in Korea. In recent studies, applying integrative oriental and western medicine can suppress the tumor, improve the survival, the immune system, and the quality of life in gastric cancer. But there isn't still a unified protocol for gastric cancer treatment, so we have difficulty in clinical application. This study will be helpful for understanding and building systems for integrative gastric cancer treatment. Conclusion : Further studies on integrative gastric cancer treatment are needed to improve the survival of gastric cancer patients and build the clinical practice guidelines of gastric cancer.

Development of Clinical Practice Guidelines for Sasang Constitutional Medicine Symptomatology - Purpose, Development Strategy and Procedure - (사상체질병증 임상진료지침 개발 연구 - 목적, 개발 전략 및 절차 -)

  • Kim, Je-Shin;Hwang, Min-Woo;Lee, Jun-Hee;Lee, Eui-Ju;Koh, Byung-Hee;Yoo, Jung-Hee;Bae, Na-Young;Kim, Yun-Hee;Bae, Hyo-Sang;Joo, Jong-Cheon;Park, Hye-Sun;Shin, Mi-Ran;Yoo, Jun-Sang
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.1
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    • pp.23-33
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    • 2013
  • Objectives This study was aimed to develop the clinical practice guidelines, which focuses on Sasang Constitutional Medicine symptomology. By developing clinical practice guidelines, we should present prevention, diagnosis, treatment and assessment of Sasang Constitutional Medicine. Methods We used the method of University of Michigan Health System Guidelines model. Electronic databases including English, Korean databases were systematically searched for clinical articles investigating Sasang Constitutional Medicine symptomology up to March 2010. And "Donguisusebowon-ShinChukbon" was basically used to develop clinical guidelines. Results and Conclusions 12,694 Articles were reviewed. Only 25 articles described adequate methods of this study. Using clinical practice guidelines, we can manage th quality of medicine, emphasis treatment appropriacy and educate patients and doctors. Finally We can get the Sasang Constitutional Medicine standardization and socioeconomic benefit.

Clinical Practice Guideline on Prostate Cancer in Korean Medicine (전립선암 치료의 한방 임상 진료 지침)

  • Song, Bong-Keun;Lee, Eun-Jung;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.1-35
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    • 2016
  • Objectives : The aim of this preliminary study is to suggest a clinical approach on prostate cancer through the analysis of existing clinical practice guidelines or clinical studies. Materials and Methods : The data related on the treatment of prostate cancer were collected using various search engines such as Pub Med, KIOM OASIS, CNKI. Then, data were analyzed to evaluate the validity of recommendation of treatment. Results : Prostate cancer has the highest prevalence around the world. Recently, the incidence of prostate cancer in Korea is rapidly increasing. Especially, it was reported that incidence rate rose up to 80% by age 80 years. In recent studies, applying combined traditional and conventional medicine were reported to improve the survival, quality of life, immune function, and suppress of tumor growth in prostate cancer. However there has not been an objective and systemic clinical guideline for prostate cancer in Korean Medicine. Accordingly, it has been difficult for doctors to apply optimized therapeutic treatment in clinics. This study will show a preliminary approach to establish clinical practice guideline for prostate cancer of Korean Medicine. Conclusion : Further objective and systemic clinical studies by Korean Medicine are needed to develop more advanced clinical practice guidelines of prostate cancer.

The Impacts of Guideline for Digestives on Physicians' Prescription of GI medication (소화기관용약제 처방지침이 의사의 소화기관용약 처방률에 미치는 효과분석)

  • Kim, Dong-Sook;Park, Choon-Seon;Jang, Sun-Mee
    • Korean Journal of Clinical Pharmacy
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    • v.18 no.2
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    • pp.124-131
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    • 2008
  • The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

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Clinical practice guidelines for intraoperative neurophysiological monitoring: 2020 update

  • Korean Society of Intraoperative Neurophysiological Monitoring;Korean Neurological Association;Korean Academy of Rehabilitation Medicine;Korean Society of Clinical Neurophysiology;Korean Association of EMG Electrodiagnostic Medicine
    • Annals of Clinical Neurophysiology
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    • v.23 no.1
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    • pp.35-45
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    • 2021
  • The utility and accuracy of intraoperative neurophysiological monitoring (IONM) has evolved greatly following the recent development of new devices for neurophysiological testing and advances in anesthesiology. Until recently, the need for IONM services has been limited to large academic hospitals, but the demand for neurophysiologists with expertise in IONM has grown rapidly across diverse types of hospital. The primary goal of the Korean Society of Intraoperative Neurophysiological Monitoring (KSION) is to promote the development of IONM research groups and to contribute to the improvement of fellowship among members and human health through academic projects. These guidelines are based on extensive literature reviews, recruitment of expert opinions, and consensus among KSION board members. This version of the guidelines was fully approved by the KSION, Korean Association of EMG Electrodiagnostic Medicine, the Korean Society of Clinical Neurophysiology, the Korean Academy of Rehabilitation Medicine, and the Korean Neurological Association.

Current Guidelines on the Management of Dyslipidemia (이상지질혈증의 국내 및 국외 치료 가이드라인 비교)

  • Choi, Yunjeong;Lee, Song;Kim, Ju Young;Lee, Kyung Eun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.276-283
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    • 2017
  • Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

An Investigation of Current Status of the Clinical Practice Guidelines in Korea (국내 임상진료지침의 개발 현황)

  • Chun, Pusoon;Lee, Young Sook
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.178-186
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    • 2015
  • Objective: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. Method: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. Results: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. Conclusion: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.