• Korean Journal of Acupuncture
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• 제41권1호
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• pp.1-6
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• 2024

Objectives : The aim of this study is to set out case series study protocol to complete clinical pathway (CP) of hip and finger degenerative arthritis by applying CP, based on Korean medicine clinical practice guideline developed by clinical experts, to clinical field. Methods : The treatments included Manual acupuncture, acupoint injection, electroacupuncture, laser acupuncture, cupping, moxibustion, chuna, and physiotherapy. They were conducted in the 2nd week of admission and 4th week of out patient department (OPD) days. We carried out 10-point Likert scale questionnaires on the clinical usefulness and the satisfaction of patients and staff after applying CP. Appropriateness and improvement on patients were conducted using a 10-point Likert scale. An open-ended questionnaire was also conducted to ask if there was any requirement to be added. Results : In past research studies, there were no related studies about Korean medicine CP on hip and finger degenerative arthritis. Final version of CP is going to be completed based on the questionnaire. Conclusions : This evidence-based case series study protocol is expected to contribute development of hip and finger degenerative arthritis.

• 기본간호학회지
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• 제20권4호
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• pp.345-358
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• 2013

Purpose: The purpose of this study was to develop a protocol that would help prevent accidents, apply physical restraints properly, and reduce the use of physical restraints in nursing homes. Method: A review of the literature and analysis of existing statutes and regulations were used to develop the preliminary protocol. To test the validity of this preliminary protocol, ten experts were selected from academia and clinical practice to review the protocol. The initial protocol was finalized after it had been reviewed by experts and tested for clinical validity in five different nursing homes. Result: The protocol consists of objectives, definitions and accident probability assessment, principle of using physical restraints, monitoring and documentation of physical restraints. Conclusion: The findings of this study can be used as guidelines to focus on preventing accidents arising out of use of physical restraints, assessing the probability of accidents, and reducing the use of physical restraints through preventive interventions. This will be helpful to prevent ethical, physical, or psychological problems arising from use of physical restraints and to protect the rights of elderly people in nursing homes.

• 임상간호연구
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• 제29권1호
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• pp.75-84
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• 2023

Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion: This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

• Journal of Korean Biological Nursing Science
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• 제19권2호
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• pp.86-97
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• 2017

Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

• Clinical and Experimental Reproductive Medicine
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• 제49권2호
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• pp.135-141
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• 2022

Objective: This study investigated the impact of two stimulation protocols using highly purified human menopausal gonadotropin (HP-hMG) on the endocrine profile, follicular fluid soluble Fas levels, and outcomes of intracytoplasmic sperm injection (ICSI) cycles. Methods: This prospective clinical trial included 100 normal-responder women undergoing ovarian stimulation for ICSI; 55 patients received concomitant follicle-stimulating hormone (FSH) plus HP-hMG from the start of stimulation, while 45 patients received FSH followed by HP-hMG during mid/late follicular stimulation. The primary outcome was the number of top-quality embryos. The secondary outcomes were the number and percentage of metaphase II (MII) oocytes and the clinical pregnancy rate. Results: The number of MII oocytes was significantly higher in the concomitant protocol (median, 13.0; interquartile range [IQR], 8.5-18.0 vs. 9.0 [8.0-13.0] in the consecutive protocol; p=0.009); however, the percentage of MII oocytes and the fertilization rate were significantly higher in the consecutive protocol (median, 90.91; IQR, 80.0-100.0 vs. 83.33 [75.0-93.8]; p=0.034 and median, 86.67; IQR, 76.9-100.0 vs. 77.78 [66.7-89.9]; p=0.028, respectively). No significant between-group differences were found in top-quality embryos (p=0.693) or the clinical pregnancy rate (65.9% vs. 61.8% in the consecutive vs. concomitant protocol, respectively). The median follicular fluid soluble Fas antigen level was significantly higher in the concomitant protocol (9,731.0 pg/mL; IQR, 6,004.5-10,807.6 vs. 6,350.2 pg/mL; IQR, 4,382.4-9,418.4; p=0.021). Conclusion: Personalized controlled ovarian stimulation using HP-hMG during the late follicular phase led to a significantly lower response, but did not affect the quality of ICSI.

• Journal of Acupuncture Research
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• 제24권1호
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• pp.127-135
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• 2007

Objectives: To evaluate the methodological quality of Korean Acupuncture Clinical trials Methods : Two independent researchers reviewed 12 protocols of Acupuncture clinical trials which were conducted in Korea 2006. Also, Survey Principal Investigator of those was conducted. We compare the results of protocol review with investigator reponses of actual practice. Quality assessment consisted of 5 items including random sequence generation, randomization method, allocation concealment, subject blinding, assessor blinding. Results : Randomization was performed using the proper procedure to insure that treatment assignment is unbiased and concealed from subjects in all clinical trials, According to protocols, 6(50%) of 12 clinical trials used computer-generated random numbers, 6(50%) remaining trials didn't describe the randomization method. Also all trials used appropriate randomization methods on the basis of the survey results: 8 trials used computer-generated random number, 2 used random table. Of 7 protocols in which allocation concealment was stated, 5(71%) reported appropriate method (Calling a central office or statisticians, Sealed opaque envelopes). However according to survey, 5(42%) of 12 trials used inappropriate allocation concealment (Keeping a master randomization list and referring to when subject entered the trial). In addition, the result of protocol review and survey response was not coincident in 5(42%) trials. Subject blinding was conducted in all except 1 clinical trials. Although 11(92%) of 12 trials were conducted using assessor blinding in actual practice, only 7(58%) reported that in protocol. Conclusion : Although randomization and blinding were conducted adequately, allocation concealment was used inadequately, Not only appropriate allocation concealment, but also every quality assessment item including randomization, blinding should be stated in more detail in protocol.

• 한국지능시스템학회논문지
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• 제20권1호
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• pp.66-75
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• 2010

유비쿼터스 서비스 인프라의 확충에 따라 헬스케어 분야가 중요한 서비스 영역으로 주목받고 있다. 유비쿼터스 헬스케어는 서비스의 실현에 있어서 의료종사자뿐만 아니라 환자 및 환자보호자의 역할이 요구되고, 또한 정보 인프라에서의 지원도 필수적이다. 의료서비스의 정형화 및 품질보증을 위해서 의료분야에서는 임상 프로토콜을 정의하고 이를 임상에 적용하고 있다. 유비쿼터스 환경에서의 의료 서비스 품질을 보증하기 위해서는 마찬가지로 임상 프로토콜을 활용하는 것이 필요하다. 유비쿼터스 헬스케어 서비스에는 의료종사자 뿐만아니라 환자 및 환자보호자, 정보 시스템이 각자의 고유 역할을 하는 것이 요구된다. 이러한 유비쿼터스 헬스케어 서비스에서의 요구사항을 만족하면서 임상프로토콜을 효과적으로 개발할 수 있도록 하는 유비쿼터스 헬스케어 임상 프로토콜을 개발하는 방법을 소개한다. 제안된 방법은 헬스케어 참여자별 태스크들을 명확히 식별하도록 하면서, 태스크간의 관계를 명확히 하도록 하여 가시화가 가능하도록 한다. 개발된 방법론은 유비쿼터스 환경에서 과민성방광 환자관리를 위한 임상 프로토콜을 개발하는데 적용하여 적용가능성을 확인했다.

• 한방재활의학과학회지
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• 제32권4호
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• pp.73-82
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• 2022

Objectives The purpose of this study is to develop a case study protocol to complete final version of Korean medicine clinical pathway (CP) by applying Korean medicine CP based on carpal tunnel syndrome Korean medicine clinical practice guidelines developed by clinical experts to clinical field. Methods After applying previously developed CP, 10-point Likert scale questionnaires on satisfaction of CP, appropriateness and improvement on out patient department (OPD) treatments are carried out in the 2^nd week of OPD treatment. An open-ended questionnaire is also carried out to ask if there is any requirement to be added or improved among CP interventions. Results Final version of CP is going to be completed based on the questionnaire, excluding articles of which average or median value is less than 5 from 10-point Likert scale. Conclusions This evidence-based case study protocol is expected to contribute development of carpal tunnel syndrome clinical pathway.

• 중환자간호학회지
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• 제8권2호
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• pp.1-12
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• 2015

Purpose: The study sought to determine the state of blood glucose control, and the consequent clinical effects and variation in blood glucose level, of adult patients admitted to intensive care units following cardiothoracic surgery by comparing the blood glucose levels before and after the application of a blood glucose control protocol. Methods: The protocol was developed by modifying and supplementing the Yale protocol, and was first used in 2012. The resulting blood glucose data of an experimental group (n = 314), to which the blood glucose control protocol had been applied, and a control group (n = 347), whose blood glucose levels had been controlled according to physicians'prescriptions without the protocol, were collected through the medical records. Results: The target blood glucose ratio increased significantly in the experimental group, and the low blood glucose ratio decreased significantly in the experimental group. The two groups exhibited a significant difference (p < .001) in the degree of variation in the blood glucose levels. The duration of the use of a ventilator was significantly reduced in the experimental group (p < .001). Conclusion: It is expected that the protocol can be used for the safe and effective control of critically ill cardiothoracic surgery patients' blood glucose levels.

• 성인간호학회지
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• 제25권3호
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• pp.250-262
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• 2013

Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.