• Title/Summary/Keyword: Clinical practice guideline

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Adaptation of Isolation Guidelines for Health Care Settings (수용개작방법을 활용한 의료기관의 격리주의지침 개발)

  • Ryu, Jae Geum;Jeong, Jae Sim;Jeong, Ihn Sook;Kim, Jeong Hye;Hong, Eun-Young;Kim, Hyang Sook;Jung, Young Sun;Kwon, Jeong Soon;Lee, Ji Young;Choi, Ji Youn;Kim, Kyung Sug;Kim, Eun Hyun;Cha, Gyeong Suk;Kim, Eun Jin;Park, Kyung Hee;Seo, Hyun Ju
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.2
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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.

Clinical Preventive Dental and Dental Hygiene Practice by Caries Management by Risk Assessment (CAMBRA) (Caries Management by Risk Assessment (CAMBRA) 모형에 따른 임상 예방치과 및 치위생 진료)

  • Cho, Young-Sik
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.545-557
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    • 2012
  • Dental caries is biofilm induced disease throughout life and is recognized significant oral health problem. This article reviewed new trends in dental caries management by risk assessment, including history, protocol/guideline, and collaborated model. Dental caries prevention and treatment according to caries management by risk assessment (CAMBRA) model is patient-centered, risk-based, evidence-based practice. Team approach is necessary and clinician need to integrate science, practice and product. Dental hygienist take a important role in implementing CAMBRA. CAMBRA model could be incorporated into clinical dental hygiene education based on dental hygiene process of care as standard of dental hygiene practice and education. Dentist and dental hygienist able to provide scientific and ethical care managing dental caries by risk assessment.

International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy

  • Seung Joo Kang;Chung Hyun Tae;Chang Seok Bang;Cheol Min Shin;Young-Hoon Jeong;Miyoung Choi;Joo Ha Hwang;Yutaka Saito;Philip Wai Yan Chiu;Rungsun Rerknimitr;Christopher Khor;Vu Van Khien;Kee Don Choi;Ki-Nam Shim;Geun Am Song;Oh Young Lee
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.141-157
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    • 2024
  • Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

Appraisal of Clinical Practice Guidelines of Temporomandibular Disorders Using AGREE II (Appraisal of Guidelines for Research & Evaluation II) (AGREE II를 이용한 턱관절 장애의 국내외 기개발 임상진료지침의 평가)

  • Yoon, Ye-Ji;Park, Hye-Sung;Kim, Hyungsuk;Jeon, Junyung;Park, Jae-Hyun;Shin, Woochul;Kim, Seyoon;Bae, Jun-hyeong;Yun, Jung-min;Kim, Koh-Woon;Ha, In-Hyuk;Lee, Yoon-Jae;Kim, Me-riong;Song, Mi-Yeon;Cho, Jae-Heung
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.4
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    • pp.67-74
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    • 2017
  • Objectives This study is aimed to identify and evaluate the already developed clinical practice guidelines (CPGs) of temporomandibular disorders (TMD) and contribute to making decisions in developing Korean medicine CPG of TMD. Methods We searched electronic database and selected CPGs of TMD according to the inclusion and exclusion criteria. Then, we made appraisal of selected CPGs by using AGREE II (Appraisal of Guidelines for Research & Evaluation II). Results Four CPGs are included and appraised with AGREE II. Among 6 domains of AGREE II, all CPGs failed to score over 60% in four domains. Only one CPG mentioned acupuncture as an adjunctive treatment for myofascial TMD. Conclusions It is difficult to indicate that included CPGs are with sufficient quality to recommend and it appears not to be appropriate to apply these already developed CPGs in Korean medicine clinical fields. Therefore, developing a new Korean medicine clinical practice guideline of TMD is required.

Clinical Pathway Verification through Process Mining

  • Jung, Jong-Duk;Kim, Suk-Hoon;Yeo, Hyun-Jin
    • Journal of the Korea Society of Computer and Information
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    • v.23 no.4
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    • pp.115-120
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    • 2018
  • A Clinical Pathway(CP) is standard process to way of treat diseases or injuries which is adapted to each hospital based on National Clinical Practice Guideline(CPG). Since CP is standard guideline for doctors and nurses working in a hospital, making and modifying CP is one of the most important administrational work for hospital and also rare work because once it is fixed, it's not changed whether there are new kind of disease discovered or new treatment is developed. However, in present, patient's waiting time during hospital residence process, is discussed as service competitive for patients. In this research, we utilize process mining tool to verify patients treatment process follows CP with EMR(Electronic Medical Record) in a sample hospital, and suggest modifcation point of CP through verification.

Development of the Nursing Practice Guideline for Pain Management according to the Guideline Adaptation Process (간호 분야 실무지침의 수용개작 방법론에 따른 통증간호 실무지침의 개발)

  • Eun, Young;Yu, Mi;Gu, Mee Ok;Cho, Yong Ae;Kim, Kyung Sook;Kim, Tae Hee;Lee, Hyun Hee;Jeon, Mi Jin
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.1
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    • pp.1-14
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    • 2019
  • Purpose: This study was done to develop a evidence-based guideline for pain assessment and management in Korea by adapting previously developed pain guidelines. Methods: The guideline adaptation process was conducted using 24 steps according to the guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed pain management guideline consisted of 9 domains and 234 recommendations. The number of recommendations in each domain was: 13 general instruction items, 51 pain assessments, 14 pain interventions, 66 pharmacological interventions for acute pain, 41 pharmacological interventions for chronic cancer pain, 35 pharmacological interventions for chronic noncancer pain, 21 non-pharmacological interventions, 2 documentations, 10 nursing education items, for pain. Conclusion: The findings suggest that the new pain management guideline can be used to address pain in hospital settings.

A Clinical Practice Guideline for Ma-huang(Ephedra sinica) Prescription in Obesity (비만치료 및 체중감량에서의 적절한 마황 사용에 대한 임상 진료지침 개발)

  • Kim, Ho-Jun;Han, Chang-Ho;Lee, Eui-Ju;Song, Yun-Kyung;Shin, Byung-Cheul;Kim, Yun-Kyung
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.2
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    • pp.27-37
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    • 2007
  • Background Clinical practice guidelines (CPG) are systematically developed statements to assist practitioners and patients on healthcare decisions. They provide recommendations for the average patient, which should take into account individual clinical judgment and the patient's values and expectations. Ephedra has sympathomimetic effect and has been used for weight loss worldwide. However, its safety is controversial especially in autonomic and cardiovascular systems. Therefore, the need of appropriate CPG for ephedra prescription in obesity was advocated in Korean Traditional Medicine. Methods The committee comprised of specialists of obesity, oriental herbology, oriental cardiology, constitutional medicine. The committee collected all relevant references about adverse effect and safety of ephedra in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study and observational study from international and domestic databases and paper journals. 11 English- and 5 Korean-language references were gathered and categorized by PICO (Patient, Intervention, Comparison, Outcome) method. We could not complete strength of recommendation which should be clarified according to the evidence grade estimation. Result The first version of CPG for ephedra prescription in obesity was issued by Korean Oriental Association for Study of Obesity. It includes topics of introduction, pharmacokinetics, side effects and adverse events, constitutional aspect and recommendations for dose, indication and contraindication. Conclusion There should be periodic upgrade of this CPG from now on. Although there are some drawbacks in this version of CPG, it has significance as the first CPG in Korean Traditional Medicine.

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Hip and Finger Degenerative Arthritis Case Series Protocol for Applying Korean Medicine Clinical Pathway (퇴행성관절염(고관절, 수지관절염) 한의표준임상경로 적용연구 프로토콜)

  • Suzy Han;Yejin Hong;Dongwoo Nam;Jeongrok Kim;Changwoo Seon;Seojeong Ha;Minjeong Kim
    • Korean Journal of Acupuncture
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    • v.41 no.1
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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.

Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology

  • Jung, Pil Young;Yu, Byungchul;Park, Chan-Yong;Chang, Sung Wook;Kim, O Hyun;Kim, Maru;Kwon, Junsik;Lee, Gil Jae;Korean Society of Traumatology (KST) Clinical Research Group
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.1-12
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    • 2020
  • Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

Nurses' Perception and Practice of Fluid Intake and Output Measurement (간호사의 수분 섭취배설량 측정에 대한 인식도와 수행도)

  • Kang, Nam-Yi;Ahn, Sukhee
    • Journal of muscle and joint health
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    • v.23 no.2
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    • pp.84-94
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    • 2016
  • Purpose: This research aimed to identify levels of nurses' perception and practice of fluid intake and output (I & O) measurement and to explore the relationship between perception and practice of it. Methods: Using a cross-sectional survey design, 195 nurses who practiced fluid I & O measurement were recruited from a general hospital. Nurses who agreed to participate in this study completed a structured study questionnaire to assess their levels of perception and practice of fluid I & O measurement. Results: A level of perception of I & O measurement was high (3.46 points out of 5), and scores for 3 subdomains of I & O (importance, accuracy, and efficacy) were evenly high. The level of practice of I & O was fairly high (3.76 points out of 5). Perception and practice of I & O were highly correlated (r=.73, p<.001). Conclusion: Nurses seem to have higher levels of perception and do practice fluid I & O measurement correctly. In order to have reliable and valid I & O measures, nurses need to have continuous education on I & O measurement based on clinical guideline to utilize it as an invaluable clinical instrument.