• Title/Summary/Keyword: Clinical practice guideline

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Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm (소음인체질병증 임상진료지침: 진단 및 알고리즘)

  • Lee, Jun-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.11-26
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Soeumin Symptomatology diagnosis and algorithm. For developin diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Soeumin Symptomatology Results & Conclusions We classified the Soeumin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern, initial-intermediate-advanced pattern. And at the unfavorable pattern, ordinary symptom is very important. So Doctors focuss on the symptom of unfavorable's ordinary symptom such as temperament inclined symptom, excessive sweating, diarrhea, and vexation.

Updates of Evidence-Based Nursing Practice Guidelines for Central Venous Infusion Therapy (근거기반 중심정맥 주입요법 간호실무지침 개정)

  • Lim, Kyung Choon;Jeong, Jae Sim;Kim, Kyeong Sug;Kim, Hyun Lim;Kim, Hyun Jeong;Kim, Dong Yeon;Lee, Mi Jeong;Lee, Joohyun
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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    • pp.42-55
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    • 2023
  • Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

The Current State of Clinical Practice Guidelines on Complementary and Alternative Medicine in Paediatrics in Countries except East Asia (동아시아를 제외한 국가에서 보완대체의학 중재를 포함한 소아 대상 임상진료지침의 현황 보고)

  • Shim, Soo Bo;Lee, Ju Ah;Lee, Hye Lim
    • The Journal of Pediatrics of Korean Medicine
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    • v.34 no.2
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    • pp.75-85
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    • 2020
  • Objectives Although clinical practice guidelines (CPGs) are becoming crucial in medical decision-making worldwide, there are very few development guidelines for children. Therefore, this preliminary study aimed to assess the status of worldwide except east asia-CPGs recommending complementary and alternative medicine interventions (CAM-i) in children worldwide except east asia in order to help developing Korean medicine CPGs (KMCPGs) for children. Methods To identify the current status of CPGs including CAM-i that have been developed so far, the author searched the related databases, and selected CPGs for children. The data related to the status of evidence-based CPGs, the materials related to the characteristics of CAM-i, and the details of recommendations for CAM-i were selected from the obtained findings. Results A total of 106 CPGs were identified based on the searches, of which 11 were finally selected as pediatric CPGs. These pediatric CPGs have been developed since 2007 to target various diseases. The countries developing these CPGs include the United Kingdom, Scotland, Australia, and the United States, with the U.K. having the largest share. The majority of CPGs used MEDLINE, Embase, and Cochrane library as databases. The most frequently recommended topic was acupuncture, followed by herbal medicine. Many CPGs suggested that more research was needed. Conclusions Through this study, the author was able to identify the characteristics of the developed pediatric CPGs that include CAM-i. More preceding studies are needed for the development of pediatric KMCPGs. It is hoped that this report can be used as the foundation for future development of pediatric KMCPGs.

Conventional Western Medicine and Complementary and Alternative Medicine on Leg Cramps: A Literature Review (하지 근경련에 대한 기존 양방적 치료와 보완대체요법: 문헌조사)

  • Kwon, Chan-Young;Lee, Boram;Cho, Jae-Heung
    • The Journal of Korean Medicine
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    • v.38 no.3
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    • pp.13-29
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    • 2017
  • Objectives: The objective of this review is to investigate the use of conventional Western medicine (WM) and complementary and alternative medicine (CAM) on leg cramps. Leg cramps are the occurrence of muscular spasm in the leg muscles which occur frequently in the elderly and are frequently observed in the clinical field. Methods: Relevant clinical studies were searched from five medical databases including PubMed, KISS, RISS, OASIS, and J-STAGE. Systematic review, clinical studies, and clinical practice guideline were included in this review. Results: In total, 27 clinical studies, 9 systematic review and meta-analysis, and 1 clinical practice guideline met the inclusion criteria. Included studies were classified and analyzed according to the type of intervention. Studies on quinine and magnesium have been most studied in WM and CAM, respectively. Although quinine shows some clinical effects on leg cramps, however, the risk of side effects are suggested. In addition, magnesium failed to improve the clinically significant effects in most studies. Five case reports using Oriental herbal medicine (OHM) were included and OHMs were effective in improving leg cramps without side effects, however, the quality of evidence was low. Clinical studies on other interventions were lacking. Conclusions: The results of this study indicate that there is no definite treatment standard for leg cramps until now, and there are limitations such as low level of evidence and side effects for each treatment. OHM can be an effective alternative to conventional intervention on leg cramps, therefore, related clinical studies are needed.

Clinical Practice Guideline for Korean Medicine for Ovarian Cancer (난소암 치료에 대한 한의 임상 가이드라인)

  • Kim, Kyung-Soon;Choi, Hong-Sik;Kim, Seung-Mo;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.37-50
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    • 2016
  • Ovarian cancer is the tenth most common cancer in Korean female, and the third most common cancer of female reproductive organ after breast cancer and uterine cervical cancer. In spite of develop of conventional treatment, high modality of ovarian cancer comes from difficulty of an early diagnosis. Recent studies revealed that combining conventional and integrative medical treatment can reduce the adverse effect of surgical operation, chemotherapy and radiotherapy. Also it can improve survival rate, quality of life. However there isn't still a systemic clinical protocol for ovarian cancer in Korean medicine. This study will be helpful to establish clinical practice guidelines of Korean Medicine for ovarian cancer. And further studies on integrative ovarian cancer treatment are needed to build the clinical practice guidelines of ovarian cancer.

Moving towards Evidence-Based Clinical Practice Guidelines

  • Jung, Jae Hung;Franco, Juan VA;Dahm, Philipp
    • Urogenital Tract Infection
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    • v.13 no.3
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    • pp.45-50
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    • 2018
  • The Institute of Medicine in its report "Clinical Practice Guidelines we can trust" defined standards for clinical practice guidelines. However, many guidelines continue to rely on expert opinion and lack a formal framework for moving from evidence to recommendations. These guidelines may or may not be labeled as "consensus statements" and do not meet contemporary standards for guideline documents we would refer to as "evidence-based". Therefore, the Grading of Recommendations Assessment, Development and Evaluation working group developed a novel, rigorous and transparent approach to grading certainty (quality) of evidence. In addition, it created a system for "moving from evidence to decisions", for example for the development of evidence-based guidelines. In this article, we aim to introduce this approach to appraising the certainty of relevant evidence and estimate the benefits and detriments of health care interventions within the larger context of evidence-based medicine.

Development of Nursing Handoff Practice Guideline and Standards for Korean Hospital (국내병원 간호사의 인수인계 실무표준, 표준지침 및 표준화된 항목 개발에 대한 연구)

  • Kim, Eun Man;Yu, Mi;Lee, Hyang Yuol;Ko, Ji Woon;Cho, Eui Young;Kim, Eul Soon
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.1-14
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    • 2014
  • Purpose: Addressing current status of nursing handoff provides information as to where to change practice for improvement in patient care. The aim of this study was to develop nursing a handoff practice guideline and standardsfor Korean hospitals. Methods: A questionnaire was used to collect data in a cross-sectional survey with 207 head nurses and 697 nurses working in general hospitals. Results: The practice guideline consisted of 2 items on purpose of handoff, 5 items on policy, 3 on environment, 5 on process, 7 on content, 3 on evaluation, and 1 on the function of education, for a total 26 of items. Standard instruction was developed related to Patients, Assessment, Situation, Safety concerns, Background, Actions, and Recommendations. Conclusion: The findings of this study indicate that the guideline can be applied in real nursing practice to improve the effectiveness of handoff procedures. It can be used to guide nurses to follow the standardized content, which presents patient details clearly. The guideline provides consistency and structure for the information that is handed over.

Clinical Practice Guideline for Taeeumin and Taeyangin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm (태음인·태양인체질병증 임상진료지침: 진단 및 알고리즘)

  • Lee, Jun-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.13-41
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    • 2015
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Taeeumin and Taeyangin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Taeeumin and Taeyangin Symptomatology diagnosis and algorithm. For developing diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Taeeumin and Taeyangin Symptomatology Results and Conclusions We classified the Taeeumin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern, initial-intermediate-advanced pattern. And we classified the Taeyangin Symptomatology by 3 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern. At the unfavorable pattern, ordinary symptom is very important. So doctors are considered to need to focus on the symptom of unfavorable's ordinary symptoms.

Survey of Pharmacy Practice for Compounding Parenteral Nutrition in Hospital Setting - 2009 (병원약국 대상으로 정맥영양제 조제 실행에 관한 연구-2009)

  • Sin, Hye-Yeon;Jung, Ki-Hwa
    • YAKHAK HOEJI
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    • v.54 no.4
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    • pp.244-251
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    • 2010
  • Standardized parenteral nutrition is required to improve patient's safety, clinical appropriateness and to increase uniformity between institution and institutions. We assessed the consistency with the American society for parenteral and enteral nutrition (A.S.P.E.N.) practice guideline for PN by evaluating current practice process for parenteral nutrition formulation in inpatients pharmacies in Korea. Each question in this survey was based on 2007 A.S.P.E.N. recommendations of standard parenteral nutrition formulation, the American society of health-system pharmacists (ASHP), and the United State Pharmacopoeia (USP) Chapter 797 guideline for compounding parenteral nutritions. All 90 Korean society of hospital pharmacist (KSHP) member directors of pharmacy were requested to respond to the survey in order to compare the survey results to ASHP national survey of pharmacy practice in hospital settings (2002) in compliance with A.S.P.E.N. guideline. We had final response rate of 35.6%. 25 (100%) hospitals complied with this Garb guideline (response rate was 84.4%) which was the highest compliance. Only 17.9% of hospital pharmacies were actively involved in complications monitoring. Monitoring complications and efficacy were least in compliance with the A.S.P.E.N. guideline. 69.0% of Korean pharmacists adjusted medication dosage based on disease state or monitoring laboratory data in compliance with the A.S.P.E.N. guideline. Over 50% of the hospital pharmacies failed to provide and evaluate staff training in aseptic manipulation skills periodically. Korean hospital pharmacies need to comply with the standard practice guideline for compounding sterile preparation in order to provide better quality of parenteral nutrition service for specific patient population.

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.