• Title/Summary/Keyword: Clinical practice guideline

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Knowledge and Practice of Middle East Respiratory Syndrome Isolation Precaution among Hospital Nurses (병원 간호사의 중동호흡기증후군 격리 지침에 대한 지식과 수행도)

  • Kim, Sunju;Song, Rhayun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.25 no.1
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    • pp.46-57
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    • 2018
  • Purpose: The purposes of the study were to examine the knowledge and practice about Middle East Respiratory Syndrome (MERS) isolation precaution, and to explore influencing factors of the isolation practice among hospital nurses. Methods: A total of 182 nurses were recruited from four general hospitals where MERS patients had been treated. The knowledge and practice of MERS isolation precaution were measured by the scales developed based on the CDC guidelines. The collected data were analyzed by SPSS/WIN 22 with descriptive statistics, T-test, One-way ANOVA, Pearson correlation coefficients, and hierachical multiple regression analysis. Results: The nurses were 30 years old in average, and half of them had less than 5 years of clinical experience. and knowledge on droplet precautions (${\beta}=.171$, p=.019) were the significant predictors, explaining 19.6% of variance in the MERS isolation guideline practice. Clinical experience (${\beta}=.225$, p=.002), working at infection unit (${\beta}=-.203$, p=.011). Conclusion: The knowledge on droplet precaution and general knowledge on MERS were the important modifiable factor to improve the MERS isolation guideline practice among hospital nurses, even after adjusting clinical experience and demographic variables. It is necessary to develop an efficient education program on specific guidelines for prevention and management of infection by improving the knowledge on infectious disease such as MERS as well as droplet precaution which are modifiable factors.

Clinical Practice Guideline for Taeyangin Disease of Sasang Constitutional Medicine (태양인체질병증 임상진료지침)

  • Park, Hye-Sun;Joo, Jong-Cheon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.71-81
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    • 2015
  • Objectives This research was proposed to present clinical practice guideline (CPG) for Taeyangin Disease of Sasang Constitutional Medicine (SCM). This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods This guideline was performed that search and collection of literature related SCM such as "Dongeuisusebowon", textbook of SCM, clinical guidebook of SCM and fundamental research to standardize diagnosis of Sasang Constitutional Medicine. Journal search related clinical trial or human complementary medicine of SCM was performed domestic and overseas. Finally, 1 article was selected and included in CPG for Taeyangin disease. Results & Conclusions The CPG of Taeyangin disease include classification, definition and standard symptoms of each pattern. Taeyangin disease is classified into exterior-origin lower back (EOLB) disease and interior-origin small intestine (IOSI) disease by region of symptom. EOLB can be replaced with Oegam-yocheok and IOSI can be replaced with Naechok-sojang that is Korean pronuncation. EOLB disease is classified into lower back favorable symptomatology (LBFS) and lower back unfavorable symptomatology (LBUS). Lower back is to say Yocheok, so LBFS can be called Yocheok favorable symptomatology and LBUS can be called Yocheok unfavorable symptomatology. LBUS is to say paraparesis symptomatology or Haeyeok, that is Korean pronunciation, symptomatology. IOSI disease is classified into small intestine favorable symptomatology (SIFS) and small intestine unfavorable symptomatology (SIUS). Small intestine is to say Sojang, so SIFS can be called Sojang favorable symptomatology and SIUS can be called Sojang unfavorable symptomatology. SIUS is to say regurgitation symptomatology or Yeolgeok, that is Korean pronunciation, symptomatology.

Updates of Nursing Practice Guideline for Enteral Nutrition (경장영양 간호실무지침 개정)

  • Cho, Yong Ae;Gu, Mee Ok;Eun, Young;Yu, Mi;Kim, Jung Yeon;Lee, Hyun Hee;Min, Ja Kyung;Song, Jung Mi
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.1
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    • pp.10-25
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    • 2020
  • Purpose: The purpose of this study was to update the previously developed nursing practice guideline for enteral nutrition (EN). Methods: The guideline update was done in 22 steps using standardized methodology for nursing practice guidelines. Results: The updated EN guideline consisted of 16 domains and 228 recommendations. The domains and number of recommendations in each domain were for IDSA (Infectious Diseases Society of America): 8 on general instruction, 9 on general instruction for special nutrition, 9 on general instruction for EN, 3 on assessment of EN, 10 on access to EN, 18 on EN device insertion, 16 on selection and preparation of nutritional supplements, 46 on administration and stopping EN, 22 on maintenance and management of EN, 9 on monitoring EN, 16 on prevention and management of complications of EN, 18 on medication administration, 20 on EN in various situations, 20 on prevention of errors, 1 on nursing education, and 3 on nursing documentation. For the levels of evidence, there were 9.7% for level I, 13.1% for level II, 62.5% for level III and 1.1% for GRADE (Grading of Recommendations Assessment, Development and Evaluation): 3.3% for low, 0.8% for moderate, 9.3% for very low. A total of 133 recommendations were newly developed and 10 previous recommendations were modified. Conclusion: This updated EN nursing practice guideline can be used to enhance evidence-based practice in fundamentals of nursing practice and it should be disseminated to nurses nationwide in order to improve the efficiency of EN practice.

Developing CPG for Implementation of CDSS in Digital Hospitals (디지털 병원의 CDSS구현을 위한 CPG 개발)

  • Lee, Hyung-Lae;Won, Chang-Won;Lee, Sang-Chul;Park, Sang-Chan
    • Journal of Korean Society for Quality Management
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    • v.42 no.1
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    • pp.81-89
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    • 2014
  • Purpose: The purpose of this study is to propose Clinical Practice Guideline(CPG) model and Clinical Index(CI) for implementing CDSS in digital hospitals. Methods: This study uses EMR data at department of family practice in A hospital; 636 patients, 570 diseases (based on ICD 10-CM criteria), and 37,000 data related with labs and treatments. This study focuses on disease J342 which is the most high rate of incidence. Results: Using the suggested model, this study calculates frequency matrix and probability matrix to find out the correlation of diseases and labs. This study indicates the lab sets of Disease (J342) as CI for CPG. Conclusion: This study suggests CPG model including Lab-based, Disease-Based and Case-based modules. Through 6 level cased-based CPG model, especially, this study develops Clinical Index(CI) such as the Incidence Rate, Lab Rate, Disease Lab Rate, Disease confirmed by Lab.

Update on polycystic ovary syndrome

  • Kim, Jin Ju
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.194-197
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    • 2021
  • Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

Validation of a Translated Guideline on Pain Assessment and Management: Focused on Abdominal Surgery Patients (통증관리 근거중심 가이드라인의 국내 타당성 검증 - 복부수술 환자를 대상으로 -)

  • Hong, Sung Jung;Lee, Eunjoo
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.159-170
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    • 2012
  • Purpose: This study was designed to examine the validity of the evidence-based guideline on pain developed by Registered Nurses Association of Ontario(RNAO) translated into Korean based on the experts' opinions. Methods: The panel consisted of experts of 60 registered nurses in surgical units, medical doctors and nursing managers who were experts in pain assessment and management. The validity of translated RNAO guideline was evaluated in terms of appropriateness, applicability, and utilization in current practice. Appropriateness and applicability of each recommendation were measured with 9 point scale, whereas utilization was measured by yes/no question. Data were analyzed by mean, standard deviation, and percent. The experts' opinions were analyzed by content analysis method. Results: In general, most of the recommendations in the guideline received above 7 point in appropriateness and applicability. However, above 20% of recommendations showed less than 50% of utilization rates in current practice. Conclusion: The reasons for low utilization of recommendations in current practice are in need for investigation. This study can be used for the development of guideline more acceptable in Korean health care settings and improve the quality of care for the abdominal surgery patients suffering from pain in Korea.

Development of the Nursing Practice Guidelines for Preventing Postoperative Pulmonary Complications using the Guideline Adaptation Process (수용개작방법을 활용한 전신마취 수술 후 폐합병증 예방 간호실무지침 개발)

  • Choi, Jin Ju;Kim, Hyeon Jeong;Kang, Hye Min;Chu, Hee Young;Kim, Kyeong Sug
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.2
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    • pp.187-198
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    • 2021
  • Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.

Comparison between domestic and foreign Clinical guidelines and previous researches on Korean medicine for psoriasis to develop the clinical trial guideline of psoriasis using Korean medicine (건선 한약제제 임상시험 가이드라인 개발을 위한 관련 국내외 가이드라인과 기존 건선치료 한약제제 연구와의 비교)

  • Kang, Se Hyun;Moon, Young-Kyun;Jeong, Woo-Yeol;Nam, Hae-Jung;Kim, Yoon-Bum;Lee, Jun-Hee;Kim, Kyuseok
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.2
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    • pp.12-32
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    • 2016
  • Objectives : The objective of this study is to develop the strategies of the psoriasis clinical trials guideline on Korean medicine by comparison between Clinical guidelines and domestic and foreign clinical trials papers of psoriasis on Korean medicine. Methods : This study is based on analysis of papers on Clinical trials guidelines, Clinical practice guideline and clinical trials about Korean medicine. The papers were searched from Pubmed, Medline, Oasis(Oriental Medicine Advanced Searching Integrated System), Korean Traditional Knowledge Portal and Google portal database. Results : A total 8 Clinical practice guidelines and 2 Clinical trials guidelines were found. Moreover, there were 15 foreign papers about clinical trials and 29 internal articles about case studies. They suggested the diagnostic strategy, classification, effective outcome measure, severity measure, precaution of combination therapy, precaution and treatment period of clinical trials, safety evaluation, patterns of Korean Medicine, clinical specific features on psoriasis.Conclusions : The criteria of every item to provide the clinical trials guideline using Korean medicine on psoriasis were developed by apply the results. If we accumulate the more clinical articles on Korean medicine, it will be great help to develop the reliable standard of that guideline.

A Systemic Review of Clinical Trials Using Medication for Acute Bronchitis: A Pre-study on the Development of Traditional Korean Medicine Clinical Practice Guideline (급성기관지염의 약물중재 임상시험에 대한 체계적 문헌 고찰: 임상시험 가이드라인 개발을 위한 예비연구)

  • Lyu, YeeRan;Park, So jung;Lee, Eun Jung;Jeon, Ju Hyun;Jung, In Chul;Park, Yang Chun
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.93-111
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    • 2017
  • Objectives: The aim of this study is to make evidence-based data for developing a traditional Korean medicine clinical practice guideline for acute bronchitis. Methods: We searched 3 international databases(PubMed, EMBASE, CENTRAL) and 7 domestic databases (KoreaMed, Kmbase, NDSL, KISS, KISTI, OASIS, KoreaTK) to identify randomized controlled trials (RCTs) of acute bronchitis using medicine in recent 10 years. The chosen trials were analyzed by their study design, age range, intervention group, control group, primary and second outcome measure, inclusion and exclusion of participants and adverse events. Results: 15 RCTs are finally included in this study and most of their medications are herbal medicine. For diagnosis and outcome measure of acute bronchitis, Bronchitis Severity Score(BSS) was mostly used. Other measurements eligible are coughing fits, quality of life scale, sputum viscosity, change of individual symptoms and patient's satisfaction. Test duration was for average 7days and safety assessment was held by recording adverse events. Except for anti-inflammatory and antibiotic trials, all medications are found to be effective and well-tolerated. General risk of bias of chosen trials is evaluated low. Conclusions: A well designed clinical trials for traditional Korean medicine of acute bronchitis is needed and this study is expected to make it available.

A Survey on Korean Medicine Doctors' Recognition and Treatment Method for Developing Clinical Practice Guideline of Nausea and Vomiting of Pregnancy (임신오조 한의표준임상진료지침 개발을 위한 한의사의 인식과 치료 실태에 관한 조사)

  • Heung-Sook Lee;Hyo-Jeong Jung;Su-Ji Choi;Dong-Il Kim
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.2
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    • pp.36-54
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    • 2023
  • Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.