• 제목/요약/키워드: Clinical practice performance

검색결과 433건 처리시간 0.026초

Performance of mid-upper arm circumference to diagnose acute malnutrition in a cross-sectional community-based sample of children aged 6-24 months in Niger

  • Marshall, Sarah K;Monarrez-Espino, Joel;Eriksson, Anneli
    • Nutrition Research and Practice
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    • 제13권3호
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    • pp.247-255
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    • 2019
  • BACKGROUND/OBJECTIVES: Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6-24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS: Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < -2, MUAC < 12.5 cm) and SAM (WHZ < -3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS: Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS: The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < -3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.

Short Communication: Links between Dental Hygiene Curriculum and Dental Hygiene Task Analysis

  • Park, Chae-Eun;Yoo, Jin-Gyeong;Lee, Su-Hyun;Lee, Yoon-Ha;Lee, Ji-Yeon;Choi, Mun-Jeong;Hwang, Soo-Jeong
    • 치위생과학회지
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    • 제22권2호
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    • pp.126-129
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    • 2022
  • Background: The problem with current dental hygienist education is that it operates as an education system based on the national examination rather than on a practical basis; thus, graduates have difficulties in practice after obtaining their license. This study aimed to propose a job-oriented curriculum by analyzing the links between the task analysis of Korean dental hygienists and dental hygiene learning goals. Methods: This study performed a relationship analysis based on a second job analysis study of dental hygienists conducted by the Korea Health Personnel Licensing Examination Institute and the learning goals of the Korean Dental Hygiene Faculty Association. Results: Based on the links between the task and learning goals of the dental hygienist, they were classified into six types: 1) tasks listed in the license exam and learning goal, 2) tasks not listed in the license exam but listed in learning goals, 3) tasks not listed in learning goals, 4) learning goals not related to tasks, 5) learning goals listed in a few tasks, and 6) tasks related to several learning goals. The results showed that most of them correspond to the 5th classification, followed by the 3rd and 4th categories, which are mostly basic science learning goals. Tasks without learning goals are not included in the curriculum; thus, the curriculum needs to be supplemented. The overlapping learning goals of several subjects for one job skill must be reduced in job-oriented education. Conclusion: We suggest that the dental hygiene curriculum be developed based on task analysis and reflected in the national dental hygienist exam. The clinical practice performance of dental hygienists will take further leap forward through task-oriented education.

만성폐쇄성폐질환 환자 사례에 대한 실시간 시뮬레이션 동영상 관찰기록 내용분석-간호술 수행을 중심으로 (Content analysis of real-time simulation video observation records about cases of patients with chronic obstructive pulmonary disease-focusing on nursing skills performance)

  • 홍지연;박진아
    • 융합정보논문지
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    • 제12권5호
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    • pp.40-50
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    • 2022
  • 본 연구는 간호대학생이 시뮬레이션 실습 시 동료 팀의 만성폐쇄성폐질환 환자 시나리오 구현 동영상을 실시간으로 관찰하면서 구조화된 동영상 관찰 기록지에 기록한 간호술 영역의 내용을 분석한 질적 연구이다. 4개의 세부영역으로 구분하여 기록된 내용을 효과적, 비효과적 측면으로 구분한 후 내용분석 방법을 사용하여 분석하였다. 연구결과 절차의 정확성에 있어서 효과적 측면은 필요한 물품준비와 증상완화를 위한 중재, 비효과적인 측면은 원칙 미준수, 부적절한 처방 이행, 이론과 수행의 연계 미흡으로 나타났다. 무균술 준수에 있어 효과적 측면은 내과적 무균술 적용과 외과적 무균술 적용, 비효과적 측면은 내과적 무균술 미수행과 외과적 무균술 미수행이었다. 안전과 안위 고려에 있어 효과적 측면은 심리적 안위 고려과 물리적 안전 고려, 비효과적 측면은 안위에 대한 실재감 부족과 환자안전 인식 미흡으로 나타났다. 설명 및 교육의 효과적 측면은 목적 설명과 방법 교육, 비효과적 측면은 설명 부족과 환자수준 미고려이었다. 본 연구에서 간호대학생은 관찰을 통하여 얻은 시각적 정보를 기록하는 과정을 통해 학습에 집중하고 기억을 강화시킬 수 있었을 것으로 사료된다. 또한 본 연구는 시뮬레이션 기반 실습을 통한 간호술 교육의 효율성을 높일 수 있는 요소들을 제시하였다는 점에서 의의가 있다.

보건의료 R&D 연구성과 활용·확산을 위한 특허맵 분석 및 활용방안 연구 (Analysis and Application Methods of Patent Map for Performance Diffusion of Translational Research in Health Technology Research and Development)

  • 전수환;이경민;김미경;제영태;신상훈;김명환;김동석;박성호;김기태;곽정애;전혜경;권준영;김동일;김병수;박노현
    • KSBB Journal
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    • 제28권6호
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    • pp.339-348
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    • 2013
  • Translational research (TR) as high quality research can accelerate collaboration strongly between biotechnology-based researchers and clinical-research experts for overcoming diseases. TR facilitates basic science translated to clinical efficacy and effectiveness from bench (basic science) to bedside (clinical practice) for the enhancement of human health. Disease-oriented TR programs were defined as unilateral, bilateral and multilateral TR in this patent performance analysis. Patent performance was measured in a R&D project on Health and Medical Technology to enhance the productivity of R&D investment on disease-oriented TR in Health Technology (HT). Patent Map (PM) analysis and Bibliometrics were conducted to collect information for the assessment of research patents of TR programs. Futhermore, PIAS (Patent Information Analysis System) and Thinklear programs were applied for quantitative and qualitative analysis successfully. These indicate that multi-dimensional analysis of patent performance for disease-oriented TR could promote the connection of R&D-IP (Research and Development-Intellectural Property) and R&BD (Research and Business Development) supporting system significantly.

플립러닝 기반의 임상치위생학 교육과정 개발 및 적용 사례연구 (A case study on the development and application of flipped learning based clinical dental hygiene curriculum)

  • 정수라;김미선;김은정;최용금
    • 한국치위생학회지
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    • 제20권2호
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    • pp.155-166
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    • 2020
  • Objectives: The purpose of this study is to prove, through the design and operation of a teaching learning model for clinical dental hygiene and practice III, the effectiveness of the flipped learning PARTNER model. Methods: A professional council was formed, composed of three professors of dental hygiene and one professor of education; each member was an expert with a Ph.D. From December 2018 to February 2019. Results: Learning preferences for the clinical learning hygiene curriculum based on flip learning showed that it had higher accessibility than traditional teaching methods. Subjects' motivation to learn was improved through flip learning, their critical thinking ability was improved through active discussion and flip team discussion, and their self-directed learning ability was also improved. Participation increased through flipped learning, and subjects' skill abilities showed their highest score by improving their performance through the whole lecture. A high satisfaction of 4.54 out of 5 points was achieved. Conclusions: It was confirmed that the development and operation of a flipped learning-based clinical hygiene curriculum can provide an effective and satisfactory learning process.

신규간호사의 실무적응지원 교육 만족도 및 역할 이행 경험에 관한 조사 (New Graduate Nurses' Satisfaction with Transition Programs and Experiences in Role Transition)

  • 권인각;조용애;조명숙;이영희;김미순;김경숙;최애선
    • 임상간호연구
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    • 제25권3호
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    • pp.237-250
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    • 2019
  • Purpose: The aim of this study was to investigate the satisfaction of newly graduated nurses with educational programs and their experiences in role transition. Methods: Data were collected from November 1 to December 15, 2018 and 483 new graduate nurses working at 15 tertiary hospitals and 10 general hospitals participated. For data collection, self-report questionnaires including the Casey-Fink Graduate Nurse Experience Survey tool and satisfaction with education were used. Data were analyzed using descriptive statistics, t-test, and one-way analysis of variance. Results: Satisfaction with education ranged from 3.09 to 3.27, and satisfaction with preceptors was 3.45(maximum 4). The skill that new nurses ranked as most difficult during the first 3 months was charting/documentation, and throughout a whole year, the top 4 difficult skills were cardiopulmonary resuscitation/emergency response, ventilator care, end-of-life care, and prioritization/time management. In comfort/confidence, new graduates felt most comfortable with support and least comfortable with patient safety. More than 50 percent of new graduates experienced stress during role transition, and the most frequently experienced stressors were related to job performance and personal life. Levels of satisfaction with education and comfort/confidence differed according to the hospital type and number of preceptors for new nurses. Conclusion: In order to facilitate the transition of new graduate nurses to professional nurse, an extended period of education, systematic and standardized transition programs, and continuous support during the first year of practice are required.

Success rate of nitrous oxide-oxygen procedural sedation in dental patients: systematic review and meta-analysis

  • Rossit, Marco;Gil-Manich, Victor;Ribera-Uribe, Jose Manuel
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권6호
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    • pp.527-545
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    • 2021
  • The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

중환자 첫 발열 평가 근거기반 가이드라인에 대한 지식과 수행 정도 (Knowledge and Performance of Guidelines for Evaluation of New Fever in Critically Ill Adult Patients)

  • 양진주;장금성;최자윤;류세앙;김윤희
    • 한국콘텐츠학회논문지
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    • 제16권12호
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    • pp.468-479
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    • 2016
  • 본 연구는 중환자 첫 발열 평가 가이드라인에 대한 간호사의 지식과 수행 정도를 확인하고자 수행된 연구이다. 대상자는 2개 병원 내 외과병동 및 중환자실에서 근무하는 총 145명의 간호사를 대상으로 하였다. 자료 분석은 SPSS 19.0 프로그램을 활용하여 분석하였고, 중환자 첫 발열 평가 가이드라인의 지식과 수행의 평균 평점은 각각 0.70점과 3.08점이다. 가이드라인의 근거수준 1영역은 지식과 수행 상위군에서 하위군보다 유의하게 높은 수행 점수를 나타냈고, 근거수준 3영역은 지식 상위군보다 지식 하위군이 더 높은 수행 점수를 나타냈다. 대상자의 가이드라인에 대한 지식과 수행은 유의한 상관관계를 나타냈다. 결론적으로 본 연구는 중환자 첫 발열 평가 가이드라인에 대한 간호사의 지식과 수행력을 향상시키고 근거기반실무를 개선시킬 필요가 있음을 제시하였다.

간호학생의 진로정체감 영향요인 (Factors Affecting Career Identity of Nursing Students)

  • 권경남;최은희
    • 한국보건간호학회지
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    • 제24권1호
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    • pp.19-28
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    • 2010
  • Objectives: The purpose of this study was to investigate factors affecting the career identity of nursing students. Method: Subjects were 313 nursing students in Daegu. Consent from teachers and students were arbitrarily obtained. Mean, standard deviation, and regression determinations utilized SPSS version 12.0. Results: Career identity score of subjects was $31.79{\pm}5.78$ on basis of 56. Factors identified to be influential to career identity included time of career decision, self-evaluated career performance, satisfaction with clinical practice and college admittance. The influence of the factors on career identity was rated as 64.1% that is high value. Conclusions: The identified factors are important in determining career identity of nursing students. Further studies are needed to generalize these results and examine widely affecting variables of career identity.

치위생과 학생의 현장임상실습교육에 관한 교수효율성 (Teaching Efficiency of Clinical Practice Education for Students in the Department of Dental Hygiene)

  • 이성숙;조명숙
    • 치위생과학회지
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    • 제10권5호
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    • pp.403-409
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    • 2010
  • 본 연구에서는 경기도 지역 치위생과 학생들의 현장임상실습교육에 있어 교수효율성을 파악하기 위하여 2010년 4월 12일부터 4월 26일까지 경기도에 소재한 7개 대학의 치위생과 3학년 학생 371명을 대상으로 자기기입식 설문법을 실시하였으며, SPSS WIN 12.0 프로그램을 이용하여 분석한 결과 다음과 같은 결론을 얻었다. 1. 치위생과 학생의 임상실습교육 교수효율성은 '중' 정도인 것으로 나타났고, 교수효율성 요인에 대한 평가는 역할모델 요인이 3.40점으로 가장 높았다. 2. 임상실습기관 규모에 따른 교수효율성은 통계적으로 유의한 차이가 없었고, 교수효율성 하위영역에서는 전문적 지식요인이 대학병원에서 가장 높았고, 통계적으로 유의한 차이를 보였다(p=.005). 3. 치위생 전공만족도에 따른 교수효율성은 전공만족도가 높을수록 교수효율성이 높았고(p=.001), 교수효율성 하위영역에서는 대인 관계술, 원조자로서의 기능, 공정한 평가, 교과에 대한 조직력(p=.005), 격려와 지지, 교수법, 교과에 대한 전문적 지식(p=.001), 의사소통술, 좋은 역할모델, 치과직원과의 협조(p=.000)에서 통계적으로 유의하였다. 4. 현장임상실습 교수유형에 따른 교수효율성은 통계적으로 유의한 차이가 없었고, 교수효율성 하위 영역에서는 격려와 지지 항목에서만 통계적으로 유의하였다(p=.005). 이상의 결과를 종합해 볼 때 현장임상실습교육에 관한 교수효율성은 '중' 정도인 것으로 나타났고, 전공만족도가 높을수록 교수효율성이 높음을 알 수 있으므로, 교수효율성을 높이기 위해서는 다양한 교수법 및 체계적인 실습프로그램이 개발되어 임상실습교육의 질을 높여야 할 것이다.