• Quality Improvement in Health Care
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• v.7 no.1
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• pp.46-58
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• 2000

Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

• Journal of Korean Clinical Nursing Research
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• v.20 no.2
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• pp.147-161
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• 2014

Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

• Journal of Society of Preventive Korean Medicine
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• v.25 no.3
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• pp.101-115
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• 2021

Objectives : This study compares clinical practice students' perception of Clinical Performance Examination (CPX) in a College of Korean Medicine using actors as Actor Standardized Patient (ASP) and enrolled students as Student Standardized Patient (SSP). Methods : Targeting the clinical practice students who completed the clinical practice education in the first semester of the fourth year in the Department of Korean Medicine, a survey was conducted on total six categories such as satisfaction with CPX using ASP and SSP, prior knowledge about clinical practice education, self-evaluation, difficulties in the process of performing the CPX, satisfaction with ASP/SSP, and familiarity with them. Results : In the results of the survey, the mean score of CPX program using SSP was higher than that of CPX program using ASP in every area. Among them, in the satisfaction with CPX itself and prior knowledge about various clinical practice education, the mean score of CPX program using SSP was statistically significantly higher than that of CPX program using ASP. Conclusions : Overall, the clinical practice students' satisfaction with CPX program using SSP was higher than that of CPX using ASP, and statistically significantly higher in some areas.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.22 no.1
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• pp.88-97
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• 2015

Purpose: This study was conducted to identify the effects of a suction care self video-based debriefing-assisted learning in the fundamentals of nursing practice for nursing students on clinical performance, self-efficacy and problem-solving process. Methods: A nonequivalent control group non-synchronized design study was used and included 97 junior nursing students at P University as participants, 48 of whom were assigned to the experimental group, and 49 of whom were assigned to the control group. The outcome measurements were clinical performance for suction care, self-efficacy, and the problem-solving process. Results: The scores of clinical performance were 23.75 in the experimental group who used the materials and 21.55 in the control group, and the difference was statistically significant (p<.000). Self-efficacy was 4.30 in the experimental group and 4.18 in the control group, which was a statistically significant difference (p=.000), and the pre-to-post differences of self-efficacy was statistically significant as well (p<.001). However, there were no significant differences in the pre-to-post differences of the problem-solving process (p<.802). Conclusions: Self video-based debriefing-assisted learning may be more effective in enhancing clinical performance and self-efficacy than that of conventional practice. Whether self-efficacy will contribute to enhanced learning motivation for nursing students needs further examination.

• The Korean Nurse
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• v.32 no.5
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• pp.93-105
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• 1994

Nursing is indeed a practice discipline with experiential learning in clinical practice areas comprising an overwhelming portion of a Nursing Student's education. The statement is used to provide a basis for discussion of some issues involved in relation to clinical nursing education. However the lack of substantial research in the area of clinical nursing education would suggest that this 'heart' of the nursing student's professional education has olng been ignored. The purpose of this study is to critically review and analysis then suggest effective approaches of clinical nursing education. First. the curriculum can be developed by faculty consistently. Curriculum design begins with the writing of philosophy and the selection of objectives for the program. The philosophy must include a statement of beliefs and intrinc values about human being. nursing and teaching learning process. Second. faculty practice can be narrowed practice-theory gaps. Third. clinical teaching strategies can be used many different methods in order to facilitate development of clinical judgement and decision making. Fourth, clinical teacher's rols can influence student's learning attitude and intrinsic value; relating to students as mature individuals; creating an atomosphere where in the student felt comfortable approaching the instructor; providing support crisis situations. Fifth. clinical nursing evaluation can be developed the integrated models.

• The Journal of Korean Academic Society of Nursing Education
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• v.5 no.1
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• pp.58-71
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• 1999

Nursing process is an essential part for nursing practice. Nursing faculty members must focus on the clinical application for students and try to identify the possible problems that students might face in the fields. The purpose of this study is to examine the actual condition of nursing process education in curricula and to investigate the response of students in clinical experience of nursing process. From 462 students in the 6 associate programs(ADN) and the 6 baccalaureate programs (BSN) data was collected by questionnaire. The results were as followed. 1. Seven programs (58.3%) opened the nursing process in mainly sophomore (BSN) or freshman(ADN). If not opened, the nursing process was taught at the major subjects(espcially fundamental nursing or adult nursing). 2. All Students responded they we supposed to use nursing process in preparing the case report. The majority(94.6%) used NANDA lists for nursing diagnosis and 55.7% of subjects consulted the Korean terms by KNA when translating. The tutors for nursing process in clinical settings were the professor in charge of the subject (68.6) or clinical instructors (48.1%) , assistants(34%). 3. The problems in clinical application that students experienced consisted of 17 items and the mean was 2.27. The biggest problem was 'the lack of the model for RN of applying the nursing process in clinical settings'(2.97). Next the big problem was 'the lack of the competency for implementing the established nursing plans'(2.69). All items were significantly different according to the level of educational programs(ADN or BSN). ADN students had more problems in applying the each step of nursing process and BSN students perceived the NANDA as a guidance of nursing diagnosis and the inconsistency of advices from several instructors or practicum to be mere problematic. 4. The mean of merits after application of nursing process was relatively fair (2.82). The best merit was 'they can identify nursing problems more exactly'(3.07). The second high merit was 'they can study the rational of nursing action' (3.03). BSN than ADN and the subjects of second year than of one year in clinical experience perceived the use of nursing process to be better. Based on this results we need to enforce the application of nursing diagnosis in the class. The use of sample cases can be the efficient method. Students can identify the possible health problems for patient from the cases in imaginary world and discuss them each other. Also we can use the discussion session after practice every other day or as needed. All this is on the good interaction between tutor and student. We must consider to have enough time for student to seize the essence of the nursing process.

• Journal of dental hygiene science
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• v.9 no.1
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• pp.43-52
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• 2009

The realistic problem about the dental hygiene education in our country is what the correlation between theoretical education and clinical education is short, and what the systematically clinical-practice education is failing to be realized. In order to solve this problem, the aim is to introduce preceptor and to present necessity in order to apply preceptor to the practice education for dental hygiene department. 1. What is the largest in the difference between the observation experience and the performance experience by element in clinical-performance activity is the patience-care service sphere(P < .001). 2. A hospital with the highest observation-practice experience level in children with the observation experience by hospital was in order of K hospital, Y hospital, H hospital, B hospital, and A hospital(P < .001, P < .01). 3. A hospital was the highest in the difference of the performance-practice experience level by hospital. And, the next was in order of H hospital, Y hospital, K hospital, and B hospital(P < .001, P < .01). 4. As for recognition on importance of clinical-practice activity in dental hygienists, the dental hygienists with more than the third year were indicated to be the highest than the dental hygienists with less than the 3rd year among 58 dental hygienists. Given seeing the results of this study, the more systematic and educational clinical-practice environment will need to be improved by suggesting a role of preceptor and to seek for a plan for application in the clinical-practice education.

• 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.

• Journal of Korean Clinical Nursing Research
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• v.21 no.2
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• pp.196-206
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• 2015

Purpose: This study was done to use a guideline adaptation process to develop a Korean evidence-based diabetic foot care clinical practice guideline for diabetic foot prevention and management. Methods: The guideline adaptation process was conducted according to the guideline adaptation manual developed by the National Evidence-Based Healthcare Collaborating Agency. The process consists of three main phases, with 9 modules including a total of 23 steps. Results: The newly developed diabetic foot care clinical practice guideline consisted of an introduction, description of diabetic foot, summary of recommendations, recommendations, references, appendices, and glossary. There were 165 recommendations in 4 sections (risk assessment for diabetic foot ulcers, prevention of diabetic foot ulcers, wound assessment of diabetic foot ulcers, and management of the diabetic foot). In grading by recommendations, for A there were 30 (18.2%), B, 8 (4.8%), C, 30 (18.2%) D, 97 (58.8%). Conclusion: This guideline can be used as educational material for healthcare workers and diabetic patients. It can also be utilized as a practice guideline for healthcare workers in the hospital and community setting.

• The Journal of Internal Korean Medicine
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• v.44 no.4
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• pp.703-725
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• 2023

Objectives: This study investigated Korean medicine doctors' perspectives on clinical practice patterns in the process of developing Korean medicine clinical practice guidelines for benign prostatic hyperplasia. Methods: A questionnaire was developed for Korean medicine doctors. A total of 323 oriental medicine doctors participated in the survey, which was live for a total of 9 days from September 22, 2022, to September 30, 2022. Results: Regarding awareness of treatments for benign prostatic hyperplasia, 63.8% of respondents showed high awareness of Korean medical treatments. However, items such as diagnostic criteria (17.7%), evaluation methods (17.0%), and Western medical treatments (22.9%) showed low recognition rates. In clinical practice, 76.2% of respondents were found to treat five or fewer patients with benign prostatic hyperplasia per month, and the average treatment period was 1 to 3 months for most at 41.2%. Korean medicine doctors diagnosed benign prostatic hyperplasia based on clinical features. The main interventions used were acupuncture, herbal medicine (prescription medicine), and moxibustion. This study has several limitations because of the low response rate for this survey; therefore, the participants are not representative of all Korean medicine doctors. In addition, because the study was conducted broadly on various topics related to benign prostatic hyperplasia, sufficient quality management was not carried out. Further studies that include a larger sample size and more in-depth studies on benign prostatic hyperplasia are needed. Conclusions: It is necessary to develop appropriate and reasonable Korean medicine clinical practice guidelines for benign prostatic hyperplasia.