• 제목/요약/키워드: Clinical standards

검색결과 479건 처리시간 0.023초

신경외과 중환자 간호의 질평가 도구개발 (Development of an evaluation tool for the quality of nursing care in neurosurgical intensive care unit patients)

  • 김남영;장금성
    • 간호행정학회지
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    • 제7권2호
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    • pp.285-300
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    • 2001
  • To meet standards for high quality of care and satisfied customers, an evaluation tool about nursing care is necessary. And, We need to evaluate our practice continuously for the improvement in quality and outcomes. This study was intended to develop an evaluation tool about nursing care in NSICU, and was progressed of 3 steps; development, content validity verification and reliability verification. Data were obtained and analysed from Feb. To April, 2000. Development process of the study was as follows A preliminary list was made item by item on the basis of clinical Experience, literature review and patients' record review. Then the standards, criteria and indicators of preliminary evaluation tool were set by 5 clinical nursing panel, and their content validity was reviewed by 27 ICU nurses. Finally, an evaluation tool was developed and verified the reliability at c-university hospital located in Kwang-Ju. The results of this was as follows 1) The evaluation tool of this study developed 8 standards, 39 criterias and 106 indicators. The standards were divided into two dimensions. One was process dimension which contained 4 standards(26 criteria), The other was outcome dimension which contained 4 standards(13 criteria). 2) the Average content validity of the tool was 3.39 at standards, 3.55 at criteria and 3.51 at indicators. 3) Interrater reliability of the tool is r=.7993(p<.001) & internal consistency reliability ${\alpha}$ is .6031 4) Scores of NSICU Patients who participated in this study were 57 at total mean score, 58 at process mean score and 56 at outcome mean score The evaluation tool developed in this study seems to be useful in evaluation nursing practice appropriately for the improvement of nursing care in NSICU. I hope that this evaluation tool can be used effectively in NSICU as an intervention for the improvement of quality control.

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Moving towards Evidence-Based Clinical Practice Guidelines

  • Jung, Jae Hung;Franco, Juan VA;Dahm, Philipp
    • Urogenital Tract Infection
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    • 제13권3호
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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.

병원 진단검사의학부의 공간구조와 설비기준에 대한 조사 - 미국, 영국, 독일을 중심으로 - (A Study on the Space Organization and Facility Equipment of Medical Laboratory - focusing on the USA, UK and Germany -)

  • 김영애
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제22권3호
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    • pp.7-15
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    • 2016
  • Purpose: As medicare services have gotten spreaded, clinical laboratory has been dominant position. So, it has been acted for quality control and clinical pathology accreditation. But there has been quite deficient information to evaluate working space and technical standards of medical laboratory for accreditation. This study goals to figure out accreditation standard and design guideline for clinical laboratory, and to give safe and efficient design information. Methods: This study has been searched by literature for accreditation standards and design guidelines of clinical pathology in USA, UK, and Germany. Results: Three countries have accredited based on working lab space, staff space, storage space, patient space and health and safety equipment. Design guidelines of three countries commonly have focused on worktable layout, worktable distance and module, and specific laboratory biosafety level. And USA guidelines stress on the architectural design such as design process and passage distance for escape, UK stress on the efficiency as functional work flow and construction cost, lastly Germany design guidelines stress on the operator's safety distance and workstation. Three countries have not only accreditation standards but also design guidelines for more specific quality management, separating from accrediting institute. Implications: In korea, it has been needed to make clinical laboratory design guideline for the safe and efficient environment and reliable and competitive medical service.

관상동맥질환 진단을 위한 심자도맵의 분류 방법 (Classification of magnetocardiographic maps in coronary artery disease diagnosis)

  • 권혁찬;김기웅;김진목;이용호;김태은;임현균;고영국;정남식
    • Progress in Superconductivity
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    • 제7권1호
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    • pp.41-45
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    • 2005
  • The diagnostic management of patients with chest pain remains a clinical challenge. Magnetocardiography (MCG) has been proposed as a new non-invasive method for detection of myocardial ischemia. To date, however, MCG technique is not intensively introduced for clinical use. One of the main reasons might be the absence of statistically valid and diagnostically clean criteria, which can determine the presence of certain heart disease. In this work, we suggested a new method to classify the diagnostic value of MCG for the detection of coronary artery disease (CAD) in patients with chest pain. MCG was recorded for three groups (healthy subjects and patients without and with CAD) by means of the 64 channel SQUID gradiometer system installed at a hospital. Using four parameters, which were found to be significantly different between groups, we evaluated a probability, in which parameters can be classified into each group based on the distribution function of the parameter in each group. For all parameters, sum of probabilities was compared between groups to determine the presence of CAD. Our classification method shows that the MCG can be a useful tool to predict the presence of CAD with sensitivity and specificity of higher than $80\%$ each.

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SQUID를 이용한 심자도 기술의 개발동향 (Review of Magnetocardiography Technology based on SQUIDs)

  • 이용호;권혁찬;김진목;김기웅;유권규;박용기
    • Progress in Superconductivity
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    • 제13권3호
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    • pp.139-145
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    • 2012
  • Electric activity of cardiac muscles generates magnetic fields. Magnetocardiography (or MCG) technology, measuring these magnetic signals, can provide useful information for the diagnosis of heart diseases. It is already about 40 years ago that the first measurement of MCG signals was done by D. Cohen using SQUID (superconducting quantum interference device) sensor inside a magnetically shielded room. In the early period of MCG history, bulky point-contact RF-SQUID was used as the magnetic sensor. Thanks to the development of Nb-based Josephson junction technology in mid 1980s and new design of tightly-coupled DC-SQUID, low-noise SQUID sensors could be developed in late 1980s. In around 1990, several groups developed multi-channel MCG systems and started clinical study. However, it is quite recent years that the true usefulness of MCG was verified in clinical practice, for example, in the diagnosis of coronary artery disease. For the practical MCG system, technical elements of MCG system should be optimized in terms of performance, fabrication cost and operation cost. In this review, development history, technical issue, and future development direction of MCG technology are described.

Assessment of the Quality of Case Reports in the Journal of Acupuncture Research Using the CARE and STRICTA Guidelines

  • Nam, Eun-Young;Hwang, Ji Hye
    • Journal of Acupuncture Research
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    • 제37권4호
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    • pp.224-232
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    • 2020
  • The purpose of this study was to assess the quality of the case reports in the Journal of Acupuncture Research (JAR). All case reports were retrieved from November 2017 to June 2020. There were 19 case reports included in this assessment based on the case report (CARE) guidelines and case report and standards for reporting interventions in clinical trials of acupuncture (STRICTA) guidelines. The overall quality of reporting was relatively high (83.08% on Case Report guidelines and 77.78% on Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines), but several crucial items remained substantially underreported, such as identifying as a case report (keywords), patient information and perspective, clinical findings, diagnostic assessment, and intervention information. In 18 out of 19 included case reports of acupuncture-related interventions, several items remained considerably underreported such as acupuncture regimen variation, depth of needle insertion, response sought, and experience of acupuncturists. In the classification by disease, condition, or syndrome, 13 out of 19 included case reports were for musculoskeletal disorders (68.4%), which is the main clinical medical field of Korean medicine services. The results of this study may help develop more appropriate reporting guidelines for case reports published in JAR.

Clinical Information Interchange System using HL7-CDA

  • Jung, Yong Gyu;Lee, Young Ho
    • International journal of advanced smart convergence
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    • 제1권2호
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    • pp.47-51
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    • 2012
  • In highly developed society, information and communication technologies are widely used for better medical services. These information and communication technologies should be more and more acceptable in all hospitals for exchange medical records. EMR becomes more convenient than the previously used paper charts. It will be able to record medical institutions every time and dual treatment. Each is different specifications for each medical institution to use the program or document to exchange it. The personal clinic records still does not exchange well. To solve this gap between medical alienation, this paper describes the concepts of HL7-CDA and proposes types of telemedicine system. To resolve time and space constraints, new form of treatment methods presents in future directions after described about related systems. CDA enables electronic medical records to the each medical center and gradually expanded by exchanging the patient's medical records. This paper is using XML-based CDA documents as a hierarchical for medical information exchange standards compliant HL7-CDA documents. It could be possible currently used structural variety of multimedia data. Thus It is able to send and receive HL7-CDA-based medical information and clinical information to identify the medical institutions of medical information with interchange system design and building standards, and through mutual exchange of clinical information.

다국적 임상시험 지원을 위한 CDISC 표준의 확장 (CDISC Extension for Supporting Multinational Clinical Trials)

  • 염지현;최인영;김석일;김혁만
    • 한국정보과학회논문지:컴퓨팅의 실제 및 레터
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    • 제15권8호
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    • pp.566-575
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    • 2009
  • CDISC 컨소시엄에서는 임상시험에서의 비효율적인 데이터 처리 과정을 개선하기 위해, 플랫폼에 독립적인 임상시험 데이터 표준을 정의하였다. 그러나, CDISC 표준은 여러 나라의 여러 기관이 함께 참여하는 다국가 임상시험에서 발생하는 임상시험 데이터를 다국어로 표현하는 방법에 많은 제약을 갖고 있다. 특히, CDISC가 제정한 표준 중 임상시험 데이터의 콘텐츠 및 포맷에 해당하는 SDTM(Study Data Tabulation Model)과 ODM(Operational Data Model)에서의 다국어 지원이 매우 미비하다. 본 논문은 CDISC의 SDTM과 ODM에서의 언어 설정에 대한 문제점을 해결하기 위해, SDTM과 ODM 표준의 확장을 제안한다. 이를 위해 SDTM에서는 다국어 지원을 위한 새로운 도메인을 설계하였고, ODM에서는 ODM의 확장 스키마를 서브타이핑 방법으로 구현하였다. 확장 SDTM과 ODM을 기반으로 임상시험 데이터를 처리하면, 다국가 임상시험이 수행되는 경우 다국어로 표현된 임상시험 데이터도 효율적으로 처리할 수 있다.