• 임상간호연구
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• 제21권1호
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• pp.31-42
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• 2015

Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

• 디지털융복합연구
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• 제16권7호
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• pp.277-288
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• 2018

본 연구는 투석실에서 간호사들 사이의 혈액 투석에 대한 실무 지침에 근거한 지식 수준과 수행도를 조사하는 서술연구로서 자기기입식 설문지를 사용하여 데이터를 수집했다. 표본은 한국의 3개 지역에 위치한 혈액 투석실의 간호사 173명으로 구성되었다. 자료 분석은 SPSS / WIN 20.0 으로 t-test, ANOVA 및 Scheff's 분석을 수행했다. 투석실 간호사의 약 98.8 %는 주로 투석회의나 심포지움에서 교육을 받았다. 근거중심실무에 대한 지식 점수는 평균 15.77 (23 개 중)로 나타났으며, 8년 이상의 경력자, 석사 학위 및 3차병원에서 일하는 간호사들이 유의하게 높은 점수를 보였다. 혈액 투석에 대한 국제적으로 인정되는 근거중심실무지침이 있음에도 불구하고 지침에 대한 실제 준수는 경험, 교육 수준 및 병원 유형에 따라 다르게 보였다. 이 연구의 결과는 혈액 투석 간호사에 대한 지식 향상 및 근거중심실무지침 활용을 위한 전략 개발에 대한 추가 연구를 위한 기본 데이터가 될 수 있다.

• 근관절건강학회지
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• 제20권1호
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• pp.31-42
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• 2013

Purpose: The purpose of this study was to develop an evidence-based dysphagia nursing care protocol for nursing home (NH) residents in Korea. Methods: The protocol was developed based on international guidelines and literatures. After testing content validity by experts, the protocol was applied to the intervention group (n=35) for 4 weeks at one NH in December, 2011, whereas the control group (n=34) received routine care. Results: The protocol was composed of one-page algorithm and detailed guidelines. Algorithm pathway was organized in 3 parts, including screening dysphagia risk, grouping by dysphagia risk level, and assigning nursing care into each group. The nursing care included positioning, oral care, meal time care, diet modification, providing exercise and maneuver, and checking dysphagia signs and symptoms. The experts verified the content validity. Protocol was revised to fit NH practice after the participant observation. Clinical validity was established upon evaluating usefulness, appropriateness, and convenience of the protocol by NH nurses. Dysphagia risk of the intervention group was significantly decreased. Conclusion: Developed protocol will improve the quality of dysphagia care in nursing homes as it can serve as a consistent and integrated standard for nursing care of residents with dysphagia.

• 성인간호학회지
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• 제26권6호
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• pp.630-641
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• 2014

Purpose: The purpose of current study was to explore the positive outcomes of advanced practice nurse who have experienced the roles in their clinical settings. Methods: This study adopted a qualitative research design based on conventional content analysis. Participants were 16 nurse practitioners have been worked at hospitals or community centers. Data were collected via focus group interviews and analyzed using thematic analysis method. Results: Patients' aspect outcomes were "client-centered care in providing continuity", "providing trust based on expertise", "promoting skilled intervention in patient recovering", "blocking the negative consequences", "quality improvement: nursing becoming tighter", "providing total care for cases that require intensive care", "improving patients outcomes by total management", "increasing confidence in evidence-based professional nursing", "rising the satisfaction by cost-effective services", "providing skilled professional practice", and "providing comprehensive care related to covering various aspects". Other themes elicited also included "promoting efficacy by inter-related health professions supervising", "the expansion of specialized practice areas increase business efficiency", "formation of outside customers due to increasing the satisfaction with skilled nursing care", "filling in the emptying spaces of doctors by practicing reliable role to bridge", "attracting external customers through successful management of subjects", "increasing staff's satisfaction on the role to make a bridge between inside and outside doctors", "24 hours medical expertise of professional staff ready secured", and "low cost, same results, that is, cost-effective" in reference to health care resources aspect. Conclusion: These findings suggested that advanced practice nurses perceived various positive outcomes and provided basic data for outcome indicators of advanced practice nurses' role.

• 한국임상약학회지
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• 제27권1호
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• pp.1-8
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• 2017

The prevalence of diabetes and its related morbidity and mortality are being increased. Despite the advancement of evidence-based pharmacotherapy in the management of diabetes, many patients in our country do not achieve satisfied therapeutic outcomes. Pharmaceutical care service can be defined as a patient-centered clinical service provided by pharmacists to improve therapeutic outcomes and quality of life of patients, by identifying, and preventing or resolving drug-related problems (DRPs). Pharmaceutical care service is interdisciplinary team-based practice, and is provided through collaborative practice agreement (CPA) between one or more physicians and pharmacists. This article describes a model of pharmaceutical care service which can be adopted in our country for patients with diabetes in the ambulatory care settings. With the successful implementation of this service, clinical, economic, and humanistic outcomes of patients will be improved. Therefore, by actively implementing pharmaceutical care service, pharmacist should contribute to the promotion of patients' health and to the advancement of health care delivery system.

• 대한치과의사협회지
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• 제52권8호
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• pp.464-471
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• 2014

This article reviewed theological background and historicak development in dental caries management by risk assessment. Dental caries prevention and treatment according to 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 dental and dental hygiene education. Dentist and dental hygienist able to provide scientific and ethical care managing dental caries by risk assessment.

• 중환자간호학회지
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• 제2권2호
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• pp.42-55
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• 2009

Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

• Perspectives in Nursing Science
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• 제8권2호
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• pp.139-147
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• 2011

Purpose: An integrative literature review was done to identify the best interventions for older adults with dyslipidemia in an effort to promote nursing involvement in the prevention of statin-induced symptoms (SIS). Such awareness could increase the capacity of interventions by geriatric nurses using evidence-based practices in the reassessment of statin therapy. Methods: CINAHL, Pubmed, and ProQuest were searched using these terms: dyslipidemia in, elderly, statins, adverse effects, and quality of life. Eleven articles fitting the inclusion criteria were identified and analyzed. Results: The findings indicate no evidence for the benefit of statin therapy for morbidity/mortality in a high-risk primary prevention set-up, specifically in the elderly population. Although SIS prevails among older adults, there are limited data that confidently support this observation along with nursing interventions specifically for the geriatric nursing community. Conclusion: Future research is necessary to shift nursing intervention with statin users (specifically in older adults) from an illness-based intervention to a preventive care plan to provide optimal care based on evidence. It is essential to involve self-reporting, cooperation, and communication with health care professionals, specifically with geriatric nurses. Additional studies are needed to further direct practice interventions in elderly statin users.

• 한국임상약학회지
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• 제18권2호
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• pp.124-131
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• 2008

The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

• Clinical Endoscopy
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• 제57권2호
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• pp.141-157
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• 2024

Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.