• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.181-207
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• 2008

With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

• Journal of Korean Academy of Nursing
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• v.46 no.5
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• pp.697-709
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• 2016

Purpose: This study was conducted to develop and test a structural model of evidence-based practice (EBP) implementation among clinical nurses. The model was based on Melnyk and Fineout-Overholt's Advancing Research and Clinical Practice through Close Collaboration model and Rogers' Diffusion of Innovations theory. Methods: Participants were 410 nurses recruited from ten different tertiary hospitals in Korea. A structured self-report questionnaire was used to assess EBP knowledge/skills, EBP beliefs, EBP attitudes, organizational culture & readiness for EBP, dimensions of a learning organization and organizational innovativeness. Collected data were analyzed using SPSS/WINdows 20.0 and AMOS 20.0 program. Results: The modified research model provided a reasonable fit to the data. Clinical nurses' EBP knowledge/skills, EBP beliefs, and the organizational culture & readiness for EBP had statistically significant positive effects on the implementation of EBP. The impact of EBP attitudes was not significant. The dimensions of the learning organization and organizational innovativeness showed statistically significant negative effects on EBP implementation. These variables explained 32.8% of the variance of EBP implementation among clinical nurses. Conclusion: The findings suggest that not only individual nurses' knowledge/skills of and beliefs about EBP but organizational EBP culture should be strengthened to promote clinical nurses' EBP implementation.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.1
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• pp.150-155
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• 2010

Purpose: The purpose of this study is to develop evidence-based nursing practice guidelines for hemodialysis in the renal failure patients with risk of bleeding and to evaluate the guidelines by applying it to the practice. Method: Referring to the SIGN, the first draft for guidelines was developed based on the advices and recommendations obtained from the procedure of critical literature analysis. Then, the draft was modified by the procedures of the expert group evaluation and pilot application to the practice. The final draft was evaluated by the expert group using AGREE instrument. Result: The first draft of guidelines was developed through 8 stages of process and was evaluated by seven experts in terms of the appropriateness, applicability, and effectiveness using a 9 point scale. The mean score of 11 items was 7.90 or above. The quality of the final draft was evaluated by 5 experts using the AGREE instrument. The mean standard score was 73.0% or above in the 19 items. Conclusion: The clinical guidelines developed by this research can be utilized as systematic and scientific guidelines for hemodialysis in the renal failure patients with risk of bleeding. In addition, the research can contribute to improving care services.

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.224-230
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• 2001

EBM is "the conscientious, explicit and judicious use of current best evidence in mating decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures.

• Journal of the Korean Data and Information Science Society
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• v.27 no.2
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• pp.451-461
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• 2016

The purpose of this study was to identify relationship among critical thinking, nursing process competency and evidence based practice competency of nurses working in middle sized hospitals. A descriptive correlational study design was used. The data were collected from 262 nurses working in the three hospitals located in G and P city using self-administered questionnaires. Data were analyzed using descriptive statistic, independent t-test, one-way ANOVA with scheffe, Pearson's correlation coefficient, and hierarchical multiple linear regression using SPSS Statistics 21.0 program. Nurses' evidence-based practice competency had positive correlation with critical thinking disposition (r=.42, p <.001) and nursing process competency (r=.58, p <.001). Full model accounted for 65.1% of evidence-based practice competency by nursing process competency (${\beta}=.57$, p <.001), critical thinking disposition (${\beta}=.34$, p <.001), critical thinking educational experience (${\beta}=.11$, p=.004), Master's degree (${\beta}=.09$, p=.032). Conclusion: o increase evidence-based practice competency of nurses, it is required to develop critical thinking disposition and nursing process competency of nurses.

• 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.

• Journal of Korean Academy of Nursing
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• v.43 no.2
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• pp.145-153
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• 2013

Purpose: The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. Methods: Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. Results: Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership. Conclusion: There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

• Journal of Korean Dental Science
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• v.3 no.2
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• pp.34-39
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• 2010

In our daily practice, we think about the diagnosis of our patient and get into a situation wherein we have to make a clinical decision. Diagnosis and treatment come from the knowledge and experiences that each dentist should have, but sometimes, we can have doubts on our decisions. "On what evidence did I make such decision? Was that really right?" Drawing our attention these days as a possible answer to this question, evidence-based dentistry seeks to apply the best available evidence gained from the scientific method to medical decision making. To make a good decision, the strength of evidence is assessed. Specifically, randomized controlled trial, systematic review, and meta-analysis are considered the highest level of evidence; cohort study, case control study, case series, animal study, bench test, and biological plausibility follow. With the approach of evidence-based dentistry, we can make objective, scientifically sound clinical decisions. It is also patient-oriented, incorporating clinical experiences and stressing good judgments; thorough and comprehensive, it uses transparent methodology. That is the reason evidence-based dentistry can be better than other assessment methods when we make a clinical decision in modern dentistry.

• Clinical and Experimental Pediatrics
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• v.63 no.12
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• pp.454-462
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• 2020

The Committee on Dyslipidemia of Korean Pediatric and Adolescents of the Korean Society of Pediatric Endocrinology has newly developed evidence-based clinical practice guidelines for dyslipidemia in Korean children and adolescents. These guidelines were formulated with the Grading of Recommendations, which include both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. These guidelines are based on the 2011 National Heart, Lung, and Blood Institute Guidelines, which focus on the prevention of cardiovascular disease in children and draw from a comprehensive review of evidence. These guidelines contain the definition of and screening process for dyslipidemia and introduce new dietary methods: the Cardiovascular Health Integrated Lifestyle Diet (CHILD)-1, the CHILD-2-low-density lipoprotein cholesterol, and the CHILD-2-triglyceride. Potential drug therapies for dyslipidemia along with their main effects and doses were also included.

• The Journal of the Korea Contents Association
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• v.21 no.10
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• pp.613-621
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• 2021

The purpose of this study was conducted to provide emergency nursing class using evidence-based practice (EBP) and to examine its effects. This study was a one-group pretest-posttest experimental design. Data were collected from 54 students in the third year of nursing at a university, between September 2, 2019 and December 9, 2019. An emergency nursing class using EBP consisting of 5-step EBP components was provided through 13 sessions. Lectures, team-based learning, and case-based learning were provided. Data were analyzed using SPSS/WIN 21.0 program with descriptive statistics and paired t-test. After the class, there were significant increase in EBP beliefs (t=-2.76, p=.008) and EBP competency (t=-5.035, p<.001). However, critical thinking disposition was not significantly increased. The findings indicate that emergency nursing classes using evidence-based practice is an efficient teaching-learning method to improve EBP beliefs and competency.