• Title/Summary/Keyword: Evidence based practice

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Practice-based Evidence for Health Promotion in Underserved Clients with Hypertension in Primary Health Care Settings

  • Hong, Woi-Hyun
    • Research in Community and Public Health Nursing
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    • v.26 no.4
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    • pp.390-397
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    • 2015
  • Purpose: The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. Methods: Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. Results: The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). Conclusion: This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.

Validation of a Translated Guideline on Pain Assessment and Management: Focused on Abdominal Surgery Patients (통증관리 근거중심 가이드라인의 국내 타당성 검증 - 복부수술 환자를 대상으로 -)

  • Hong, Sung Jung;Lee, Eunjoo
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.159-170
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    • 2012
  • Purpose: This study was designed to examine the validity of the evidence-based guideline on pain developed by Registered Nurses Association of Ontario(RNAO) translated into Korean based on the experts' opinions. Methods: The panel consisted of experts of 60 registered nurses in surgical units, medical doctors and nursing managers who were experts in pain assessment and management. The validity of translated RNAO guideline was evaluated in terms of appropriateness, applicability, and utilization in current practice. Appropriateness and applicability of each recommendation were measured with 9 point scale, whereas utilization was measured by yes/no question. Data were analyzed by mean, standard deviation, and percent. The experts' opinions were analyzed by content analysis method. Results: In general, most of the recommendations in the guideline received above 7 point in appropriateness and applicability. However, above 20% of recommendations showed less than 50% of utilization rates in current practice. Conclusion: The reasons for low utilization of recommendations in current practice are in need for investigation. This study can be used for the development of guideline more acceptable in Korean health care settings and improve the quality of care for the abdominal surgery patients suffering from pain in Korea.

Development of Evidence-based Nursing Practice Guidelines for Febrile Children in Emergency Room (응급실 내원 발열 소아환자의 열관리를 위한 근거중심 간호실무 가이드라인 개발)

  • Jeong, Min-Jin;Shin, Hyun-A;Kim, Yun-Hee;Lee, Jee-Hyang;Lee, Seung-Ja;Song, Mi-Ra
    • Child Health Nursing Research
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    • v.18 no.4
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    • pp.214-221
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    • 2012
  • Purpose: The purpose of this study was to develop evidence-based nursing practice guidelines for the care of febrile children in the emergency room and to evaluate the guidelines by applying them to practice. Methods: This study was conducted using a methodological design. referring to the Scottish intercollegiate guideline network, draft of guidelines were developed based on the recommendations found from the critical literature analysis. Then, the draft was modified by an expert group and a pilot application. The final draft was evaluated by the expert group using appraisal of guidelines for research and evaluation. Finally, the final guideline and algorithm were completed. Results: The guideline includes 39 recommendations for the care of febrile children in the emergency room. Conclusion: The clinical guidelines developed through this research can be utilized as systematic and scientific guidelines for the care of febrile children in the emergency room. In addition, the research results will contribute to improving care services.

Convergence effectiveness verification for developing practice guidelines for dementia patients cognitive programs (치매환자 인지프로그램 실무지침 개발을 위한 융합적 효과검증)

  • Ham, Min-Joo
    • Journal of the Korea Convergence Society
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    • v.12 no.5
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    • pp.85-91
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    • 2021
  • This study is a methodological study that explains the procedure for verifying effectiveness in developing practical guidelines for cognitive programs suitable for dementia patients. Based on the development of evidence-based new clinical practice guidelines, a preliminary recommendation for the domestic dementia patient care guidelines was developed. The practical guidelines consisted of the final four types, and the content validity score of the configuration items was 0.87 to 1 point. In the sub-categories of field applicability, appropriateness score was 3.95 to 4.34 points, applicability score was 3.57 to 4.27 points, and predicted effect score was 3.84 to 4.22 points. Through the examination of the content validity and field applicability of experts, it was confirmed that the practical guidelines developed in this study can be used as the basis for establishing an intervention plan for dementia cognitive program managers engaged in clinical practice. In future studies should further facilitate the development of evidence-based treatment guidelines to select appropriate treatment activities for dementia patients.

Nurses' Awareness and Performance about Evidence-based Pain Management in Older Adults (병원 간호사의 근거중심 노인통증관리 지침에 대한 인지도와 수행도)

  • Kim, Eun-Kyoung;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.24 no.1
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    • pp.20-30
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    • 2012
  • Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

Opioid Pharmacotherapy for Chronic Noncancer Pain: The American Experience

  • Chapman, C. Richard
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.3-13
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    • 2013
  • Chronic noncancer pain is a significant and growing public health challenge in the United States. Lacking effective alternative interventions for effective chronic noncancer pain management, many physicians have turned to opioid pharmacotherapy. Increased opioid prescribing brings not only gains in therapeutic benefit but also a higher incidence of adverse drug events including increased medication misuse and opioid related mortality. Currently the United States must confront the dual problems of widespread undertreated chronic noncancer pain and a prescription opioid abuse crisis. Withholding pain relieving drugs from patients in need is unjustifiable, yet drug diversion, abuse and adverse drug events have become major social as well as medical problems. At the heart of this crisis is the lack of definitive evidence about the risk to benefit ratio of opioid pharmacotherapy for chronic noncancer pain both on an individual case and on a population basis. This article describes the extent and severity of the American chronic noncancer pain problem and the history of opioid pharmacotherapy for chronic noncancer pain in the United States. It then discusses the concept of evidence based practice and reviews current evidence supporting opioid pharmacotherapy for chronic noncancer pain as well as adverse drug events related to opioid pharmacotherapy including misuse and abuse. Finally, it considers the conflict of providing pain relief versus protecting society and reviews steps that governmental agencies, industry and others are taking to contain and ultimately resolve the problems of excessive prescribing and conflicting priorities.