• 제목/요약/키워드: Evidence based practice

검색결과 566건 처리시간 0.026초

2017 과민성장증후군의 임상진료지침 개정안 소개 (Review of the Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition)

  • 정혜경
    • 대한소화기학회지
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    • 제72권5호
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    • pp.252-257
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    • 2018
  • This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS.

조영제 유발 신장병증 예방을 위한 수액요법에 관한 근거기반 임상실무지침 개발 (Evidence-Based Clinical Practice Guideline for Fluid Therapy to Prevent Contrast-induced Nephropathy)

  • 이경해;신경민;이현정;김소영;채정원;김미라;한민영;안미숙;박진경;정미애;추상희;황정화
    • 임상간호연구
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    • 제23권1호
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    • pp.83-90
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    • 2017
  • Purpose: This study was to develop evidence-based clinical practice guideline in order to prevent contrastinduced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). Methods: The guideline was developed based on the "Scottish Intercollegiate Guidelines Network (SIGN)". The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. Results: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. Conclusion: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.

신경계물리치료에서의 근거중심실기(2) -지속가능한 EBP 수행을 위한 정보검색 기술- (Evidence-Based Practice in Neurological Physical Therapy (2) -Information Research Technology for Sustainable Practice of EBP-)

  • 이문규;김태윤;임재헌
    • PNF and Movement
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    • 제15권2호
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    • pp.115-124
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    • 2017
  • Purpose: Researchers found that blocks of evidence-based practice (EBP) implementation lacked opportunities for EBP education. The study found that physical therapists had negative views of research as well as their roles in EBP, lacked confidence in EBP, and had limited access to web-based materials. The purpose of this study was to highlight the importance of information research technology for efficient EBP in a clinical environment. Methods: The web-based information research technologies that should be used for sustainable EBP include: the clinical practice guideline (CPG) and PubMed's My NCBI service. Journal mailing services and other academic information sources should also be used to gather information from RSS feeds. An EBP library or archive must be created. A site that provides EBP-specific information is also needed. Results: We should usually do EBP. Practitioners must learn and use information technologies that will help them improve their EBP skills. Conclusion: Facilitating EBP implementation and building an EBP system require related education as well as a practical work environment and equipment. However, the highest priority is individual efforts and trial. Information technology will complement the lack of time. It is important to use information research technology to overcome real obstacles. Lasting EBP must use a number of web-based information research technologies to overcome the practical challenges encountered in EBP implementation.

근거기반실무(Evidence-based Practice) 자기효능감, 교과목 요구도, 장애요인 및 촉진요인 탐색을 위한 혼합연구: 교수 및 임상실습 프리셉터를 중심으로 (Mixed Method Research Investigating Evidence-Based Practice Self-efficacy, Course Needs, Barriers, and Facilitators: From the Academic Faculty and Clinical Nurse Preceptors)

  • 오의금;양유리;유재용;임지윤;성지현
    • 대한간호학회지
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    • 제46권4호
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    • pp.501-513
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    • 2016
  • Purpose: The current challenges faced by nurses in providing high quality and evidence-based practice (EBP) supported care require profound changes in nursing education. To understand the changes needed to strengthen EBP education, the researchers examined EBP self-efficacy, course needs, barriers, and facilitators for academic faculty and clinical nurse preceptors to teach EBP in undergraduate nursing curricula. Methods: For this study, mixed-method approach was used with survey data collected from 73 academic faculty members from 54 universities. Further, 17 clinical nurse preceptors in three academic hospitals provided qualitative data for exploration of barriers and facilitators to teaching EBP. Data analysis used SPSS/WIN 21.0 and content analysis. Results: Quantitative data showed that although the overall level of self-efficacy among faculty was moderate, the implementation levels were relatively low. Most faculty members agreed with the need to integrate EBP courses into undergraduate nursing curricula. The qualitative data showed that the barriers to teaching EBP were lack of knowledge, skill, and initial investment for teaching EBP; hierarchical, rules-oriented nursing culture; potential learner overloads in processing EBP; limited research dissemination and application. Facilitators were identified as the importance of EBP to the profession of nursing; collaboration in schools and hospitals; and continuing education in teaching/utilizing EBP. Conclusion: The findings indicate that for successful integration of EBP ni nursing education there is a need for faculty training and integrated EBP courses.

간호사의 근거중심실무역량에 대한 영향요인 (Factors Influencing Competency in Evidence-based Practice among Clinical Nurses)

  • 김연숙;김지미;박미미
    • 간호행정학회지
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    • 제21권2호
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    • pp.143-153
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    • 2015
  • Purpose: The aim of this study was to describe competency in evidence-based practice (EBP) among clinical nurses and to explore critical thinking disposition (CTD) and organizational culture (OC) as possible predictors for competency in EBP. Also this study was conducted to identify baseline data for purpose of developing evidence-based OC to ensure safety of patients and to improve quality of nursing services in clinical setting. Methods: With a descriptive correlation study design, a competency in EBP questionnaire was administered to a convenience sample of nurses (N=393) from a single general hospital in Gyeonggi Province. Results: The overall mean score for competency in EBP was $3.03{\pm}0.53$. Factors influencing competency in EBP were education (${\beta}=0.23$, p<.001), attendance at lectures on EBP (${\beta}=0.18$, p<.001), intellectual eagerness & healthy skepticism (${\beta}=0.27$, p<.001) among CTD, and hierarchy-oriented OC (${\beta}=0.14$, p=.005), which explained about 35% of the total variance. Conclusion: Critical thinking and competency in EBP should be part of nursing education especially for undergraduate students as well as strengthening clinical practice by activation of EBP. The results of this study that hierarchy-oriented OC, is a significant predictor for competency in EBP is difficult to accept. Its seemed to require further exploration.

종합병원 간호사의 근거기반실무 준비도와 근거기반실무 역량의 영향 요인 (Factors Influencing of Evidence based Practice Competency and Evidence based Practice Readiness in General Hospital Nurses)

  • 류세앙;김윤숙;김윤희
    • 간호행정학회지
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    • 제22권5호
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    • pp.448-460
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    • 2016
  • Purpose: The study was done to verify evidence-based practice (EBP) readiness and factors contributing to EBP competency in general hospital nurses. Methods: Participants were 219 nurses working in 7 general hospitals in G-city and J Province. Data were collected from May 12 to May 28, 2015 and analyzed using one-way ANOVA, Pearson's correlation and stepwise multiple regression. Results: Mean score for EBP competency was $3.89{\pm}0.83$, for critical thinking disposition, $3.35{\pm}0.36$, for EBP attitude, $3.53{\pm}0.66$, for beliefs about value of EBP, $3.42{\pm}0.56$, for ability in research performance, $2.86{\pm}0.57$, for time to devote to EBP, $2.57{\pm}0.69$ and for organization support for EBP, $3.36{\pm}0.46$. EBP competency was significantly correlated with critical thinking disposition (r=.37, p<.001), beliefs about value of EBP (r=.43, p<.001), ability in research performance (r=.44, p<.001), and time to devote to EBP(r=.33, p<.001). Factors influencing EBP competency in general hospital nurses were research performance (${\beta}=.29$, p<.001), beliefs about value of EBP (${\beta}=.24$, p<.001), critical thinking disposition (${\beta}=.15$, p=.014), recognition of EBP (${\beta}=-.18$, p=.002), which together explained 35% of total variance. Conclusion: Findings indicate that introduction and activation of EBP in general hospitals is essential and development of systematic training programs to strengthen critical thinking disposition and EBP competency are needed.

한국형 노인요양시설 근거중심 감염관리 가이드라인 개발 (Development of Evidence-based Guidelines for Nursing Home's Infection Control in Korea)

  • 박연환;이성현;이유미;이지영;이민혜
    • 근관절건강학회지
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    • 제25권2호
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    • pp.135-147
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    • 2018
  • Purpose: The purpose of this study was to develop evidence-based guidelines for infection control in nursing homes in Korea (ENIK). Methods: Three steps were planned for the development which were developing a draft and testing the content validity. First, the draft was based on evidence and developed through focus group interviews with nurses in nursing homes, a comprehensive review of international guidelines and literature, and systematic reviews of interventions for infection control and outbreaks in long-term care facilities. Clinical applicability was established through reviews of nursing records and job assignments in one nursing home. The final step consisted of experts evaluating the content validity. The ENIK was revised to fit Korean nursing homes. Results: The ENIK consisted of recommendations in 9 compositions and a one-page practical algorithm. The principles of infection control were presented by statements and specific strategies were recommended in resident care programs. The infection control practical algorithm was organized into 3 steps: screening at admission, prevention, and control at the early stage. The practice to control infection was composed of a 5-step process. Conclusion: The ENIK will contribute to improving the competency of infection control practice because it provides standardized practice and is tailored to Korean nursing homes.

임상시험의 단계별 이해 및 실제 (Understanding of Clinical Trials and Application to the Real Practice)

  • 최성구
    • 생물정신의학
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    • 제19권4호
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    • pp.153-158
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    • 2012
  • Understanding of a clinical trial is essential in developing clinical guideline and adopting evidence based practice. In designing and executing clinical trials, following ethical requirements should be considered : social value, scientific validity, fair subject selection, informed consent, favorable risk-benefit ratio, institutional review board, and respect for human subjects. According to the stage of drug development, purpose of trials, accumulated scientific data, clinical trials for drug development are classified as phase 1, 2, 3, and 4. Phases of clinical trials can be overlapped and the judgment of entering into the next phase should be considered highly strategically. In reading, evaluating and interpreting clinical trial reports, various skills and challenges exist. Patient sample composition, trial duration, selection of endpoints, responders and non-responders, placebo effect, patient recruitment, and extrapolation to the real world are the examples of those challenges. Treatment success will come from the well balanced approach of evidence based decision making and consideration of specific single case.

음성 장애 치료 연구의 최근 동향: 증거에 기초한 임상 치료 및 전이 생물학적 연구 (Recent Trends in the Treatment of Voice Disorders: Evidence-based Practice and Translational Biology Research)

  • 최성희
    • 말소리와 음성과학
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    • 제2권1호
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    • pp.99-112
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    • 2010
  • This study attempted to review the recent, high-quality evidence-based practical research related to the treatment effectiveness of voice disorders which focus on randomized controlled trials (RCTs) and translational research of vocal fold tissue engineering for vocal fold regeneration. Methodology including PICO (P; Populations or Patients, I; Interventions, C; Comparison group (control, placebo, gold standard), O; Outcomes or measures made) information for RCTs and animal models (species), regenerative therapy method, and outcomes of translational research for clinical application was summarized and discussed for future voice disorder research.

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