• 제목/요약/키워드: Evidence-Based practice

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University/Hospital Collaborations to Promote Research and Evidence Based Practice in Clinical Environments

  • Griffiths, Rhonda
    • Perspectives in Nursing Science
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    • v.4 no.1
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    • pp.19-25
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    • 2007
  • Systems and processes to provide clinical education to students of nursing have been established between universities and health facilities in all countries where nurse education is tertiary based. However, systems and processes to link nurse researchers based in universities to their clinical colleagues are less well developed. When collaborations are established they are frequently based on personal networks, and while the rhetoric of the organizations encourages these collaborations, they are largely unrecognised by senior administrators in health facilities. The research is frequently "invisible" and the clinician researchers usually do not have access to appropriate infrastructure and other resources that are required to support large projects that have the potential to change practice across organisations. This situation influences the focus and scope of nursing research and limits opportunities for clinicians to be engaged in the generation of professional knowledge. The University of Western Sydney (UWS) has taken a strategic approach to the development of collaborations for research and has linked with health services in Western Sydney to establish and maintain research centres and adjunct appointments. The partner organisations jointly fund the infrastructure of the centres which include a Professor, research assistant position(s) and administrative staff. Five Professors of Nursing have been appointed to positions in one of three nursing research centres. This paper describes the approach established by the School of Nursing at UWS to build collaborations with clinical areas to promote research. This approach could be adopted or adapted by other facilities.

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Updates of Nursing Practice Guideline for Intravenous Infusion (정맥주입요법 간호실무지침 개정)

  • Gu, Mee Ock;Cho, Yong Ae;Eun, Young;Jung, Ihn Sook;Kim, Hyun Lim;Yoon, Hee Sook;Kim, Eun Hyun;Yoon, Ji Hyun;Chang, Hee Kyung
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.361-375
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    • 2017
  • Purpose: This study was conducted to update the existing nursing practice guideline for intravenous infusion guidelines according to the evidence-based practice guideline in South Korea. Methods: Guideline update process was performed using 22 steps according to the manuals developed by NICE and SIGN. Results: Updated nursing practice guidelines for the intravenous infusion were consisted of 23 domains and 322 recommendations. The number of recommendations in each domain were 4 for general instruction, 12 for vascular access device selection, 20 for site selection, 9 for insertion, 54 for stabilization, 21 for maintaining patency, 4 for blood sampling, 33 for exchange and removal, 28 for add-on device selection, 28, 72 for infusion related complications, 56 for infusion therapies, 7 for education, and 2 for documentation and report. There were 15.9% of A, 30.2% of B, 53.9% of C in terms of grade recommendations. A total of 178 (51.6%) recommendations were newly developed and 24 previous recommendations have been deleted. Conclusion: Updated nursing practice guideline for intravenous infusion was expected to be an evidence-based practice guideline for intravenous infusion in South Korea. This guideline is suggested to be disseminated to clinical nursing settings nationwide to improve the efficiency of intravenous infusion practice.

Updates of Nursing Practice Guideline for Oral Care (근거기반 구강간호 실무지침 개정)

  • Cho, Yong Ae;Lee, Seon Heui;Kim, Kyeong Sug;Im, Hyo Min;Kim, Tae Hee;Choi, Mi Young;Seo, Hyun Ju;Park, Hyo Sun;Wang, Keum Hyun;Kim, Chan Hee;Choi, Hee Kyung
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.141-153
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    • 2020
  • Purpose: This study aimed to update the previously published nursing practice guideline for oral care. Methods: The guideline were updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 1.0. Results: Updated nursing practice guideline for oral care was consisted of 10 domains and 79 recommendations. The number of recommendations in each domain were: 5 general issues, 2 oral care indications, 9 oral assessment, 16 general oral care, 12 oral care for critically ill patients, 16 oral care for cancer patients, 12 oral care for cancer patients with oral complications, 5 oral care education, 1 oral care referral, and 1 documentation and report. In terms of grades for recommendations, 11.4% was grade A, 17.0% was grade B, and 68.2% was grade C. Twelve new recommendations were developed and 7 previous recommendations were deleted. Conclusion: Updated nursing practice guideline for oral care is expected to serve as an evidence-based practice guideline for oral care in South Korea. It is recommended that this guideline be spread to clinical nursing settings nationwide to improve the effectiveness of oral care practice.

Utilization of Evidence-Based Clinical Nursing Practice Guidelines in Tertiary Hospitals and General Hospitals (상급종합병원과 종합병원의 근거기반 임상간호실무지침의 활용도)

  • Eun, Young;Jeon, Mi Yang;Gu, Mee Ock;Cho, Young Ae;Kim, Jung Yeon;Kwon, Jeong Soon;Kim, Kyeong Sug
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.3
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    • pp.233-244
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    • 2021
  • Purpose: The purpose of this study was to investigate the actual utilization of clinical practice guidelines developed by Hospital Nurses Association. Methods: The subjects were 70 nurses who were in charge of guideline distributions in 70 advanced general hospital and general hospitals with 500 beds or more nationwide. Data were collected between June and August, 2020 by mail (return rate: 88.6%). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 24.0. Results: Among the clinical practice guidelines developed by Hospital Nurses Association, 72.9~90.1% were placed with book and electronic file in nursing department and 24.3~35.8% were placed with book and electronic file in each nursing unit at hospital. The average number of utilized clinical practice guidelines were 3.96±3.88, and average score of guideline utilization was score 2.85±0.79 which means 'use sometimes'. Conclusion: To improve the distribution and utilization of the clinical practice guidelines, it is necessary to enhance the recognition of values of evidence based nursing practice targeting head of nursing department and to stimulate the distribution and utilization of the clinical practice guidelines using diverse education programs for staff nurses.

Development and Evaluation of an Evidence-Based Nursing Protocol for Fever Management in Adult Patients (성인 발열 환자를 위한 근거기반 간호 지침 개발 및 평가)

  • Shin, Yong Soon;Kim, Sung Reul;Yoo, Sung-Hee;Kim, Sun Hwa;Kim, Jeoung Hee;Kim, Hyun Jung;Na, Ra;Chae, Jee Sun;Lee, Hye Jin;An, Young Hee;Kim, Kyoung-Ok
    • Korean Journal of Adult Nursing
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    • v.25 no.3
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    • pp.250-262
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    • 2013
  • Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

Topics for Evidence-Based Clinical Nursing Practice Guidelines in Korea (국내 근거기반 임상간호실무지침의 주제 선정)

  • Gu, Mee Ok;Cho, Myoung Sook;Cho, Yong Ae;Jeong, Jae Sim;Jeong, Ihn Sook;Park, Jeong Sook;Kim, Hea Jeong;Eun, Young
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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    • pp.307-318
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    • 2011
  • Purpose: This study was to identify topics for evidence-based clinical nursing practice guidelines in Korea. Methods: Data were collected from 330 staff nurses from 10 general hospitals and 53 nurses in charge of nursing education in 110 hospitals with over 500 beds. Using open questions, the nurses identified activities which could not be verified, which lacked consistency among nurses, clinical units and/or hospitals, which were not based on the up-to-date knowledge and which needed reform. The data were analysed by content analysis using a qualitative methodology. Results: Collected data consisted of 1882 clinical topics, which were classified into 50 topics, 207 mid-categories, and 456 sub-categories. The most frequent topics in order of frequency were medications, central line management, intravenous injections, urinary catheterization, perioperative nursing care, skin tests, pressure ulcer care, blood transfusions, laboratory examination-culture, respiratory care which were performed routinely in clinical setting by staff nurses. Conclusion: The research findings indicate the urgent need to develop evidence-based clinical nursing practice guidelines related to these research findings. Further research is needed to identify topics related to health promotion, and symptom/management of health problem.

Adaptation of Evidence-based Surgical Wound Care Algorithm

  • Han, Jung-Yeon;ChoiKwon, Smi
    • Journal of Korean Academy of Nursing
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    • v.41 no.6
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    • pp.768-779
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    • 2011
  • Purpose: This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. Methods: This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. Results: A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ${\leq}$.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. Conclusion: The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

Korean Surgical Practice Guideline for Pancreatic Cancer 2022: A summary of evidence-based surgical approaches

  • Seung Eun Lee;Sung-Sik Han;Chang Moo Kang;Wooil Kwon;Kwang Yeol Paik;Ki Byung Song;Jae Do Yang;Jun Chul Chung;Chi-Young Jeong;Sun-Whe Kim;Committee of the Korean Surgical Practice Guideline for Pancreatic Cancer
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.1
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    • pp.1-16
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    • 2022
  • Pancreatic cancer is the eighth most common cancer and the fifth most common cause of cancer-related deaths in Korea. Despite the increasing incidence and high mortality rate of pancreatic cancer, there are no appropriate surgical practice guidelines for the current domestic medical situation. To enable standardization of management and facilitate improvements in surgical outcome, a total of 10 pancreatic surgical experts who are members of Korean Association of Hepato-Biliary-Pancreatic Surgery have developed new recommendations that integrate the most up-to-date, evidence-based research findings and expert opinions. This is an English version of the Korean Surgical Practice Guideline for Pancreatic Cancer 2022. This guideline includes 13 surgical questions and 15 statements. Due to the lack of high-level evidence, strong recommendation is almost impossible. However, we believe that this guideline will help surgeons understand the current status of evidence and suggest what to investigate further to establish more solid recommendations in the future.

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

  • Jung, Hye-Kyung
    • The Korean Journal of Gastroenterology
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    • v.72 no.5
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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.

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

  • Lee, Kyung Hae;Shin, Kyung Min;Lee, Hyeon Jeong;Kim, So Young;Chae, Jung Won;Kim, Mi Ra;Han, Min Young;Ahn, Mi Sook;Park, Jin Kyung;Chung, Mi Ae;Chu, Sang Hui;Hwang, Jung Hwa
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.1
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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.