• Title/Summary/Keyword: Evidence-based Practice

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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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경장영양 간호실무지침 개정 (Updates of Nursing Practice Guideline for Enteral Nutrition)

  • 조용애;구미옥;은영;유미;김정연;이현희;민자경;송정미
    • 임상간호연구
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    • 제26권1호
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    • pp.10-25
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    • 2020
  • Purpose: The purpose of this study was to update the previously developed nursing practice guideline for enteral nutrition (EN). Methods: The guideline update was done in 22 steps using standardized methodology for nursing practice guidelines. Results: The updated EN guideline consisted of 16 domains and 228 recommendations. The domains and number of recommendations in each domain were for IDSA (Infectious Diseases Society of America): 8 on general instruction, 9 on general instruction for special nutrition, 9 on general instruction for EN, 3 on assessment of EN, 10 on access to EN, 18 on EN device insertion, 16 on selection and preparation of nutritional supplements, 46 on administration and stopping EN, 22 on maintenance and management of EN, 9 on monitoring EN, 16 on prevention and management of complications of EN, 18 on medication administration, 20 on EN in various situations, 20 on prevention of errors, 1 on nursing education, and 3 on nursing documentation. For the levels of evidence, there were 9.7% for level I, 13.1% for level II, 62.5% for level III and 1.1% for GRADE (Grading of Recommendations Assessment, Development and Evaluation): 3.3% for low, 0.8% for moderate, 9.3% for very low. A total of 133 recommendations were newly developed and 10 previous recommendations were modified. Conclusion: This updated EN nursing practice guideline can be used to enhance evidence-based practice in fundamentals of nursing practice and it should be disseminated to nurses nationwide in order to improve the efficiency of EN practice.

근거 중심 Kampo medicine 임상진료지침의 현황 (Evidence-based Clinical Practice Guidelines On Kampo (Japanese Herbal) Medicine : The Current State of Kampo Clinical Practice Guidelines)

  • 사사키 유이;황정운;김경한;박유리;심호종;박동선;전윤정;김지환;장보형;신용철;고성규
    • 대한예방한의학회지
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    • 제20권1호
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    • pp.55-64
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    • 2016
  • Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

한국형 우울증 임상진료지침 개발(II) (Korean Clinical Practice Guideline for the Treatment of Depressive Disorder(II))

  • 강이헌;김수영;이민수
    • 생물정신의학
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    • 제13권4호
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    • pp.219-225
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    • 2006
  • Depression has been causing huge direct and indirect losses to people's health because of its high prevalence, various clinical patterns, drug reaction and diverse courses different among individuals, but its treatment has not been systematic but dependent on individual clinicians' experience and knowledge. To correct this problem, it has been highly necessary to develop clinical guidelines defined as "systematically developed statements to assist practitioners' and patients' decisions about appropriate healthcare for specific clinical circumstances." Currently, countries throughout the world are making efforts to establish evidence-based guidelines among different levels of guidelines and to evaluate and test them. Although such efforts have been unsatisfactory in Korea because of several constraints including lack of high-quality RCT, the Korean Depression Clinical Practice Guideline has started to develop evidence-based guidelines, which are established through strictly designed processes. Thus, the present study purposed to review methods adopted in the development processes and to present the processes of developing the evidence-based guidelines clearly and transparently.

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