• 한국호스피스완화의료학회:학술대회논문집
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• 2001.12a
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• pp.187-187
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• 2001

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.68-84
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• 1995

Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

• KIEAE Journal
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• v.12 no.4
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• pp.59-69
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• 2012

In order to create humanitarian living environment with sustainable ecological environment, urban regeneration project has been implemented recently seeking diverse methods for residents'participation stressing the process of communication with the residents changing from the existing one way planning by limited number of experts. Particularly, it is essential to develop systematic tools to promote the voluntary and positive participation of the residents because residents have to perform as the master of urban streetscape design project that requires sophisticated knowledge and experience and also because the residents have to function as sustainable maintainers and managers of their streetscape. This study intends to identify the organizational structure and major contents of design guideline as a tool to support the voluntary and positive participation of the residents in streetscape maintenance. For this purpose based on the structural system and characteristics of Chicago streetscape design guideline that was developed as tool for residents' participation, efforts were made to set up framework of design guideline for sustainable streetscape project with the users' participation with their overall understanding and trust. In detail, the author studied the resident participatory process for sustainable maintenance and management in a long term landscape project and the principle and theories of design planning for streetscape that supports the utilizing behaviors of the users, and how this information should be linked and organized to form the structure and contents of design guideline. As a tool supporting residents' participation and helping the residents perform the responsible function as sustainable maintainers and managers of their streetscape through social maturity with ontological sense of masters of their local community as they experience the gradual processes of their streetscape maintenance project, streetscape design guideline has its meaning in the efforts that tried to achieve deep participation of the residents through researches converging the two academic sectors of urban architecture and social psychology.

• Journal of Korean Clinical Nursing Research
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• v.20 no.2
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• pp.147-161
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• 2014

Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

• Journal of Korean Clinical Nursing Research
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• v.21 no.1
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• pp.31-42
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• 2015

Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

• Quality Improvement in Health Care
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• v.24 no.2
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• 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.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• Journal of Korean Society for Quality Management
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• v.22 no.4
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• pp.120-131
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• 1994

A questionaire survey has been conducted to find out the total quality management practices in Korea. Its initial purpose is to search for some general measure of depth and width of spread of quality management throughout Korean industries, specifically in manufacturing and service sectors. This can be used as a guideline for supporting any activities endeavoring to find appropriate methods to boost quality management in Korea. Also, through comparisional analysis at the macro-level, some characteristics in quality management practices are shown to exist in Korean industries. The analysis is based on perceptions of surveyed people about quality management practices in their companies.

• Journal of Environmental Impact Assessment
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• v.3 no.1
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• pp.9-30
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• 1994

Environmental Impact Assessment System, ever since its enactment in Korea fourteen years ago, has been steadily improved by introduction and implementation of new concepts and methodologies which include Environmental Impact Statement(EIS) preparation technique, selection of environmental factors, and the like. However, current guideline requires that every EIS, regardless of the specifics of the project type or characteristics of the site, must evaluate and study for all twenty-two environmental factors as set forth in the regulation. The situation causes many undesirable problems like; lack of site specific evaluation in most EISs, over-sized EIS drafts, consuming too much time and costs for EIS preparation, and so on. The objectives of this study are: - To establish a set of criteria to classify the types of the projects in terms of features of the project content and the characteristics of the site area. - To establish a guideline for selecting major environmental factors of the project type criteria, and - To provide basic materials for the preparation of complets draft EIS of the Amendment of Environmental Impact Assessment Act.