• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.3
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• pp.366-378
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• 2000

Type 2 Diabetes Mellitus patients have chronic metabolic disorder and they need self care for their lifetime. But most Diabetes Mellitus patients don't know how to do a self care due to the lack of adequate support from health care professionals. It has been reported that lack of exercise therapy compliance guide is very important one. This study was conducted to develop an exercise therapy protocol applied to an efficacy expectation promoting program based on Bandura's self efficacy model for type 2 Diabetes Mellitus patients. Firstly, a conceptual framework was developed through efficacy expectation promoting Program based on Bandura's self efficacy model. In order to identify the contents of program and to design a preliminary protocol, a with the consultation experts was made. A clinical validity was tested using twenty type 2 Diabetes Mellitus patients who received follow-up care regularly through the diabetic out-patient clinic from October, 1998 to May, 2000. After this process, the final protocol was developed. The results of this study are summarized as bellows : The final exercise therapy protocol applied to an efficacy expectation promoting program for type 2 Diabetes Mellitus Patients consists of individualized exercise test and prescription, a small booklet relating personal experience with Diabetes Mellitus and a telephone coaching program for 12 weeks on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. It is concluded that the exercise therapy protocol applied to an efficacy expectation promoting program is applicable to type 2 diabetes mellitus. And this exercise therapy protocol could show a positive effect on the exercise compliance of Diabetes Mellitus patients.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.44-55
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• 2001

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

• Journal of Korean Clinical Nursing Research
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• v.22 no.1
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• pp.1-9
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• 2016

Purpose: This study was done to identify effects of oral care protocol on oral mucositis and oral care performance in hematologic malignancy patients receiving chemotherapy. Methods: The design of this study was a nonequivalent control group pretest-posttest design. Both groups were patients diagnosed with hematologic malignancies who were receiving chemotherapy-each group had 20 patients. In the experimental group, patients were given intensive education on oral care based on the oral care protocol, whereas in the controlled group, each patient was given an educational brochure. Before chemotherapy, and 3 days, 7 days, and 14 days after chemotherapy, oral mucositis status of two groups were assessed using the guide to physical assessment of the oral cavity. Oral care performance was examined before chemotherapy and 14 days later. Results: The experimental group with the oral care protocol showed a significant difference (F=18.15, p<.001) in the oral mucositis status, and also in oral care performance (t=-10.33, p<.001). Conclusion: Findings indicate that the application of the oral care protocol is an effective tool for lowering the occurrence of oral mucositis and enhancing oral care performance in hematologic malignancy patients receiving chemotherapy.

• Journal of Korean Clinical Nursing Research
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• v.24 no.3
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• pp.356-362
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• 2018

Purpose: This study was a retrospective cohort study to evaluate the effect of evidence-based guidelines for catheter dysfunction among hemodialysis patients, Success rate and bleeding complications in catheterization were examined. Methods: We performed a retrospective cohort study, including 94 patients with catheter dysfunction who were receiving hemodialysis at a university hospital; 55 in the control group and 39 in the protocol group. This protocol was composed of the catheter dysfunction assessment, conservative management of catheter dysfunction, drug management of catheter dysfunction, catheter function test and maintenance management. Data were analyzed with a Chi-square test and t-test using SPSS/WIN 23.0 program. Results: The patency rate of the protocol group was significantly higher than that of the control group. The rate of bleeding complications was not statistically significant for either the control group or the protocol group before or after application. Conclusion: The application of the guidelines effectively increased the patency rate of the catheter without bleeding complications. It is hoped that this guideline can be disseminated to nurses nationwide to improve the efficiency of catheter function for hemodialysis patients.

• Women's Health Nursing
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• v.8 no.3
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• pp.380-388
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• 2002

The purpose of this Quasi-experimental design was to assess the effects of a hysterectomy on women's emotional response and ultimately, to develop a nursing protocol recommending nursing education for women undergoing a hysterectomy. The subjects at D university hospital receiving a hysterectomy,(for benign gynecological disease) were invited to participate in the study. Subjects who agreed to participate were allocated into control or experimental groups. Each group consisted of 30 women. The subjects emotional adaptation was surveyed through mood questionnaires. The data were analyzed using SAS program. The findings of the study are as follows: In the post test, the "experimental group" reported higher emotional adaptation than the "control group". Between pre and post testing, the "experimental group" showed significant improvement in emotional response; the "control group" did not. In conclusion, allocating nursing information to women both before and after undergoing a hysterectomy was confirmed as an effective nursing intervention for promoting women's emotional adaptation. Therefore, we propose a nursing protocol should be adapted recommending nursing education for women undergoing a hysterectomy.

• Journal of Korean Academy of Nursing
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• v.35 no.2
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• pp.292-302
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• 2005

Purpose: Concept analysis was performed on the behavioral concept of endotracheal suctioning (ETS), to identify the goal, to develop astandardized clinical protocol, to identify the antecedents and consequences, and to differentiate the improper use of ETS. Method: Walker & Avant's concept analysis was employed using clinical guidelines, books and review articles in which the procedures of ETS were written in detail and published in Pubmed within the last 20 years. Result: The macro-goal of ETS was to remove accumulated respiratory secretions. Three defining attributes of ETS were identified; catheter, suctioning and asepsis. Each attribute involved empirical referents, such as the size and depth of the catheter, the suction pressure, duration and method for suctioning. The antecedents of ETS were identical to the clinical evidences for the need of ETS such as the nursing assessment data. The consequences of ETS serve as an evaluation criteria on the effectsof ETS based on the goal of ETS. Conclusion: The concept analysis of ETS demonstrates an example of considering a specific nursing protocol of ETS as a behavioral concept, applying concept analysis to it to identify it's key behavioral components as defining attributes and empirical referents and then developing and applying the standard ETS protocol.

• Korean Journal of Adult Nursing
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• v.27 no.3
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• pp.304-313
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• 2015

Purpose: Aspiration pneumonia (AP) is the major complication of dysphagia in patients with acute stroke. Nursing management for dysphagia influences on patients' health outcomes. The purpose of this study was to develop and evaluate the effects of Dysphagia Nursing Protocol (DNP) for patients with acute stroke. We aimed to examine the incidence of AP and the dependency rate at the discharge. Methods: We used a non-equivalent control group posttest only design in this study. DNP was developed with content validity index > 0.75 in all items. This protocol was composed of the evaluation, education, complication prevention, and checking phases. After training the staff nurses, we applied DNP protocol to the experimental group. The control group was enrolled from June to August 2013 (n=80), and the experimental group was June to August 2014 (n=64). Results: The incidence of AP was 16.3% in control group while 4.7% in experimental group (p=.028), and the Odds Ratio (OR) was 0.26 (p=.045). The dependency ratio was 66.3% in control group while 43.8% in experimental group (p=.011), and the OR was 0.33 (p=.011). Conclusion: DNP was beneficial for the reducing the risk of AP and the improved the functional status.

• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.355-365
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• 2015

Purpose: The purpose of this study was to evaluate nursing protocols for superficial cryotherapy in different medical institutions. Methods: The study was conducted with a cross-sectional descriptive design. The medical institutions including general hospitals, hospitals, and geriatric hospitals were randomly selected. A total of 435 nurses from 126 institutions completed a questionnaire. Data were collected from December 2014 to June 2015. Results: Forty-two institutions (39.5%) had nursing protocol for cryotherapy. The nurses reported that durations of cold application were 2 minutes to 5 hours. Frequently used cold therapy devices in order of frequency were frozen gel packs, ice packs, and frozen IV fluid bags. There were variances in the duration of cold application according to the types of institution ($x^2=7.78$, p=.020) and nursing units ($x^2=26.42$, p<.001). In addition, intervals of cold application were different according to the nursing units (x=12.23, p=.032). There were differences in cold application instruments by regional groups (x=70.38, p<.001). Most of the nurses (95.6%) responded that national nursing protocol for superficial cryotherapy were needed. Conclusion: There were difficulties in providing consistent nursing interventions because of the practical differences and absence of evidence-based guidelines for cryotherapy. The researchers recommend that basic studies with various instruments be conducted and proper nursing protocols be developed for cryotherapy.

• Journal of Korean Critical Care Nursing
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• v.8 no.2
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• pp.1-12
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• 2015

Purpose: The study sought to determine the state of blood glucose control, and the consequent clinical effects and variation in blood glucose level, of adult patients admitted to intensive care units following cardiothoracic surgery by comparing the blood glucose levels before and after the application of a blood glucose control protocol. Methods: The protocol was developed by modifying and supplementing the Yale protocol, and was first used in 2012. The resulting blood glucose data of an experimental group (n = 314), to which the blood glucose control protocol had been applied, and a control group (n = 347), whose blood glucose levels had been controlled according to physicians'prescriptions without the protocol, were collected through the medical records. Results: The target blood glucose ratio increased significantly in the experimental group, and the low blood glucose ratio decreased significantly in the experimental group. The two groups exhibited a significant difference (p < .001) in the degree of variation in the blood glucose levels. The duration of the use of a ventilator was significantly reduced in the experimental group (p < .001). Conclusion: It is expected that the protocol can be used for the safe and effective control of critically ill cardiothoracic surgery patients' blood glucose levels.

• Journal of Korean Critical Care Nursing
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• v.7 no.1
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• pp.33-39
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• 2014

Purpose: The propose of this study was to introduce the clamping protocols for a biliary external drainage tube and trace the results of using clamping protocols to prevent some possible biliary complications or enable their early detection in living-donor liver transplantation. Method: This study was a retrospective study to analyze the cases of 97 subjects who had undergone liver transplantation in a hospital in Seoul, Korea. Clamping protocol 1 was applied to 47 patients, and clamping protocol 2 was applied to 50 patients. Results: In the case of protocol 1, the success rate of the clamping protocol was 74.5%, while that of protocol 2 was 84.0%. However, there was no significant difference in the compiled statistics from authentic sources (p = .246). Conclusions: The difference in the success rate between the two protocols was not significant for the clamping protocols of the biliary external drainage tube. However protocol 2 is suggested for the clamping method due to the simplicity of application. Further study with a large sample size is suggested.