• 사상체질의학회지
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• 제30권2호
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• pp.28-41
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• 2018

Objectives The purpose of this study is to evaluate the quality of case reports about Sasang Constitutional Medicine(SCM). Methods Case reports published from March, 2015 to March, 2018 in Journal of SCM were identified by searching from Oriental Medicine Advanced Searching Integrated System(OASIS). We assessed the quality of reporting of them based on CAse REport (CARE) guideline. Results A total of 39 case reports were finally included for the assessment. Overall quality of reporting was acceptable because case report even less reporting items mentioned 70.4% of them. However, the quality level was uneven because the maximum report rate was 77.8 %, the minimum 44.4 %, and the median 66.7 % when rigorously assessed. More than 50% of 39 case reports did not report 6 items about intervention adherence and tolerability, Diagnostic challenges, patient's perspective on interventions, informed consent, timeline, and adverse events, and did not sufficiently report 4 items about inclusion of terms such as case reports or SCM in keyword, symptoms of patient in abstract, information such as occupation relevant with psychosocial history, and the rationale for conclusions. Conclusions Efforts to improve the quality of reporting in SCM, and to develop case reporting guidelines appropriate for SCM are required.

• 중환자간호학회지
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• 제15권1호
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• pp.1-12
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• 2022

Purpose : This study aimed to identify the status of intrahospital transport (IHT) of critically ill patients and provide baseline data to form recommendations for safer transport. Methods : Data were collected from 141 intensive care unit (ICU) nurses who attended national conferences between February and August, 2018. The collected data were analyzed using descriptive statistics and ANOVA, and post-hoc analysis was conducted with the Scheffé and Games-Howell tests. Results : Of the nurses surveyed, 61.7% answered that their workplace had a transport guideline. In terms of the experience of ICU nurses, 31.2% of respondents answered that they had received training on IHT. This result indicated that the degree of implementation of the guidelines for IHT was generally high, but some, including guidelines on personnel, equipment, and monitoring, were not. Guidelines of IHT were well observed when the institutes had specific guidelines for IHT of critically ill patients with specified transport grades, a scoring system to assess stability of a patient, a checklist and a protocol for action in case of problems, and when healthcare providers were provided with training. Conclusion : These results suggest that organized infrastructure, such as a transport guideline with transport grades, a checklist to improve the implementation of guidelines, and a protocol for coping with a problem, should be provided for safe transport. Additionally, effective education and evaluation to improve the competency of staff participating in the transport of patients will help reduce the occurrence of adverse events in intensive care transport in hospitals and promote patient safety.

• Journal of Trauma and Injury
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• 제33권1호
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• pp.1-12
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• 2020

Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7237-7243
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• 2015

응급실은 병원으로 입원하는 주요 경로로서, 감염환자의 1차적 내원의 가능성이 높은 곳이다. 국내에서 질병관리본부가 2009년에 제정한 "응급실에서의 감염관리 표준지침"이 응급실 감염환자 관리 방안과 표준시설기준을 규정하고 있으나 각 병원 응급실의 감염환자 시설은 병원마다 차이가 있고 지침에 따른 일관된 감염환자 관리시설을 갖추었다고 보기 어렵다. 본 연구는 응급실에서의 감염관리 표준지침의 실효성을 알아보기 위해 법적 강제성을 갖는 "응급의료에 관한 법률"과 비교하여, 첫째 지침이 법률 시설기준에 반영된 여부를 분석하였고, 둘째 2009년 전후에 신축 또는 개축한 응급실들을 분석대상으로 하여 각 시설기준 항목들의 반영여부를 파악하였다. 그 결과 지침과 법률 시설기준의 상호연관성은 없었다. 분석대상 응급실들의 시설은 법적기준을 모두 충족한 반면 지침의 감염관리시설은 선별적으로 적용되어 있었고, 설치 항목들이 건축년도에 관계없이 분석대상 응급실에 대부분 적용되어 "응급실에서의 감염관리 표준지침"의 제정과는 무관한 것으로 나타났다. 본 연구 결과는 향후 응급실의 감염관리시설의 법적기준 체계 보완에 참고자료로 활용 될 수 있을 것이다.

• 임상간호연구
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• 제24권2호
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• pp.209-226
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• 2018

Purpose: This purpose of this study was to develop evidence-based practice guideline for isolation in health care settings to prevent transmission of infectious diseases utilizing guideline adaption process. Methods: The process of guideline adaptation was performed according to the Korean hospital nurses association's guideline adaptation manual which consisted of three main phases, 9 modules, and 24 steps. Results: The adapted isolation guideline consisted of introduction, overview of isolation guideline, summary of recommendations, recommendations, references, and appendices. The guideline includes 224 recommendations in 4 sections which are organizational administration, standard precautions, transmission-based precautions, and education/counselling. Conclusion: The adapted isolation guideline is recommended to be disseminated and utilized by nurses and clinicians nationwide to improve the isolation practices for infected or colonized patients with communicable diseases and to decrease the transmission of infections in the healthcare settings.

• 대한한방소아과학회지
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• 제32권3호
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• pp.131-140
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• 2018

Objectives The purpose of this study is to assess the quality of case reports from the Journal of Pediatrics of Korean Medicine. Methods Case reports were selected from the Journal of Pediatrics of Korean Medicine from January 2015 to April 2018, by utilizing Oriental Medicine Advanced Searching Integrated System (OASIS). The quality of the reports were reviewed based on the Consensus-based Clinical Case Reporting Guideline Development (CARE) guideline. Results Total of 13 case reports were finally selected for the assessment. 73.08% of the case reports included necessary information based on the CARE guideline but the rest of the reports did not. More than 50% of the reports were missing data regarding 'Timeline', 'Diagnostic challenges', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', or 'Patient perspective or experience'. Also, the reports did not include 'Key word', 'Introduction in abstract', 'Case presentation in abstract', or 'The rationale for conclusions' information. Conclusions Case reports from the Journal of Pediatrics of Korean Medicine have important role in pediatrics. Efforts are needed to improve the quality of the case reports as well as to develop reporting guidelines for the Journal of Pediatrics of Korean Medicine.

• 한국임상약학회지
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• 제27권4호
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• pp.276-283
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• 2017

Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권1호
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• pp.59-66
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• 2013

Purpose: Although Computerized Tomography is one of the most useful diagnosis devices and Frequency of use by all kind of patient is higher than other device, it can be hardly to find out adequate data to planning of Computerized Tomography Unit. So questions have been raised about how to organize the unit. Methods: In order to suggest architectural guideline of Computerized Tomography Unit, expert interview, field survey and analysis to the floor plan have been conducted in this article. The area calculation was based on center line. Results: This article suggests a number of the guideline and the example of the planning which contains how to design Computerized Tomography Unit. Especially, in the case of the example on the planning, main points of the guideline is reflected. Implications: The result of this survey would be useful as a reference when the architect tries to design Computerized Tomography unit.

• 한국의료질향상학회지
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• 제7권1호
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• pp.46-58
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• 2000

Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

• 한방비만학회지
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• 제7권2호
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• pp.27-37
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• 2007

Background Clinical practice guidelines (CPG) are systematically developed statements to assist practitioners and patients on healthcare decisions. They provide recommendations for the average patient, which should take into account individual clinical judgment and the patient's values and expectations. Ephedra has sympathomimetic effect and has been used for weight loss worldwide. However, its safety is controversial especially in autonomic and cardiovascular systems. Therefore, the need of appropriate CPG for ephedra prescription in obesity was advocated in Korean Traditional Medicine. Methods The committee comprised of specialists of obesity, oriental herbology, oriental cardiology, constitutional medicine. The committee collected all relevant references about adverse effect and safety of ephedra in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study and observational study from international and domestic databases and paper journals. 11 English- and 5 Korean-language references were gathered and categorized by PICO (Patient, Intervention, Comparison, Outcome) method. We could not complete strength of recommendation which should be clarified according to the evidence grade estimation. Result The first version of CPG for ephedra prescription in obesity was issued by Korean Oriental Association for Study of Obesity. It includes topics of introduction, pharmacokinetics, side effects and adverse events, constitutional aspect and recommendations for dose, indication and contraindication. Conclusion There should be periodic upgrade of this CPG from now on. Although there are some drawbacks in this version of CPG, it has significance as the first CPG in Korean Traditional Medicine.