• Title/Summary/Keyword: Practice Guideline

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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.

GOOD LABORATORY PRACTICE -PRINCIPLES AND PRESENT STATUS IN JAPAN

  • Omori, Yoshihito
    • Toxicological Research
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    • v.1 no.1
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    • pp.31-41
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    • 1985
  • The Japanese Good Laboratory Practice (GLP) Standard on Drugs was finalized as a guideline and implemented in April, 1983. This standard is intended to ensure the quality and integrity of the data from nonclinical toxicity studies submitted to the Ministry of Health and Welfare in support of applications for approval to manufacture or import new drugs or to be used in the reevaluation of previously approved drugs. The standard includes a guideline for organizational matters, personnel, facility, equipment, testing operation, documentation and conduct of studies. Principles and influences of implementation of Japanese GLP will be discussed briefly in comparison with foreign GLPs.

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Numerical Analysis of Turbulent Flow around Tube Bundle by Applying CFD Best Practice Guideline (CFD 우수사례 지침을 적용한 관 다발 주위의 난류유동 수치해석)

  • Lee, Gong Hee;Bang, Young Seok;Woo, Sweng Woong;Cheng, Ae Ju
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.37 no.10
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    • pp.961-969
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    • 2013
  • In this study, the numerical analysis of a turbulent flow around both a staggered and an inline tube bundle was conducted using ANSYS CFX V.13, a commercial CFD software. The flow was assumed to be steady, incompressible, and isothermal. According to the CFD Best Practice Guideline, the sensitivity study for grid size, accuracy of the discretization scheme for convection term, and turbulence model was conducted, and its result was compared with the experimental data to estimate the applicability of the CFD Best Practice Guideline. It was concluded that the CFD Best Practice Guideline did not always guarantee an improvement in the prediction performance of the commercial CFD software in the field of tube bundle flow.

Development of Clinical Practice Guidelines in a Hospital (병원단위의 임상진료지침 개발과정)

  • Shin, Youngsoo;Kim, Chang-Yup;Oh, Byung-Hee;Han, Kyou-Sup;Yoon, Byung-Woo;Han, Joon-Koo;Khang, Young-Ho
    • 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.

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A Basic Study for Development of Clinical Practice Guidelines of Korean Medicine in Autism Spectrum Disorder -Based on Pre-existing Clinical Practice Guidelines of Autism Specturm Disorder- (자폐스펙트럼장애의 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구 -기존에 개발된 자폐스펙트럼장애 가이드라인을 중심으로-)

  • Kim, Sang Min;Lee, Jin Yong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.1
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    • pp.52-62
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    • 2017
  • Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.

Development of the Prevention Guideline of Deep Vein Thrombosis in Patients with Surgery according to the Guideline Adaptation Process (수술환자의 심부정맥혈전증 예방 지침 수용개작)

  • Yoon, Ji Hyun;Lee, Ihn Seon;Lee, Kyeong Yoon;Jang, Mi Ja;Lee, Jung Min;Nam, Min Sun;Park, Ji Hyeon;Hwang, Ji Won;Song, Hyun Ju;Cho, Yong Ae;Kwon, In Gak;Kim, Mi Young
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.337-347
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    • 2014
  • Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

Development Protocol of Korean Medicine Clinical Practice Guideline for Myofascial Pain Syndrome (근막통증증후군의 한의표준임상진료지침 개발 프로토콜)

  • Byeonghyeon Jeon;Hyeonjun Woo;Won-Bae Ha;Cheoung Su Kim;Jung-Han Lee
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.203-213
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    • 2023
  • Objectives This study aimed to develop a Korean medicine (KM) clinical practice guideline for myofascial pain syndrome (MPS) via the collaboration of clinical and methodological experts. Methods The study will include an initial survey to establish a common understanding of MPS. To develop the clinical guideline, a multidisciplinary development group was formed. The group will finalize the clinical questions based on a preliminary draft. The GRADE methodology is going to be applied to determine the level of evidence and grading of the recommendations. Finally, approval from the relevant medical societies will be obtained. Results A protocol for developing a KM clinical guideline for MPS was presented. Before finalizing the clinical key questions, a literature search was conducted according to the protocol, and a draft of 19 clinical key questions was established. Conclusions An evidence-based KM clinical guideline for MPS is expected to contribute to the management of MPS. This may also serve as a reference for the development of other KM clinical practice guidelines in the future.

Summary of the Chronic Obstructive Pulmonary Disease Clinical Practice Guideline Revised in 2014 by the Korean Academy of Tuberculosis and Respiratory Disease

  • Yoon, Hyoung Kyu;Park, Yong-Bum;Rhee, Chin Kook;Lee, Jin Hwa;Oh, Yeon-Mok;Committee of the Korean COPD Guideline 2014
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.3
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    • pp.230-240
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients both domestically and globally. The Korean clinical practice guideline for COPD was revised in 2014. It was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases, as well as participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. This revised guideline covers a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea. We drafted a guideline on COPD management by performing systematic reviews on the topic of management with the help of a meta-analysis expert. We expect this guideline will be helpful medical doctors treating patients with respiratory conditions, other health care professionals, and government personnel in South Korea.

Evidence-Based Nursing Practice Guideline: Ostomy Care (근거기반 임상실무지침: 장루간호)

  • Lee, Yun Jin;Park, Hyun Suk;Kim, Min Kyung;Seo, Hui Won;Lee, Mi Ju;Won, Eun Ae;Jo, Gha Na
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.154-163
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    • 2020
  • Purpose: The aim of this study was to develop an evidence-based guideline for stoma management providing institutional policy, assessment, complications and follow-up care. Methods: The guideline adaptation manual consisting of 23 steps developed by the National Evidence-Based Healthcare Collaborating Agency was used for this study. It presents an overview of the process used to develop the guideline and lists specific recommendations from the guideline. Results: It provides 55 recommendations that include the following 8 topics: 1) Organization and policy recommendations, 2) Preoperative nursing; Ostomy education, stoma site marking, 3) Ostomy formation, 4) Postpoperative nursing; education, assessment, high output stoma management, 5) Selection of ostomy products, 6) Colostomy irrigation, 7) Stomal and peristomal complications, 8) Follow-up care after discharge. Conclusion: The guideline can be used to address stoma management in hospital settings. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patients' outcomes.