• 한국의료질향상학회지
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• 제3권2호
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• pp.36-51
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• 1997

Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

• 임상간호연구
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• 제19권1호
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• pp.128-142
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• 2013

Purpose: This study was conducted to adapt the previously developed intravenous infusion guidelines with good quality for development of the evidence-based intravenous infusion nursing practice guideline in Korea. Methods: Guideline adaptation process was conducted according to guideline adaptation manual version 2.0 developed by NECA (Kim, Kim et al., 2011) which consisted of three main phases, 9 modules including a total of 24 steps. Results: Adapted intravenous infusion nursing practice guideline was consisted of 19 domains and 180 recommendations. The domains and number of recommendations in each domain were: general guide, 4; assessment, 1; vascular access device selection, 4;site selection, 14;site preparation, 5;site care, 29; maintaining patency, 11; blood sampling via vascular access, 4; vascular access device exchange and removal, 9; add-on device selection, 27; infusion related complications, 63; education, 7; and documentation and report, 2. There were 11.9% of A, 28.4% of B, 58.7% of C in grade of recommendations. Conclusion: Adapted intravenous infusion nursing practice guideline is expected to contribute providing an evidence based practice guides for intravenous infusion. The guideline is recommended to be disseminated to nurses nationwide to improve the efficiency of intravenous infusion practice.

• 한국융합학회논문지
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• 제11권6호
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• pp.215-225
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• 2020

본 연구는 정부 기관에서 제시하는 청소년 신체활동지침의 실천과 스마트폰으로 인한 문제경험과의 관계를 파악하고자 한다. 이를 위해 62,225명의 "2017년 청소년건강행태조사" 데이터를 활용하여 신체활동지침의 실천과 스마트폰 변인간의 관계를 분석하였으며, SPSS 23.0 프로그램을 이용하여 다중회귀분석을 실시하였다. 분석결과 "60분이상 신체활동"을 제외한 모든 신체활동이 스마트폰으로 인한 문제경험에 부(-)적 영향을 미치는 것으로 나타났다. 또한, 유산소운동, 근력운동, 스포츠클럽참여, 좌식행동 등 정부 기관에서 제시하는 신체활동지침을 실천하는 학생은 미실천학생에 비해 스마트폰 문제경험이 감소하였으며 이는 성별로 유의한 차이를 보였다. 본 결과에 따라, 스마트폰 중독예방에 있어 해당 지침을 활용한 학술적인 심층연구와 성별로 차별화된 신체활동 증진 프로그램이 가능할 것으로 기대한다.

• 중환자간호학회지
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• 제6권2호
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• pp.12-23
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• 2013

Purpose: This study was conducted to develop a Korean version of evidence-based enteral tube feeding (ETF) guidelines through adaptation of existing ETF guidelines. Methods: The guideline adaptation process was conducted into 24 steps according to a manual for guideline adaptation version 2.0 developed by NECA. Results: The adapted ETF nursing practice guideline was consisted of 9 domains and 20 recommendations, including confirmation of tube placement, risk of aspiration, assessment gastric residual volume, body positioning, treating feeding tube occlusion, administration rate, medication, tube flushes, and interruption of feeding. The results of the grading of recommendations assessment by expert penal showed that 8 recommendations in Grade A, 4 in grade B, and 8 in Grade C were emerged from the process. The range of content validity index scores by expert penal was 0.8-1.0. Conclusion: It is expected that the adapted ETF nursing practice guideline could be helpful for nurses to practice evidence-based ETF for their patients.

• 임상간호연구
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• 제25권1호
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• pp.67-79
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• 2019

Purpose: This study was conducted to update the existing evidence-based nursing clinical practice guideline in management of pressure injury in South Korea. Methods: The update process underwent the 22 steps according to the update method based on the international standards. Results: The updated nursing practice guideline for pressure injury consists of 4 domains and 436 recommendations. The numbers of recommendations in each domain were 25 for hospital policies, 51 for assessment, 350 for prevention and management, and 10 for education. There were 2.5% of A, 13.3% of B, 84.2% of C in terms of grading of recommendations. Among these, the major revision was done in 32 recommendations (7.4%). A total of 299 recommendations (68.6%) were added newly. Minor revisions, such as change or addition of some words, were also made in 25 recommendations(5.7%). No change was made in 80 recommendations (18.3%) compared to the previous ones. Conclusion: The nursing practice guideline for pressure injury has been updated. This updated guideline can be used as educational materials for both healthcare workers and patients with pressure injury.

• 임상간호연구
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• 제27권2호
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• pp.187-198
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• 2021

Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.

• Journal of Gastric Cancer
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• 제18권4호
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• pp.313-327
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• 2018

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.

• 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.

• 임상간호연구
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• 제22권3호
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• pp.285-293
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• 2016

Purpose: The purpose of this study was aimed to develop evidence-based nursing practice guideline for preventing intermittent urinary catheterization (IUC) related complications using guideline remake process. Methods: Guideline remake process was conducted according to guideline adaptation manual developed by Gu et al (2012) which consisted of three main phases and 9 modules including a total of 24 steps. Results: Newly developed IUC guideline consists of introduction, overview of intermittent catheterization, summary of recommendations, recommendations, references, and appendices. There were 50 recommendations in 5 sections including assessment, equipments, catheterization, complications management, and education/consult. Three recommendations (6%) were graded A, and five (10%) and 41 recommendations(82%) were B and C, respectively. Conclusion: The IUC remade-guideline was developed based on evidence-based nursing and therefore, this guideline is recommended to be disseminated and utilized by nurses nationwide to improve the quality of care for IUC and to decrease the IUC related complications.

• 임상간호연구
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• 제23권1호
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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.