• 의료법학
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• 제9권2호
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• pp.181-207
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• 2008

With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

• 대한예방한의학회지
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• 제23권1호
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• pp.15-26
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• 2019

Background and Aim : Health care and cosmetics as well as quality of life is now a matter of concern and many categories of complementary and alternative medicine fall into the territory of the medical practice of Korean medicine. Accordingly, penalties are being taken for unlicensed medical practices of Korean medicine in so called complementary and alternative medicine area. There is a possibility of violating the law for the public part because it is not clearly stipulated in the law as to what is a licensed medical practice. Materials and Method : The significance of the Medical Service Act and the Act on Special Measures for the Control of Public Health Crimes were reviewed, and the related supreme court cases were discussed upon the legal aspect of processing the unlicensed medical practice of Korean medicine. The legal information was provided from the National Law Information Center of the Ministry of Government Legislation, and the information websites of the Supreme Court and the Constitutional Court. Results : The concept of medical practice, which is essential in judging the case of unlicensed medical practice, is 'prevention and treatment of diseases through diagnosis, examination, prescribing, medication, or surgical procedures based on medical expertise', and the 'acts that may result in harm and injury of health unless performed by a medical person'. With respect to the medical practice of Korean medicine, the concept includes 'prevention and treatment of diseases using the principle of traditional Korean Medicine'. Conclusions : The concept of medical practice should be clearly stipulated in the law for the control over the unlicensed medical practices of Korean medicine. And it is important to move from the current concept of medical person-oriented medical practice emerging from the national system of healthcare control, to a concept that can accept the era of health managing-oriented medical environment and the co-governance of the healthcare providers and consumers for the future.

• 디지털콘텐츠학회 논문지
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• 제14권4호
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• pp.505-511
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• 2013

근래 이슈가 되고 있는 클라우드 컴퓨팅은 분산컴퓨팅 환경에서 사용자가 요구하는 컴퓨팅 자원을 최적화하여 유연하고 확장성 있게 지원할 수 있어 각광받는 새로운 패러다임이다. 클라우드 컴퓨팅 환경은 가상화 환경을 구성함으로써 실제적인 구현 및 서비스가 가능해진다. 본 논문에서는 오픈소스 기반의 클라우드 컴퓨팅을 연구하고 대학교 내에서 컴퓨터를 이용한 실습을 수행할 시 요구되는 시스템 환경을 오픈소스 클라우드 컴퓨팅 기반의 환경을 통해 구현하고자 한다. 클라우드 컴퓨팅을 통한 가상화 기반의 실습 환경은 최적화된 자원을 제공할 수 있을 뿐만 아니라 실습 자원 관리의 편리성, 실습 결과에 대한 손쉬운 관리 등의 효율성을 가져올 수 있다. 이로 인해 실습환경 설정에 소요되는 시간을 줄일 수 있을 뿐만 아니라, 교수 입장에서는 실습결과물들을 쉽게 관리 할 수 있게 된다. 또한 다양한 실습환경의 요구사항들을 유연성 있게 적용함으로써 시스템에 대한 활용성 또한 높아지게 된다.

• 가정과삶의질연구
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• 제30권4호
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• pp.147-161
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• 2012

Remarriage has been prevalent in Korea since the mid-1990s. Remarried families have reported that they face many challenges and difficulties. Life for those who remarry can worsen when the children from a previous marriage live together with new family members. It is interesting that some remarried families adjust well while others do not. This study focuses on developing a practice model for strengthening the resilience of remarried families with children based on a literature review. To understand and support remarried families, the resilience perspective was chosen, focusing on a strengths perspective with developmental, ecological, and preventative perspectives. In terms of resilience, the proposed practice model was developed on the basis of three concepts: belief systems, organizational patterns, and communication. The model can be used to help remarried families accomplish adequate integration by growing as a new family and can prevent another divorce. Moreover, it can assist practitioners and policy-makers develop programs and policies with a strengths perspective rather than a deficit or problem-oriented perspective. Based on the model, various programs need to be developed to strengthen the resilience of remarried families. The development of supportive programs is suggested. These can include remarriage preparation programs, remarriage life education programs, interactive web-based programs, and family camps. For a long time, remarried families have been labeled as abnormal and atypical owing to the normal family myth. This negative perception of remarried families must be altered so that they are accepted with a positive outlook in a society. For further studies, the development of diverse supportive adaptation programs for various types of remarried families and active research on them are recommended. The practice model can assist with the adaptation and growth of remarried families by strengthening their resilience.

• 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.

• 성인간호학회지
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• 제20권5호
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• pp.778-790
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• 2008

Purpose: This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses. Methods: Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center. Results: The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point. Conclusion: The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.

• 디지털콘텐츠학회 논문지
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• 제15권5호
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• pp.595-602
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• 2014

이미 잘 알려져 있는 클라우드 컴퓨팅은 사용자가 요구하는 컴퓨팅 자원을 최적화하여 유연하고 확장성 있게 지원할 수 있어 다양한 분산컴퓨팅 분야에 적용되고 있다. 클라우드 컴퓨팅은 가상화 기술을 통해 실제적인 구현 및 서비스가 가능하며 여러 가상화 기술과 제품들이 개발, 출시되고 있다. 본 논문에서는 클라우드 컴퓨팅의 가상화 기반으로 교육 실습 환경을 구축하고, 각 실습환경의 성능을 분석하였다. 클라우드 컴퓨팅 기반의 가상화 실습 환경은 최적화된 자원을 제공할 수 있으며, 실습 제공자는 자원 관리의 편리성, 결과에 대한 손쉬운 관리, 실습환경의 성능 및 상태 등의 수월하게 관리하고 파악 할 수 있다. 또한, 다양한 실습환경을 구축하는데 있어 요구되는 시스템 환경을 유연성 있고 신속하게 제공할 수 있어 시스템의 활용성 또한 높아지게 된다. 나아가 가상화 실습환경의 성능 분석을 통하여 구동될 수 있는 교육 어플리케이션의 성능을 미리 평가하고 가늠할 수 있다.

• 임상간호연구
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• 제26권2호
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• pp.240-253
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• 2020

Purpose: This study was conducted to provide basic data for the systematization of 13 areas related to Advanced Practice Nurses (APN). Methods: The three-phase study was conducted as follows. 1) review of APN system and curriculum, 2) Focus Group Interviews (FGI) with 9 APNs, 6 physicians, and 3 nursing professors on the APN system, 3) analysis of clinical practice of the 13 APN areas, and of the accreditation and certification system for APNs, medical board, and medical subspecialty board. Based on the above data, a systematic plan was drawn. Results: The 13 APN areas could be divided into 7 groups based on a review of the APN system and curriculum for the 13 areas. Analysis based on clinical practice showed that the 13 APN areas could be divided into 4 groups. Two themes and seven categories emerged in FGI. The two themes were 1) 13 APN areas that need to be discussed, 2) improving the curriculum for APN. Considering these themes from FGI and the system of the medical subspecialty board, results could be integrated into 2 groups - clinical area and non-clinical area. Conclusion: The 13 APN areas need to be integrated in order to activate the APN system. For that, further discussions on improvements and a standard curriculum according to legislation related to APN should be carried out.

• 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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• 제24권3호
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• pp.263-272
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• 2018

Purpose: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. Results: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. Conclusion: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.