• Title/Summary/Keyword: Study protocol

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Development and Effect of Pain Management Protocol for Nursing Home Patients with Dementia (노인 간호 요양시설에서의 치매환자 통증관리 프로토콜 개발 및 효과)

  • Chang, Sung-Ok
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.1
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    • pp.29-43
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    • 2007
  • Purpose: This study was done to develop a pain management protocol for nursing home patients with dementia and to examine effects of the protocol on pain assessments and interventions by the nurses and on pain relief signs in the patients. Method: The six steps in the protocol development and the examination of effect are outlined. Three rounds using the Delphi technique and one group pretest-posttest design experiment were developed. Design issues, such as sample selection and sample size, are addressed in relation to the study protocol. Results: After implementation of the pain management protocol, there were significant changes nursing actions including frequency of number of physical examinations, utilization of pain assessment tools, and request to doctors for discomfort management and there were significant changes in frequency in the number of verbal and physical expressions of pain, and emotional patterns. Conclusion: This is the first pain management protocol for patients with dementia in Korea. However, more study will be needed to determine the methodological strength and necessary revisions for the protocol.

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Development and Implementation of a Feeding Protocol for Infants in a Pediatric Cardiac Intensive Care Unit (소아심장외과 중환자실 장관영양 프로토콜 개발 및 효과평가)

  • Uhm, Ju-Yeon;Lee, Hyojin
    • Child Health Nursing Research
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    • v.22 no.4
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    • pp.326-335
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    • 2016
  • Purpose: It is crucial to provide adequate enteral nutrition for postoperative recovery, wound healing and normal growth in infants in pediatric cardiac ICUs. This study was done to develop a feeding protocol using the vaso-active inotropic (VAI) score and to evaluate the impact of nutritional outcomes following the new feeding protocol for infants who underwent cardiac surgery. Methods: This study consisted of three phases. First, a feeding protocol was developed based on a literature review. Second, ten experts rated the content validity. Third, a comparison study was conducted to evaluate the impact of the new feeding protocol. Data were analyzed using SPSS Version 20. Results: Twenty-nine infants were enrolled in the pre-protocol group, and 22 infants in the post-protocol group. Patients in the 2 groups were similar. Time to reach feeding goal was significantly decreased from 56.0 (27-210) hours to 28.5 (10-496) hours in the post-protocol group (Z=-4.22, p<.001). Level of enteral feeding knowledge among nurses increased significantly after implementation of the protocol. Conclusion: The feeding protocol using VAI score facilitates the achievement feeding goal to decrease feeding interruptions and help nurses in their practice. Larger studies are necessary to examine clinical outcomes following the implementation of this feeding protocol.

Development and Evaluation of an Enteral Nutrition Protocol for Dysphagia in Patients with Acute Stroke (연하 곤란이 동반된 급성 뇌졸중 환자를 위한 장관 영양 프로토콜 개발 및 효과)

  • Yoo, Sung-Hee;Kim, So-Sun
    • Journal of Korean Academy of Nursing
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    • v.44 no.3
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    • pp.280-293
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    • 2014
  • Purpose: The study was done to develop an evidence-based enteral nutrition (EN) protocol for effective nutritional support for dysphagia in patients with acute stroke, and to evaluate effects of this protocol on clinical outcomes. Methods: A methodological study was used to develop the EN protocol and a quasi-experimental study to verify the effectiveness of the protocol. The preliminary EN protocol was drawn by selecting recommendations from previous well-designed EN guidelines, and then developing additional recommendations based on high-quality evidence. Content validation was assessed by an expert group, and clinical applicability by care providers and patients. The scale-level content validity index of the final EN protocol was 0.99. Assessment was done of differences in percentage of caloric goals achieved and presence of undernutrition, aspiration pneumonia, and gastrointestinal (GI) complications after application of the EN protocol. Results: In the EN protocol group, the percentage of caloric goals achieved ($R^2=.24$, p=.001) and the reduction of GI complications (p=.045) were significantly improved, but the presence of undernutrition (p=.296) and aspiration pneumonia (p=.601) did not differ from the usual care group. Conclusion: Results indicate that the new EN protocol for dysphagia in patients with acute stroke significantly increased their nutritional intake and reduced GI complications.

Simulation Study on the Performance of the IEEE 802.4 Token Passing Bus Protocol (IEEE 802.4토큰 패싱 버스 프로토콜의 성능에 관한 시뮬레이션 연구)

  • Lim, Dong-Min;lee, Hwang-Soo;Un, Chong-Kwan
    • Journal of the Korean Institute of Telematics and Electronics
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    • v.26 no.3
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    • pp.22-31
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    • 1989
  • In this paper, we analyze the performance of the IEEE 802.4 token passing bus protocol through a simulation model of the protocol. In order to analyze performance of the protocol in the initialization, transition and fault recovery states as well as in the steady state, the protocol functions are divided into five processes each of which can effectively simulate protocol behaviors according to the variations of protocol parameters. From the simulation study, we obtain protocol parameters which severely influence the protocol performance and find out that proper selection of the protocol parameter values for token passing is very important to obtain good performance of the protocol when the priority scheme is used.

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The effects of knee joint position sense following local and general load protocols (국소적 부하와 전신적 부하가 슬관절 위치 감각에 미치는 영향)

  • Hwang, Yoon-Tae;Park, Rae-Joon;Choi, Jin-Ho
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.429-440
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    • 2005
  • The purpose of this study was to compare the effects of knee joint position sense following local and general load protocols in 25 healthy male subjects. Proprioception of the knee joint was evaluated by measuring absolute angular errors at matching angles before, after and between 2 different types of load protocols. Proprioception tests(on the dominant knee) were performed in which proprioception of the passivepassive reproduced and active-active reproduced knee position was measured. Local load was provided with maximum isokinetic knee extension-flexion on the isokinetic dynamometer(Cybex), and general load was 10 minutes running on a treadmill. Peak torque(knee extension and flexion) and heart rate(beats per minute) was evaluated as an indicator of local and general fatigue during load protocols. The results were as follows: 1. For pasive-pasive reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol(P<.05). However, no significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol (P>.05), no significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P>.05). 2. For active-active reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol (P<.05). Also, significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol(P<.05), significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P<.05). 3. A significant decrease of peak torque of knee extensors and flexors was seen after local load, although heart rate was significantly increased(P<.05). No significant change of peak torque of knee extensors and flexors was seen after general load(P>.05), although heart rate was also significantly increased(P<.05). The previous study revealed that knee proprioception is significantly altered when the muscle mechanoreceptors are dysfunctional due to muscle fatigue, although the joint mechanoreceptors have no significantly effect on knee proprioception when the presence of knee muscle fatigue. However, the results of this study are different from those of the previous study in that muscle weakness of the knee could not be seen after general load. This study shows that general load may diminish motor control by the central nervous system. Proprioceptional decline without muscle weakness of knee after general load suggests a change in the proprioceptional pathway without influence from muscle mechanoreceptors.

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Cryptanalysis on a Three Party Key Exchange Protocol-STPKE'

  • Tallapally, Shirisha;Padmavathy, R.
    • Journal of Information Processing Systems
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    • v.6 no.1
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    • pp.43-52
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    • 2010
  • In the secure communication areas, three-party authenticated key exchange protocol is an important cryptographic technique. In this protocol, two clients will share a human-memorable password with a trusted server, in which two users can generate a secure session key. On the other hand the protocol should resist all types of password guessing attacks. Recently, STPKE' protocol has been proposed by Kim and Choi. An undetectable online password guessing attack on STPKE' protocol is presented in the current study. An alternative protocol to overcome undetectable online password guessing attacks is proposed. The results show that the proposed protocol can resist undetectable online password guessing attacks. Additionally, it achieves the same security level with reduced random numbers and without XOR operations. The computational efficiency is improved by $\approx$ 30% for problems of size $\approx$ 2048 bits. The proposed protocol is achieving better performance efficiency and withstands password guessing attacks. The results show that the proposed protocol is secure, efficient and practical.

Development of a Blood Glucose Control Protocol for Medical ICU Patients (내과 중환자실 환자의 혈당조절 프로토콜 개발)

  • Kim, Eun Sung;Choi-Kwon, Smi
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.3
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    • pp.27-38
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    • 2009
  • Purpose: The purpose of this study was to develop a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The blood glucose control protocol was developed through the following process: selection of preliminary protocols, clinical application, and evaluation. The clinical validity of the protocol was measured by application, along with examination of the effects of the Yale and the Mayo blood glucose protocols. Seventeen medical ICU adults patients whose blood glucose levels exceeded 200 mg/dL consecutively participated in the study. The development protocol was evaluated by an expert group. Results: Incidence of normal blood glucose levels (p=.041) increased significantly in the Yale protocol application group. Also, incidence of severe hyperglycemia (p=.029) decreased significantly and time to target range of glucose (p=.023) decreased significantly after application of the Yale protocol. However, there was no significant difference in incidence of hypoglycemia (p=.666) between three groups. Conclusion: Using the developed protocol as a basis for the modified Yale protocol was found to be effective in improving the state of blood glucose control for medical ICU patients and is expected to be used for nursing intervention in critical care.

A Comparative Study on the Clamping Protocols of a Biliary External Drainage Tube in Adult Living-donor Liver Transplant Recipients (성인 생체 간이식 수혜자에서 담도 외-배액관 잠그기 훈련 방법 비교)

  • Chung, Jin Ah;Choi, Hye Ran
    • 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.

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Development of a Protocol for Nursing Care after Death for Adult Patients in Hospitals (병원 성인 환자의 사후 간호 프로토콜 개발)

  • Kim, Ki Kyong;Kim, Aeng Do;Ahn, Kyung Ah;Cheon, Jooyoung
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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    • pp.75-84
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    • 2023
  • Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion: This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

Priority oriented dobule reservation probocol for very high speed wireless LANs (초고속 무선 LAN을 위한 Priority Oriented Dobule Reservation 프로토콜)

  • 조광민;정상일;강철신
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.22 no.1
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    • pp.151-161
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    • 1997
  • In this paper we designed a high speed wireless multiple access protocol, which is suitable for future multimedia wireless LAN systems which support high quality video teleconferencing, telephony and graphic databases. In the proposed protocol, Slotted-ALOHA protocol is used for transmitting random data packets and the packet reservation multiple access(PRMA) protocol for transmitting periodic data packets. The use of minislot is introduced for the reservation scheme. In order to measure the performance characteristic of the proposed protocol, a simulator is designed using an object oriented programming language, C++, and an exhaustive simulation study is carried out. From the simulation results, it is observed that the proposed protocol and the existing PRMA protocol have almost the same delay characteristic when network traffic is low. However, the proposed protocol is superior to the PRMA protocol when traffic becomes higher. The proposed protocol and the results can be utilized for the design of the wireless access systems and future broadband wireless LANs.

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