• 제목/요약/키워드: clinical practice guideline

검색결과 353건 처리시간 0.025초

눈질환자의 퇴원 후 증상관리를 위한 전화상담 알고리즘 개발 (Development of Telephone Consultation Algorithm for Patient Discharged with Ophthalmic Disease)

  • 이현정;박현애
    • 간호행정학회지
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    • 제17권3호
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    • pp.336-348
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    • 2011
  • Purpose: This methodological study was done to develop a telephone consultation algorithms and practice guidelines for patient discharged with ophthalmic diseases. Methods: The ophthalmic problems of the patients were identified and expert knowledge on managing the problems was acquired. Algorithms and practice guidelines were developed based on the expert knowledge. The content validity of algorithms and practice guidelines was evaluated by the experts. Results: The preliminary algorithms and practice guidelines were developed from 60 detailed signs and symptoms and 45 nursing interventions. The experts agreed that 57 detailed signs and symptoms linked with nursing interventions were valid, with the content validity index over 80%. Meeting with nurse experts and ophthalmologists was convened to review the rest of the 3 detailed signs and symptoms linked with nursing interventions. Finally, 60 detailed signs and symptoms and 46 nursing interventions were confirmed. Conclusion: This study suggests that the algorithms and practice guidelines are effective decision-making tools and utilization of these algorithms and practice guidelines is expected to improve the quality of clinical nursing and patient satisfaction.

요통에 관한 침구임상 진료지침 프로토콜 개발을 위한 전자우편 설문조사 (E-mail Survey for Developing Clinical Guideline Protocol on Acupuncture Treatment for Low Back Pain)

  • 이승훈;남동우;강중원;김은정;김현욱;송호섭;김선웅;김갑성;이건목;이재동
    • Journal of Acupuncture Research
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    • 제26권3호
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    • pp.115-131
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    • 2009
  • Objectives: This survey was done in order to find out how Korean medical doctors derive pattern identification for acupuncture prescriptions in treating low back pain in real clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society from March 26th to April 14th in 2009. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results : 1.57 Korean medical doctors selected meridian pattern identification based on the course of the meridians(44.6%), visceral pattern identification(32.1%), pattern identification based on cause of disease(14.3%) as the most commonly used pattern identification methods for acupuncture prescription when treating low back pain patients in real clinical practice. 2. In meridian pattern identification based on the course of the meridians, gallbladder meridian of hypochondriac region(13.0%), bladder meridian of lateral low back region(11.2%), governer vessel of central low back region(11.7%) were selected 3. In visceral pattern identification, yang deficiency of kidney(20.2%), deficiency of kidney(19.3%), liver(16.7%), yin deficiency of kidney(14.0%), violence qi of kidney(8.8%), small intestine(7.9%) were selected. Conclusions : In our e-mail survey, Korean medical doctors answered that Meridian Pattern Identification based on the course of the meridians is the most often used diagnosis method. Visceral pattern identification, pattern identification based on cause of disease, meridian pattern identification based on symptom and pattern identification based on qi-blood-yin-yang theory in order of frequency used, were selected for low back pain diagnosis in real clinical practice.

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2017 과민성장증후군의 임상진료지침 개정안 소개 (Review of the Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition)

  • 정혜경
    • 대한소화기학회지
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    • 제72권5호
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    • pp.252-257
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    • 2018
  • This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS.

2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

  • Korean Liver Cancer Association (KLCA) and National Cancer Center (NCC) Korea
    • Korean Journal of Radiology
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    • 제23권12호
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    • pp.1126-1240
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    • 2022
  • Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.

COVID-19 vaccine-induced immune thrombotic thrombocytopenia: a review

  • Siti Nur Atikah Aishah Suhaimi;Izzati Abdul Halim Zaki;Zakiah Mohd Noordin;Nur Sabiha Md Hussin;Long Chiau Ming;Hanis Hanum Zulkifly
    • Clinical and Experimental Vaccine Research
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    • 제12권4호
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    • pp.265-290
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    • 2023
  • Rare but serious thrombotic incidents in relation to thrombocytopenia, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), have been observed since the vaccine rollout, particularly among replication-defective adenoviral vector-based severe acute respiratory syndrome coronavirus 2 vaccine recipients. Herein, we comprehensively reviewed and summarized reported studies of VITT following the coronavirus disease 2019 (COVID-19) vaccination to determine its prevalence, clinical characteristics, as well as its management. A literature search up to October 1, 2021 using PubMed and SCOPUS identified a combined total of 720 articles. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, after screening the titles and abstracts based on the eligibility criteria, the remaining 47 full-text articles were assessed for eligibility and 29 studies were included. Findings revealed that VITT cases are strongly related to viral vector-based vaccines, which are the AstraZeneca COVID-19 vaccine (95%) and the Janssen COVID-19 vaccine (4%), with much rarer reports involving messenger RNA-based vaccines such as the Moderna COVID-19 vaccine (0.2%) and the Pfizer COVID-19 vaccine (0.2%). The most severe manifestation of VITT is cerebral venous sinus thrombosis with 317 cases (70.4%) and the earliest primary symptom in the majority of cases is headache. Intravenous immunoglobulin and non-heparin anticoagulant are the main therapeutic options for managing immune responses and thrombosis, respectively. As there is emerging knowledge on and refinement of the published guidelines regarding VITT, this review may assist the medical communities in early VITT recognition, understanding the clinical presentations, diagnostic criteria as well as its management, offering a window of opportunity to VITT patients. Further larger sample size trials could further elucidate the link and safety profile.

2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

  • Hong Jun Park;Byung-Wook Kim;Jun Kyu Lee;Yehyun Park;Jin Myung Park;Jun Yong Bae;Seung Young Seo;Jae Min Lee;Jee Hyun Lee;Hyung Ku Chon;Jun-Won Chung;Hyun Ho Choi;Myung Ha Kim;Dong Ah Park;Jae Hung Jung;Joo Young Cho;Endoscopic Sedation Committee of Korean Society of Gastrointestinal Endoscopy
    • Clinical Endoscopy
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    • 제55권2호
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    • pp.167-182
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    • 2022
  • Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

전이성 대장암에서 표적치료와 면역치료 (Emerging Treatment in Metastatic Colorectal Cancer)

  • 김재현;박선자
    • Journal of Digestive Cancer Research
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    • 제6권2호
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    • pp.45-49
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    • 2018
  • Colorectal cancer (CRC) is the third most common cause of cancer-related death in the world. Although the long-term outcome of patients with metastatic CRC is still poor, target therapy including anti EGFR agents and anti VEGF agents and immunotherapy including anti PD-1 antibody and anti CTLA-4 antibody have shown clinical benefits in the treatment of patient with metastatic CRC. In the future, the personalized treatment strategy based on the clinical characteristics and biologic features of patients with metastatic CRC will be necessary. In this review, we summarized the mechanisms and clinical evidences of target therapy and immunotherapy, and the guideline of clinical practice in patients with metastatic CRC.

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응급구조과 학생의 병원감염 표준주의에 대한 인지도와 수행도 (Emergency Medical Technology Students' Awareness and Performance of Standard Precautions in Hospital Infection Control)

  • 최성수;윤성우
    • 한국산학기술학회논문지
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    • 제14권5호
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    • pp.2262-2270
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    • 2013
  • 이 연구는 임상실습을 실시하면서 병원감염에 노출되어 있는 응급구조과 학생들을 대상으로 병원감염관리 표준주의 지침의 인지도와 수행도를 파악함으로써 감염예방과 노출을 감소시킬 수 있는 효율적인 실천방안을 마련하는데 기초자료를 제공하고자 하였다. 연구결과 병원감염관리 표준주의 인지도에 비해 수행도가 낮은 결과를 보였고, 인지도와 수행도는 양의 상관관계가 있는 것으로 나타났으며 통계적으로 유의한 차이가 있었다(r=0.325, p=0.000). 향후 응급구조과 학생들의 병원감염관리 수행도를 증진 시킬 수 있도록 교과과정과 실습기관에서의 지속적인 교육프로그램이 수행되어야 할 것이다.

간호사들의 항암제 취급실태와 안전수칙에 대한 인지도와 실천도 (Cognition and Practice of Safe Handling of Cytotoxic Drugs in University Hospital Nurses)

  • 김매자;전명희;최진선;박종순
    • 종양간호연구
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    • 제4권2호
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    • pp.154-165
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    • 2004
  • Purpose : To provide basic data for establishing the policy of safe handling of cytotoxic drugs and for building training materials and clinical guidelines for nurses handling cytotoxic drugs. Methods: 255 nurses in Seoul and 257 nurses in D metropolitan area participated in the study. Questionnaires were based on the safe handling guideline for cytotoxic drugs issued by OSHA and ONA. Results: Nurses in Seoul scored higher in the cognition for safe handling guidelines of cytotoxic drugs in preparation, administration. as well as total score compared with nurses in D metropolitan area. The practical score also showed higher in nurses in Seoul in administration, disposal and total score. But both groups showed low level of practical score. The answers why they could not follow the guideline for cytotoxic drugs were "don't have", "busy", and "don't know", etc Conclusion: Handling of the cytotoxic drug is very common and important. The study findings suggest that hospitals especially in D metropolitan area should educate the nurses and supply equipments for safe handling of cytotoxic drugs. Thus, repetitive and continual education of all nurses including experts is needed. In addition, it is necessary to supply enough protective equipment for preventing exposure to the cytotoxic drugs.

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Adaptation of Evidence-based Surgical Wound Care Algorithm

  • Han, Jung-Yeon;ChoiKwon, Smi
    • 대한간호학회지
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    • 제41권6호
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    • pp.768-779
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    • 2011
  • Purpose: This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. Methods: This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. Results: A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ${\leq}$.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. Conclusion: The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.