• Title/Summary/Keyword: clinical practice guideline

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Clinical Practice Guidelines for the Medical and Surgical Management of Primary Intracerebral Hemorrhage in Korea

  • Kim, Jeong Eun;Ko, Sang-Bae;Kang, Hyun-Seung;Seo, Dae-Hee;Park, Sukh-Que;Sheen, Seung Hun;Park, Hyun Sun;Kang, Sung Don;Kim, Jae Min;Oh, Chang Wan;Hong, Keun-Sik;Yu, Kyung-Ho;Heo, Ji Hoe;Kwon, Sun-Uck;Bae, Hee-Joon;Lee, Byung-Chul;Yoon, Byung-Woo;Park, In Sung;Rha, Joung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.175-187
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    • 2014
  • The purpose of this clinical practice guideline (CPG) is to provide current and comprehensive recommendations for the medical and surgical management of primary intracerebral hemorrhage (ICH). Since the release of the first Korean CPGs for stroke, evidence has been accumulated in the management of ICH, such as intracranial pressure control and minimally invasive surgery, and it needs to be reflected in the updated version. The Quality Control Committee at the Korean Society of cerebrovascular Surgeons and the Writing Group at the Clinical Research Center for Stroke (CRCS) systematically reviewed relevant literature and major published guidelines between June 2007 and June 2013. Based on the published evidence, recommendations were synthesized, and the level of evidence and the grade of the recommendation were determined using the methods adapted from CRCS. A draft guideline was scrutinized by expert peer reviewers and also discussed at an expert consensus meeting until final agreement was achieved. CPGs based on scientific evidence are presented for the medical and surgical management of patients presenting with primary ICH. This CPG describes the current pertinent recommendations and suggests Korean recommendations for the medical and surgical management of a patient with primary ICH.

National Survey of Kangaroo Care Practice, Barriers, Knowledge, and Belief (신생아중환자실 캥거루 케어 전국 실태조사- 간호행위, 장애요인, 간호사의 지식과 신념)

  • Kim, Hee Young;Jang, Eun Kyung;Lee, Jin-Hee;Lee, Eun Jung;Oh, Seyeon;Jo, Keum Sig
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.211-221
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    • 2017
  • Purpose: A National survey was conducted to assess neonatal intensive care nurses' practice, barriers, knowledge, and belief regarding Kangaroo Care (KC). Methods: A descriptive survey was conducted. Kangaroo care questionares were sent to nurses in all hospitals in Korea whose were identified as providing neonatal intensive care services(N=263). Descriptive statistics were used to summarized the data. Results: Among 67 neonatal care units, 61.1% adapted KC in their practice. About 60% of nurses in the KC providing hospital actually practiced KC. Major barrier of practicing KC were infant safety concerns, as well as work load of nurses. Respondants who had practiced KC were more knowledgable and were more positive in their belief regarding KC. Conclusion: The findings suggest that in order to overcome barriers of practicing KC, educational programs are recommended designed for nurses. In addition, development of KC practice guideline is necessary to facilicate successful and safe KC.

The Controversy Regarding the Optimal Management of Chronic Low Back Pain: Interventional vs. Medical Treatment (만성요통의 적정 치료를 둘러싼 논란: 중재적 치료 대 보존적 치료)

  • Kwon, O-Hyun
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.1-2
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    • 2010
  • Chronic non-specific low back pain (CLBP) is one of the major health problems casting substantial amount of economic expenses and negative impact on quality of life onto an individual as well as society. On contrary to public familiarity, the ways of management of CLBP are diverse and there is yet no general consensus about which approach is better than others or to whom the specific management should be applied. Some hold the negative point of view on the efficacy of the invasive maneuver such as epidural injection because there is no controlled clinical trial (RCT) yielding better long term outcome of those invasive managements over conservative ones. But the experts of interventional or surgical treatment stress the methodological difficulty in performing RCT and assert that those invasive treatments can bring the prompt and complete resolution of low back pain and restoration of function in appropriately selected cases. These seemingly opposite views on the invasive management on CLBP are rather complimentary each other than to be contradictory.

A Study on Dynamic Clinical Process Generation based on Clinical Decision Support System (의사결정시스템을 이용한 진료 프로세스 동적 생성에 관한 연구)

  • Min Yeong-Bin;O Je-Yeon;Gang Seok-Ho
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 2006.05a
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    • pp.1227-1234
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    • 2006
  • 최근 의료 서비스의 질적 향상을 위해 지식 기반의 의사결정지원 시스템 (Decision Support System)의 도입이 지속적으로 이루어지고 있으며, 이의 대표적 예로 임상실행지침(CPG : Clinical Practice Guideline) 중심의 진료 시스템이 있다. 임상실행지침은 환자가 병원에서 거치는 프로세스를 표현한 것으로, 질환에 대한 환자의 표준화된 진료 프로세스 지식이다. 본 연구에서는 임상실행지침, 의료 지식, 환자의 실시간 데이터를 연결시켜 환자가 병원에서 받아야할 진료 과정을 동적으로 생성하는 의사결정지원 시스템을 제시한다. 본 시스템은 임상실행지침과 의료지식을 바탕으로 추상화된 진료 프로세스 템플릿을 생성하고, 이 템플릿의 인스턴스에 해당하는 환자의 실시간 데이터를 반영하여 이후의 진료 프로세스를 동적으로 생성한다.

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Diagnostic Laryngeal Electromyography (진단적 후두근전도)

  • Chung, Sung-Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.2
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    • pp.107-112
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    • 2008
  • Diagnostic laryngeal electromyography (LEMG) relatively evaluates the electrophysiologic status of the larynx and provides critical clinical informations that no other tests can provide. However, LEMG is still not widely applied as a routine tool in clinical practice. One reason for this is the technical and interpretative difficulties of LEMG. But if LEMG is performed by a team approach consisting of an otolaryngologist and a neurologist, the technique and the interpretation of LEMG are not difficult to master. Another reason is that there is still not exact standard guideline for clinical application of LEMG. LEMG is an essential diagnostic test in evaluating patients with neuromuscular disorders, particulary vocal fold immobility, reduced mobility of vocal fold. The more we have used LEMG, the more we have found it useful in the evaluation and treatment of voice disorders, and the role of LEMG will be extended.

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Clinical Year in Review 2014: Critical Care Medicine

  • Lee, Jeong Moon;Lee, Heung Bum
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.1
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    • pp.6-12
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    • 2014
  • Severe sepsis is the most common cause of death among critically ill patients in non-coronary intensive care units. In 2002, the guideline titled "Surviving Sepsis Campaign" was published by American and European Critical Care Medicine to decrease the mortality of severe sepsis and septic shock patients, which has been the basis of the treatment for those patients. After the first revised guidelines were published on 2008, the most current version was published in 2013 based on the updated literature of until fall 2012. Other important revised guidelines in critical care field such as 'Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit' were revised in 2013. This article will review the revised guidelines and several additional interesting published papers of until March 2014, including the part of ventilator-induced lung injury and the preventive strategies.

Belief in Evidence-Based Practice, Awareness of Importance and Performance of Nursing Practice Guidelines among Novice Nurses and Preceptors in a Tertiary General Hospital (상급종합병원 신규간호사와 프리셉터 간호사의 근거기반실무에 대한 신념, 간호실무지침에 대한 중요도와 수행도)

  • Seo, Ju Hee;Eun, Young
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.2
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    • pp.149-162
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    • 2023
  • Purpose: This study was to investigate the belief in evidence-based practice, awareness of importance and performance of intravenous infusion and pressure ulcer evidence-based practice guidelines among nurses in a tertiary general hospital. Methods: The subjects of this study were 217 nurses working in a tertiary general hospital. Data collection was performed between February 11 and February 25, 2022. Data analysis was conducted descriptive statistics, t-test, hierarchical regression analysis, and Importance-Performance Analysis. Results: The mean score of belief for evidence-based practice among novice nurses was 3.34 out of 5, while preceptor nurses scored a mean of 3.41 out of 5. There was no significant difference in belief scores between novice nurses and preceptor nurses (t=-1.21, p=.227). The factors influencing the performance of evidence-based practice guidelines for intravenous infusion were belief in evidence-based practice (β=.14, p=.009) and importance of intravenous infusion (β=.51, p<.001), and the factors influencing the performance of evidence-based practice guidelines for pressure ulcer were belief in evidence-based practice (β=.15, p=.002) and importance of pressure ulcer (β=.65, p<.001). Importance-Performance Analysis of the evidence-based practice guidelines of two groups were used to identify common and different items. Conclusion: To improve the performance of evidence-based practice guidelines, it is necessary to enhance the evidence-based practice belief and importance of evidence-based practice guidelines. In particular, evidence-based practice should be provided to improve nursing quality through education on items of low-importance and low-performance and items of high-importance but low-performance guidelines identified through Importance-Performance Analysis.

Treatment Guidelines of Sepsis and Septic Shock (패혈증과 패혈쇼크의 치료 지침)

  • Lee, Heung Bum;Moon, Hee
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.491-498
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    • 2009
  • Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

Legal Analysis and Development of managerial guideline to nursing activities related to observation (간호사의 경과관찰업무에 대한 판례분석 및 관리지침 개발)

  • Kim, In-Sook;Kim, Ki-Kyoung;Kim, Dae-Ran
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.2
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    • pp.273-281
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    • 2002
  • Purpose. The study was done to develop nursing guidelines to prevent nursing negligence in the clinical setting that would lead to malpractice. Method. A comprehensive review of the literature and focus groups interviews were used to search for malpractice cases related to "observation", one of the most basic nursing activities. The cases were analyzed with respect to nursing practice and a legal expert was consulted on the content. Results. 4 malpractice cases related to observation negligence were selected for this study; 1) a case of failing to observe dyspnea after a thyroidectomy, 2) a case of failing to observe a depressed patient for suicide attempts, 3) a case of failing to observe a VP shunt obstruction, 4) a case of failing to observe a cardiac ischemia after a bronchoscopy. 11 guidelines were developed for clinical nurses and 13 guidelines for nursing managers. Conclusion. These guidelines are useful in preventing malpractice due to nursing negligence. Therefore nurses need to apply them to their practices and continue to make an effort to develop guidelines for other malpractice situations.

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3D Facial Scanners: How to Make the Right Choice for Orthodontists

  • Young-Soo Seo;Do-Gil Kim;Gye-Hyeong Lee;Kyungmin Clara Lee
    • Journal of Korean Dental Science
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    • v.17 no.1
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    • pp.1-13
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    • 2024
  • With the advances of digital scanning technology in dentistry, the interests in facial scanning in orthodontics have increased. There are many different manufacturers of facial scanners marketing to the dental practice. How do you know which one will work best for you? What questions should you be asking? We suggest a clinical guideline which may help you make an informed decision when choosing facial scanners. The characteristics of 7 facial scanners were discussed in this article. Here are some considerations for choosing a facial scanner. *Accuracy: For facial scanners to be of real value, having an appropriate camera resolution is necessary to achieve more accurate facial image representation. For orthodontic application, the scanner must create an accurate representation of an entire face. *Ease of Use: Scanner-related issues that impact their ease of use include type of light; scan type; scan time; file type generated by the scanner; unit size and foot print; and acceptance of scans by third-party providers. *Cost: Most of the expenses associated with facial scanning involve the fixed cost of purchase and maintenance. Other expenses include technical support, warranty costs, transmission fees, and supply costs. This article suggests a clinical guideline to make the right choice for facial scanner in orthodontics.