• 간호행정학회지
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• 제23권1호
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• pp.63-75
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• 2017

Purpose: This study was conducted to adapt the standardized evidence-based nursing protocol using the IPC (intermittent pneumatic compression) intervention to prevent venous thromboembolism in surgical patients. Further, an investigation was done to measure knowledge on prevention of venous thromboembolism, surrogate incidence of venous thromboembolism and to assess IPC compliance in the study patients compared with those in surgical patients who underwent IPC intervention due to previous clinical experience. Methods: An analysis was done of the nine modules suggested by National Evidence-based Healthcare Collaborating Agency (NECA) in the adaptation manual of the clinical practice guideline for protocol adaptation. A nonequivalent control group post test design as a quasi-experiment was used to verify the effect of the IPC protocol. Results: There was a significant difference in knowledge of prevention of venous thromboembolism, IPC application time after intervention and the number of IPC applications between the experimental group (n=50) using the IPC nursing protocol and the control group (n=49). However, the symptoms of deep vein thrombosis and pulmonary thromboembolism were not observed in either the experimental group or the control group after the intervention. Conclusion: Results confirm that the standardized IPC nursing protocol provides effective intervention to prevent venous thromboembolism in surgical patients.

• 한방재활의학과학회지
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• 제32권4호
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• pp.73-82
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• 2022

Objectives The purpose of this study is to develop a case study protocol to complete final version of Korean medicine clinical pathway (CP) by applying Korean medicine CP based on carpal tunnel syndrome Korean medicine clinical practice guidelines developed by clinical experts to clinical field. Methods After applying previously developed CP, 10-point Likert scale questionnaires on satisfaction of CP, appropriateness and improvement on out patient department (OPD) treatments are carried out in the 2^nd week of OPD treatment. An open-ended questionnaire is also carried out to ask if there is any requirement to be added or improved among CP interventions. Results Final version of CP is going to be completed based on the questionnaire, excluding articles of which average or median value is less than 5 from 10-point Likert scale. Conclusions This evidence-based case study protocol is expected to contribute development of carpal tunnel syndrome clinical pathway.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8595-8598
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• 2016

Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.214-233
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• 2016

There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

• PNF and Movement
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• 제15권2호
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• pp.115-124
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• 2017

Purpose: Researchers found that blocks of evidence-based practice (EBP) implementation lacked opportunities for EBP education. The study found that physical therapists had negative views of research as well as their roles in EBP, lacked confidence in EBP, and had limited access to web-based materials. The purpose of this study was to highlight the importance of information research technology for efficient EBP in a clinical environment. Methods: The web-based information research technologies that should be used for sustainable EBP include: the clinical practice guideline (CPG) and PubMed's My NCBI service. Journal mailing services and other academic information sources should also be used to gather information from RSS feeds. An EBP library or archive must be created. A site that provides EBP-specific information is also needed. Results: We should usually do EBP. Practitioners must learn and use information technologies that will help them improve their EBP skills. Conclusion: Facilitating EBP implementation and building an EBP system require related education as well as a practical work environment and equipment. However, the highest priority is individual efforts and trial. Information technology will complement the lack of time. It is important to use information research technology to overcome real obstacles. Lasting EBP must use a number of web-based information research technologies to overcome the practical challenges encountered in EBP implementation.

• 대한한방부인과학회지
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• 제33권4호
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• pp.23-35
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• 2020

Objectives: The purpose of this study is to confirm the effectiveness and safety of acupuncture for Endometriosis. So providing a clinical basis for abdominal acupuncture treatment helping to develop clinical practice guideline. Methods: Clinical studies applying acupuncture on Endometriosis were searched through Pubmed, China Academic journal (CAJ), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (OASIS). Interventions and results of the selected clinical studies were analyzed. Results: 8 Clinical studies were finally included according to inclusion and exclusion criteria. Those were randomized controlled studies. All of those studies were searched in China Academic journal (CAJ) in Chinese. Interventions of control group were made with simple acupuncture and oral administration of Danazol or herbal medicine. Outcome measurements included Treat effect, Relief in related symptoms, and CA-125. All studies reported statistically significant results on abdominal acupuncture and there were no serious adverse effects. Conclusions: This study suggested abdominal acupuncture has statistically significant treat effect. Thus this treat helps improve quality of life for patients. However the results should be taken cautiously as more clinical studies are needed.

• 동의신경정신과학회지
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• 제33권2호
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• pp.181-214
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• 2022

Pediatric epilepsy, a chronic, recurrent brain disorder, is the most common neurological disorder in children. Its prevalence is increasing. Early management is very important since 30~40% of cases persist into adulthood. To provide basic data for future clinical research on pediatric epilepsy using Korean medicine treatment and cooperation between Western medicine doctors and Korean medicine doctors, we reviewed recent clinical research in traditional Chinese medicine (TCM) using herbal medicine for pediatric epilepsy. A total of 23 articles (1 clinical practice guideline, 3 systematic reviews, 15 randomized controlled trials (RCTs), and 4 non-RCTs) were reviewed in this study. The authors summarized characteristics of included studies regarding study subjects, diagnostic tools, pattern identification tools, treatment period, evaluation tools, detail of herbal medicines, treatment effects, and adverse events. Combination therapy using both herbal medicine (HM) and anti-epileptic drugs (AEDs) was performed more frequently than herbal medicine alone. Liver-pacifying medicinal, water-draining medicine, and orifice-opening medicine were frequently used. The main single HMs were Cheonma, Boglyeong, Jogudeung, and Seogchangpo. Combined therapy using HM and AEDs had significant benefits in improving total effective rate. It also appeared to be safer than AEDs. However, since the quality of clinical trials was poor and only studies in the last 10 years were included, the clinical evidence was uncertain. Finally, the authors provided limitations of this study and several suggestions for future research based on our analysis results.

• 기본간호학회지
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• 제18권4호
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• pp.463-471
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• 2011

Purpose: The purpose of this study was to develop nursing practice guidelines for water treatment system used in hemodialysis and to evaluate the guidelines by applying them in practice. Method: The first draft for the guidelines was developed based on advice and recommendations obtained from procedure review of critical literature. The draft was modified through evaluation by an expert group and pilot application to practice. The final draft was evaluated by the expert group using the AGREE instrument (Appraisal of Guidelines for Research and Evaluation). Results: For the pilot test using the draft guidelines, 144 samples were collected from the water treatment system and hemodialysis machines. Results showed no bacteria. Endotoxin tests and chemical tests passed the criteria. After revision of the draft guidelines and additions to the draft guidelines, the final draft was confirmed. The quality of the final draft was evaluated by 4 experts using the AGREE instrument. The mean standard score was 76.9% for the 19 items. Conclusion: The clinical guidelines developed in this research can be utilized as systematic and scientific guidelines for water treatment systems used in hemodialysis. In addition, the results of the research can contribute to improving care services.

• 한국간호교육학회지
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• 제16권1호
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• pp.150-155
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• 2010

Purpose: The purpose of this study is to develop evidence-based nursing practice guidelines for hemodialysis in the renal failure patients with risk of bleeding and to evaluate the guidelines by applying it to the practice. Method: Referring to the SIGN, the first draft for guidelines was developed based on the advices and recommendations obtained from the procedure of critical literature analysis. Then, the draft was modified by the procedures of the expert group evaluation and pilot application to the practice. The final draft was evaluated by the expert group using AGREE instrument. Result: The first draft of guidelines was developed through 8 stages of process and was evaluated by seven experts in terms of the appropriateness, applicability, and effectiveness using a 9 point scale. The mean score of 11 items was 7.90 or above. The quality of the final draft was evaluated by 5 experts using the AGREE instrument. The mean standard score was 73.0% or above in the 19 items. Conclusion: The clinical guidelines developed by this research can be utilized as systematic and scientific guidelines for hemodialysis in the renal failure patients with risk of bleeding. In addition, the research can contribute to improving care services.

• 한국임상약학회지
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• 제24권4호
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• pp.296-303
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• 2014

Background: The first pharmacy student practice undergoing 6 year pharmacy school curriculum have begun in the hospital pharmacy, community pharmacy, pharmaceutical company and administrative office since 2013. Although most of practice sites have prepared the program of pharmacy student practice education for several years under guideline of Korean Association of Pharmacy Education, generally community pharmacies which start the pharmacy student practice education have difficulty in performing the desirable student practice program due to absent experience for it. So we reported the comparison of student practice programs between mono pharmacy and multiple pharmacies conducted by Gyeongsang National University College of Pharmacy to provide the future design information of the ideal pharmacy student practice in community pharmacy. Method: Students who practiced both multiple (multi) and mono pharmacy (mono) programs for each 5 weeks were participated the survey to evaluate the student practice programs. Results: The results of the survey on the student practice program reported that students were much more satisfied with the multiple pharmacies program than mono pharmacy program in both practical contents ($4.12{\pm}0.72$ : $3.27{\pm}1.28$; multi : mono) and satisfaction ($4.54{\pm}0.54$ : $3.54{\pm}1.3$; multi : mono) and they all gave the highest points ($5.00{\pm}0.00$) to multiple pharmacies program for recommendation because the multiple pharmacies program was significantly helpful for their experience to plan the future career. Conclusion: Mono and multiple pharmacy practice programs would be a great helpful for student's future career. However, the disadvantages of each program should be amended gradually for the unified and specialized program to be established the ideal community pharmacy student practice in Korea. The results will be affected the pharmacy practice program for students in community pharmacy and the other colleges of pharmacy to design the ideal community pharmacy practice program.