• 제목/요약/키워드: clinical practice guidelines

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안전한 매선요법 시술을 위한 멸균, 소독 및 무균법 (Disinfection, Sterilization and Aseptic Technique for Thread Embedding Acupuncture)

  • 윤영희;손재웅;고성규;최인하
    • 한방안이비인후피부과학회지
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    • 제29권1호
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    • pp.103-112
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    • 2016
  • Objective : Thread embedding acupuncture has become popular as a minimally invasive treatment for facial wrinkles and laxity. However, there is little published clinical practice guidelines about disinfection, sterilization and aseptic technique for thread embedding acupuncture. This study is to introducing a specific guidelines about disinfection, sterilization and aseptic technique for thread embedding acupuncture.Method : We reviewed internal regulations and guidelines about hospital infection, and Traditional Korean medicine doctors, nurses, and director of central supply room discussed in depth and established a regulation of disinfection, sterilization and aseptic technique for thread embedding acupuncture.Result : The regulation of disinfection, sterilization and aseptic technique for thread embedding acupuncture consisted of ① management of supplies, ② guidelines of disinfection, sterilization, and reuse, ③ aseptic technique for thread embedding acupuncture.Conclusion : Microbial management is an essential element of medical care and quality. Traditional Korean medicine doctors will care for disinfection, sterilization, and this should not neglect to comply with the procedures and guidelines in the medical field as well as to understand the aseptic techniques.

치위생과 학생의 임상실습 기간 중 역할·활동요인, 이상·가치요인 스트레스, 스트레스 량의 관련성 (Role·activity factors, ideal·value factors stress and stress amount relationship in clinical practice of dental hygiene students)

  • 류혜겸
    • 한국치위생학회지
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    • 제20권5호
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    • pp.685-695
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    • 2020
  • Objectives: The purpose of this study was to investigate role·activity factors, ideal·value factors stress and stress amount relationship in clinical practice of dental hygiene students. Methods: The participate in this study were 231 dental hygiene department students. the survey was conducted from August 24 to September 30, 2018, using a structured questionnaire(1040460-A-2018-036). The collected data were compared and analyzed using a ANOVA and multiple regression. Results: The factors affecting the amount of stress were investigated. Role and activity factors stress in case of too much assignment, repeat simple and funtional work, ideal and value factors stress in case of utilized as a subsidiary work practice institution rather than clinical practice, lake of awareness that the training institution is a trainee. Conclusions: School institution and departments form organic relationships with industries. Uniform training guidance for each training institution does not help with diversity or creativity and problem-solving skills. It gives some autonomy to the training guidance of training institutions, also a clear standard for the contents of the training. we need a system that can provide and evaluate basic guidelines for what students can do in clinical practice.

신세포암에 사용되는 전신 항암요법의 요양급여기준에 관한 고찰 (Assessment of Appropriateness of Criteria for Insurance Coverage on Systemic Therapy used in Renal Cell Carcinoma)

  • 김정연;박은지;배민경;윤정현
    • 한국임상약학회지
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    • 제21권4호
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    • pp.319-331
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    • 2011
  • Purpose: The purpose of this study is to evaluate current criteria for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on the systemic therapy used in the treatment of advanced or metastatic renal cell carcinoma (RCC), by reviewing all available clinical evidences including a variety of clinical practice guidelines. Methods: We searched clinical databases and collected data from published phase 1 through 3 randomized clinical trials on all systemic therapies used in RCC, including novel targeted therapies. Additionally, current clinical practice guidelines on the management of kidney cancer or RCC were reviewed. Based on the collected data we evaluated the appropriateness of the HIRA criteria for insurance coverage on the systemic therapy of RCC whether they are evidence-based and up to date. Results: On the basis of the collected data we concluded that there was a need for a revision in HIRA criteria for systemic therapy of RCC. Despite recent emerging therapeutic advances and changes in therapeutic strategies of management of RCC, some of anticancer regimens were inappropriately listed even though they were not proven to provide efficacy or safety superior to those of other therapies. We thus proposed an updated recommendation based on current clinical evidences. Conclusion: Systemic therapy of RCC is being rapidly changed with the advancement of understanding of the molecular biology of cancer. Consequently newly developed targeted therapies are becoming the standard therapy in the management of medically or surgically unresectable advanced or metastatic RCC. To provide effective and safe therapy to patients with RCC, the criteria for insurance coverage should be made carefully taking into consideration of most up-to-date and high-quality clinical evidences, and should be continuously reviewed so as to reflect evidence-based clinical practice.

병원 간호사의 중동호흡기증후군 격리 지침에 대한 지식과 수행도 (Knowledge and Practice of Middle East Respiratory Syndrome Isolation Precaution among Hospital Nurses)

  • 김선주;송라윤
    • 기본간호학회지
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    • 제25권1호
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    • pp.46-57
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    • 2018
  • Purpose: The purposes of the study were to examine the knowledge and practice about Middle East Respiratory Syndrome (MERS) isolation precaution, and to explore influencing factors of the isolation practice among hospital nurses. Methods: A total of 182 nurses were recruited from four general hospitals where MERS patients had been treated. The knowledge and practice of MERS isolation precaution were measured by the scales developed based on the CDC guidelines. The collected data were analyzed by SPSS/WIN 22 with descriptive statistics, T-test, One-way ANOVA, Pearson correlation coefficients, and hierachical multiple regression analysis. Results: The nurses were 30 years old in average, and half of them had less than 5 years of clinical experience. and knowledge on droplet precautions (${\beta}=.171$, p=.019) were the significant predictors, explaining 19.6% of variance in the MERS isolation guideline practice. Clinical experience (${\beta}=.225$, p=.002), working at infection unit (${\beta}=-.203$, p=.011). Conclusion: The knowledge on droplet precaution and general knowledge on MERS were the important modifiable factor to improve the MERS isolation guideline practice among hospital nurses, even after adjusting clinical experience and demographic variables. It is necessary to develop an efficient education program on specific guidelines for prevention and management of infection by improving the knowledge on infectious disease such as MERS as well as droplet precaution which are modifiable factors.

불임증 임상진료 지침 개발의 기초 자료 확보를 위한 전자우편 설문 조사 (Email survey in obtaining basic data for the development of clinical practice guideline for infertility in Korean Medicine)

  • 김동일
    • 대한한방부인과학회지
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    • 제23권4호
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    • pp.80-94
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    • 2010
  • Purpose: This survey was done in order to determine Korean medical doctors (K.M.D)' expertise on clinical practice guideline for infertility and the degree of concordance with the guideline. Methods: The questionnaires were distributed via e-mail to all members of Korean Medical Doctors Society and Korean Gynecology Society from August $30^{th}$ to September $1^{st}$ in 2010. Two hundred sixty nine of completed questionnaires were analyzed through two groups, members of the Gynecology Society and nonmembers of the Gynecology Society. Results: According to the analysis of the outcome of the survey done by 99 members of the Korean Gynecology Society and 170 non-members, two-thirds of the participants had prior information of the clinical practice guideline. 63.6 percent of the participants feel strong necessity of the development of Korean medical infertility clinical practice guideline. Seventy percent of the participants are willing to participate in developing or reviewing a clinical guideline. On the question in active utilization and concordance to the guideline once the Korean medical infertility guideline is developed, 44% answered they would while 34.6% said they would utilize the guideline after some modifications. On the prospect of the impact of the development and application of Korean medical clinical practice guideline for infertility, majority of the participants marked positively that the standardization of clinical practice for infertility will lead to the nation's participation with the Nation's Support Work and that the development will somewhat contribute to the standardization of the clinical practice. Conclusions: The survey confirmed high demand of the clinical practice guidelines for infertility and the degree of concordance for infertility amongst Korean Medical doctors.

월경전증후군 한의표준임상진료지침 개발을 위한 한의사의 의견과 치료에 대한 실태조사 (A Survey on Korean Medicine Doctor' Opinion and Treatment for Developing Korean Medicine Clinical Practice Guideline for Premenstrual Syndrome)

  • 김누리;김정훈;정서윤;김평화;이은희
    • 대한한방부인과학회지
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    • 제35권4호
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    • pp.77-90
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    • 2022
  • Objectives: This study was aimed to figure out korean medicine doctors' opinion and treatment of Korean medicine clinical practice guidelines (CPG) for premenstrual syndrome (PMS). Methods: We conducted a questionnaire survey targeting korean medicine doctors belonging to the Korean Association of Oriental Medicine by e-mail and text and analyzed the answers. Results: 1. The average monthly number of patients visiting the respondents' clinics for PMS was 2.7, the main age group was 20-30s (80.8%) and the treatments the patients given before were mostly western treatments such as painkiller and combined oral contraceptives. 2. The treatment period for PMS was mostly less than 3 months (69%), and the frequency of acupuncture treatment was the most twice per week (41.1%). 3. The most effective herbal medicine for affective symptoms was Soyo-san, and for physical symptoms was Gyejibokryung-hwan. The most commonly used acupuncture point was 三陰交 (SP6). 4. Other opinions of the clinicians about Korean medicine clinical practice guideline of PMS were the need for promotion of PMS, convenience of taking herbal medicines and price competitiveness. Conclusions: We figured out korean medicine doctors' opinion of PMS CPG, clinical diagnosis and treatment.

Appraisal of Guidelines for Research & Evaluation (AGREE) II를 이용한 교통사고 상해증후군의 국내·외 기개발 임상진료지침의 평가 (Appraisal of Guidelines for Research & Evaluation II Appraisal of Clinical Practice Guidelines for Traffic Injuries)

  • 박경원;이준석;김현태;박선영;허인;신병철
    • 한방재활의학과학회지
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    • 제31권4호
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    • pp.129-143
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    • 2021
  • Objectives This study was aimed to evaluate clinical practice guidelines (CPGs) of traffic injuries, which has already been developed at domestic or outside of country, and to explore the Korean medical treatments included in the CPGs. Methods Twelve electronic databases (PubMed, Cochrane library, China National Knowledge Infrastructure [CNKI {Chinese Academic Journals, CAJ}], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], KoreaMed, Korean Medical Guideline Information [KoMGI), National Guideline Clearinghouse [AHRQ], Core Outcome Measures in Effectiveness Trials Initiative Website [COMET], Turning Research into Practice [TRIP], The National Institute for Health and Care Excellence [NICE], and Medical Research Information Center [MedRIC]) up to July 2021 were searched. Only systematically developed CPGs for traffic injuries were selected and appraised. The appraisal was conducted by using Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results Six CPGs were included and evaluated. All CPGs were appraised as highly recommended because they exceeded 60% in more than 4 among 6 domains of AGREE II, including domain of 'rigor of development', and 30% in the rest. Recommendations related to Korean medicine treatments such as on manual therapy related to Chuna were given in 6 CPGs, 4 for acupuncture, 1 for Qigong and 1 for Taping. Conclusions The 6 CPGs were developed up to now through a systematic development methodology and there were many recommendations for Korean medical treatments related to manual (Chuna) treatment, acupuncture and Qigong. However, the evidence for the side effects and risk factors of Korean medical treatments was scantly reflected in CPGs. Therefore, it is considered that balanced CPG with benefits and risks should be developed, covering Korean medical diagnosis, treatment and prognosis.

전립선비대증의 진료지침 개발 (Development of a Clinical Practice Guideline : Benign Prostatic Hyperplasia)

  • 유승흠;채수응;김춘배;강명근;송재만;이은식;이정구;이춘용;홍성준
    • 한국의료질향상학회지
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    • 제3권2호
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    • pp.36-51
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    • 1997
  • Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

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임상 간호사들의 연구 관련 활동 실태 및 연구결과 활용의 장애 요인 (Nurses′ Research Activities and Barriers of Research Utilization)

  • 오의금;오현주;이윤정
    • 대한간호학회지
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    • 제34권5호
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    • pp.838-848
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    • 2004
  • Purpose: This study was to describe nurses' research activities, perceptions and performances of evidence-based practice and barriers to the use of research evidence in nursing practice in Korea. Method: A cross-sectional survey design was used. A questionnaire, except for Barriers Scale, was developed for the study. Data was collected from a convenient sample of 437 registered nurses working at research and education oriented university hospitals. Result: Nurses' research-related activities were relatively low compared to previous studies. Also perceptions and performances of evidence based nursing practice were low. Preferred informational resources for clinical decision making were identified as ward manuals/clinical guidelines, manager/senior nurses, and literature/research. The major barriers to research utilization were a lack of implication for practice along with inadequate facilitation to implement research evidence and difficulty understanding research written in English. Priorities of barriers factor were Administrator, Communication, Adopter, and Research. Conclusion: The findings provide directions for future training, education, and managerial policy to achieve successful evidence based nursing practice.

위암 표준진료권고안 (Clinical Practice Guideline of Gastric Cancer in Korea)

  • 김재규
    • Journal of Digestive Cancer Research
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    • 제4권1호
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    • pp.10-16
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    • 2016
  • There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.

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