• Title/Summary/Keyword: clinical protocol

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Reasons for Variation in Sensitivity and Specificity of Visual Inspection with Acetic Acid (VIA) for the Detection of Pre-Cancer and Cancer Lesions of Uterine Cervix

  • Parashari, Aditya;Singh, Veena
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7761-7762
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    • 2013
  • Alternative strategies such as visual inspection of cervix with acetic acid, are real time, economical and easily implemented methods for cervical cancer screening. However, variable sensitivity and specificity have been observed in various community based studies. The possible reasons could include variation in man power training, light source used for visualization, and preparation of diluted (4-5%) acetic acid and its storage. A standardized protocol for training, teaching material (easy to understand in the local language) for trainees, supervision and reinforcement by intermittent and supplementary training to check the quality of their observation, a standard protocol for preparation dilute acetic acid and its storage and a standard good light source (equivalent to day light) are needed to minimize the variation in sensitivity and specificity of VIA in community settings.

Clinical Protocol Knowledge Representation Method for Ubiquitous Healthcare Service Based on Enuresis Patients care (유비쿼터스 헬스케어 서비스 기반의 야뇨증 환자 치료를 위한 임상 프로토콜 지식표현 방법)

  • Hwang, Koung-Soon;Lee, Sun-A;Lee, Keon-Myung;Kim, Wun-Jea;Yun, Seok-Jung
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 2008.04a
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    • pp.229-232
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    • 2008
  • 본 논문은 유비쿼터스 헬스케어 서비스 기반의 환자 치료를 위한 임상프로토콜 지식표현 방법을 제안한다. 제안한 방법은 프로토콜 태스크 관리 모듈, 이벤트 스케줄링 모듈, 그리고 자동실행 및 지식 공유를 위해 XML형식의 저장 모듈을 지원한다. 본 논문에서는 제안한 방법을 모바일(cell phone, PDA)과 웹 어플리케이션을 사용하여 야뇨증 환자치료를 지원하기 위한 유비쿼터스 헬스케어 서비스 기반의 임상 프로토콜 기술방법을 적용하였다.

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Breast Magnetic Resonance Image (MRI) Guideline: Breast Imaging Study Group of Korean Society of Magnetic Resonance in Medicine Recommendations

  • Choi, Seon Hyeong;Kang, Bong Joo;Jung, Seung Eun
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.4
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    • pp.205-208
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    • 2018
  • The purpose of this study is to establish an appropriate protocol for breast magnetic resonance imaging (MRI) in the discipline of image quality standards. The intention of the protocol is to increase effectiveness of medical image information exchange involved in construction, activation, and exchange of clinical information for healthcare.

Development of Nursing Protocols for Hospitalized Foreign Patients (외국인 환자 입원간호 프로토콜 개발 연구)

  • Kim, Keum Soon;Ahn, Jung Won;Choi, Yun Kyoung;Seo, Sooryang
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.2
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    • pp.161-172
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    • 2016
  • Purpose: The purpose of this study was to develop a nursing protocol for care of hospitalized foreign patients based on necessary nursing care and to evaluate content validity and practical applicability. Methods: A survey was conducted to identify the need for protocol development and to prioritize necessary content to be included in the protocol (N=110). A draft protocol was developed, and 7 experts and 115 nurses evaluated content validity and practical applicability of the protocol. Results: Results of the needs survey showed that all participants agreed there is a need for a protocol. Based on the survey results, a protocol was developed which included: regional culture and healthcare, admission/discharge care, surgical care, pain management, care in diagnostic testing, medication administration, and blood transfusion. Score on the experts' evaluation of content validity of the protocol was $3.66{\pm}0.28$. Practical applicability score was $3.61{\pm}0.29$ in the experts' group and $3.16{\pm}0.11$ in the nurses' group. Total score for validity of the overall content was $29.46{\pm}5.62$. Conclusion: The nursing protocol developed in this study for care of hospitalized foreign patients can contribute to improvement in quality of nursing care for these patients and can also be used as a teaching guideline to educate nurses.

Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients (체외막산소화장치 적용 중환자를 위한 근거기반 간호 프로토콜 개발 및 효과 평가)

  • Kim, Soomi;Kim, Chul-Gyu
    • Journal of Korean Academy of Nursing
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    • v.53 no.3
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    • pp.275-294
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    • 2023
  • Purpose: This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol. Methods: The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol's effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses' outcome variables were evaluated using a questionnaire. Results: First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001). Conclusion: This protocol may help prevent infections and pressure injuries in patients, and improve nurses' satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

Role of vitamin C and rectal indomethacin in preventing and alleviating post-endoscopic retrograde cholangiopancreatography pancreatitis: a clinical study

  • Amir Sadeghi;Rana Jafari-Moghaddam;Sara Ataei;Mahboobe Asadiafrooz;Mohammad Abbasinazari
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.214-220
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    • 2023
  • Background/Aims: This study aimed to determine whether vitamin C in addition to indomethacin decreases the occurrence and severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) occurrence and severity. Methods: This randomized clinical trial included patients undergoing ERCP. The participants were administered either rectal indomethacin (100 mg) plus an injection of vitamin C (500 mg) or rectal indomethacin (100 mg) alone just before ERCP. The primary outcomes were PEP occurrence and severity. The secondary amylase and lipase levels were determined after 24 hours. Results: A total of 344 patients completed the study. Based on intention-to-treat analysis, the PEP rates were 9.9% for indomethacin plus vitamin C plus indomethacin and 15.7% for indomethacin alone. Regarding the per-protocol analysis, the PEP rates were 9.7% and 15.7% in the combination and indomethacin arms, respectively. There was a remarkable difference between the two arms in PEP occurrence and severity on intention-to-treat and per-protocol analyses (p=0.034 and p=0.031, respectively). The post-ERCP lipase and amylase concentrations were lower in the combination arm than in the indomethacin alone arm (p=0.034 and p=0.029, respectively). Conclusions: Vitamin C injection in addition to rectal indomethacin reduced PEP occurrence and severity.

Assessment of therapeutic clinical trials for proximal humeral fractures

  • Jonathan Koa;Mohamad Y. Fares;Mohammad Daher;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.237-246
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    • 2024
  • Proximal humeral fractures (PHFs) are a common injury among the older population. An ideal therapeutic protocol has yet to be developed, and numerous clinical trials are being conducted to find the best therapeutic approach. The purpose of this study is to evaluate the current body of knowledge available via interventional clinical trials. In December 2022, interventional clinical trials relating to PHFs on Clinicaltrials.gov were screened. Trial characteristics included duration, status, intervention, phase, outcomes, location, and study design. Publications associated with each trial were searched on PubMed/Medline using the ClinicalTrials.gov registry number. The final dataset comprised 64 trials. The most common trial status was completed (36%). The majority did not have a Food and Drug Administration-defined phase (67%), was randomized (81%), involved a single facility (72%), used a parallel assignment intervention model (80%), and used an open-label approach (45%). Eleven trials were associated with a publication, and the publication rate was 17%. Average enrollment was 86 participants, and mean trial duration was 51.4 months. Europe/UK/Russia/Turkey participated in the most trials (70%). Most of the trials were initiated after 2010 (87.5%). Procedure-related interventions (55%) were most common. Disability/function was the most common primary outcome assessed (61%). The low publication rate and the multitude of trials conducted after 2010 highlight the urgency and need for trial results to be published to establish an ideal therapeutic protocol. Since the majority of the trials involved a single institution and an open-label approach, reinforcing blinding and establishing multi-centered trials can improve the validity of the clinical trial results.

The Application and Effect of the Nursing Protocol of Pediatric Peripheral Intravenous Infusion (아동의 말초정맥주사 간호프로토콜 적용 및 효과)

  • Choi, Heekang;Kang, Mijung;Kang, Hyunju;Kim, Eunhye
    • Perspectives in Nursing Science
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    • v.14 no.2
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    • pp.45-54
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    • 2017
  • Purpose: The aim of this study was to compare the effect of training and implementation of a pediatric peripheral intravenous infusion protocol on the nurses' performance and infusion complication rate. Methods: A quasiexperimental study using a posttest comparison of a one group pretest-time series design was utilized. This method was developed to measure nursing knowledge and performance based on a pediatric peripheral intravenous infusion protocol. To calculate the occurrence rate of complications, the number of complications were divided into the number of intravenous insertions. Results: It was shown that the training developed by the study team in 2015 contributed to nurses' increased knowledge, as well as improved job performance. Furthermore, the implementation of the protocol revealed that the number of peripheral intravenous insertions, an invasive procedure, decreased. Additionally, the nursing workload related to pediatric intravenous infusions was reduced. Conclusion: This protocol may contribute to the improved scientific quality and efficiency of nursing management of peripheral intravenous infusions.

Effect of Evidence-Based Practice Protocol for Catheter Dysfunction in Hemodialysis Patients: Focus on Patency Rates and Bleeding Complications (혈액투석 환자의 도관 기능부전 관리 프로토콜 적용이 도관개존 성공률 및 출혈 합병증에 미치는 영향)

  • Lee, Kyung Mi;Kim, Mi Yeon
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.3
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    • pp.356-362
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    • 2018
  • Purpose: This study was a retrospective cohort study to evaluate the effect of evidence-based guidelines for catheter dysfunction among hemodialysis patients, Success rate and bleeding complications in catheterization were examined. Methods: We performed a retrospective cohort study, including 94 patients with catheter dysfunction who were receiving hemodialysis at a university hospital; 55 in the control group and 39 in the protocol group. This protocol was composed of the catheter dysfunction assessment, conservative management of catheter dysfunction, drug management of catheter dysfunction, catheter function test and maintenance management. Data were analyzed with a Chi-square test and t-test using SPSS/WIN 23.0 program. Results: The patency rate of the protocol group was significantly higher than that of the control group. The rate of bleeding complications was not statistically significant for either the control group or the protocol group before or after application. Conclusion: The application of the guidelines effectively increased the patency rate of the catheter without bleeding complications. It is hoped that this guideline can be disseminated to nurses nationwide to improve the efficiency of catheter function for hemodialysis patients.

A Rehabilitation protocol for Arthroscopic Bankart repair in Korean Medicine : A Case Report (Bankart 병변의 관절경적 복원술 후 한방 재활치료 프로토콜을 적용하여 호전된 증례 보고)

  • Geum, Ji-Hye;Baek, Dong-gi;Lee, Jung-Han
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.177-187
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    • 2019
  • Objectives: The aim of this study was to report the clinical improvement of a patient who underwent arthroscopic Bankart repair using a rehabilitation protocol involving Korean medicine. Methods: The patient was treated with acupuncture, cupping, Korean Medicine, Chuna therapy, and Doin exercise therapy during the admission period. To estimate the patient's status, we used the Numeric Rating Scale (NRS), Pain Disability Index (PDI), assessments of the range of motion (ROM) and Muscle Manual Test (MMT) for the shoulder joint. Results: After administering the abovementioned treatments, we found that the patient's NRS, PDI, and ROM and MMT for the shoulder joint were improved. Conclusions: The rehabilitation protocol involving Korean medicine can be applied to and produce good results for patients who undergo arthroscopic repair for Bankart lesions. The limitation of the study was that the number of cases we studied was insufficient to prove the effectiveness. Hence, further studies are needed for designing the rehabilitation protocol involving Korean medicine.