• Title/Summary/Keyword: evidence-based

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간호관리학 실습에서의 근거기반간호 교육 적용: 결과평가와 확산 전략 (Implementation of Evidence Based Nursing Education into Nursing Management Clinical Practicum: Outcome Evaluation and Diffusion Strategies)

  • 박명화
    • 간호행정학회지
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    • 제19권1호
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    • pp.39-47
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    • 2013
  • Purpose: This practice study was done to describe the process and outcomes of application of Evidence Based Nursing (EBN) Education to nursing management clinical practicum and suggest strategies to diffuse EBN into nursing management education. Methods: Education on the evidence based nursing management process was provided to 65 senior nursing students from a university. Nursing management clinical practicum integrated with EBN. The setting was a five full day-clinical practicum. Group and individual training on EBN process with lectures, small group discussions, conferences, and educational prescription were provided. Outcomes were analyzed using paired t test for 65 participants. Results: Evidence based nursing competency increased significantly showing improvement in understanding EBN, formulating clinical question, searching & classifying the evidence, recognizing level of evidence, considering patient preference, and evaluating outcomes. Nursing students' access and use of evidence based information resource also improved. Conclusion: The results of this study indicate that the application of EBN to nursing management clinical practicum is effective to improve EBN competency in undergraduate students and should be further applied in nursing education using the systematic strategies.

The Feasibility and Future Prospects of Robot-Assisted Surgery in Gastric Cancer: Consensus Comments from the National Evidence-based Collaborating Agency Round-Table Conference

  • Shin, Eunhee;Choi, Jieun;Seo, Seongwoo;Lee, SeonHeui
    • 보건행정학회지
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    • 제25권2호
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    • pp.67-70
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    • 2015
  • To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.

미국의 일차의료 평가 동향 및 시사점: 미국의 리얼월드 평가 안내서를 중심으로 (Trend and Implication of Primary Care Evaluation in U.S.)

  • 서유신;김희선;유빛나;김진희;박종연
    • 보건의료기술평가
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    • 제6권2호
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    • pp.88-94
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    • 2018
  • This review aims to provide implications for relevant domestic policies and researches from Patient-Centered Medical Home (PCMH), a reinforcement model for primary care and its evaluations in the United States. As chronic diseases became dominant, changes in the health care delivery system in which primary care is central was required. The United States initiated primary care-reinforcing policies based on the PCMH following the increased demand for evidence-based health care policies. The current activities of the United States such as sharing research tools used to evaluate primary care interventions and circulating evaluation findings provide examples to Korea. Systematic evaluations for primary care interventions are required and appropriate methods using various types of data to reflect the real-world settings should be prepared. It is necessary to conduct policy assessment studies of public interests considering regional context. Support for the researches to make and advance from the existing environment must be examined.

Evidence based practice within the complementary medicine context

  • McLean, Lisa;Micalos, Peter Steve;McClean, Rhett;Pak, Sok Cheon
    • 셀메드
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    • 제6권3호
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    • pp.15.1-15.4
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    • 2016
  • Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

근거 중심의 학습을 통한 학생들의 임상 실무 능력 개선에 관한 연구 (The Study of an Improvement of Clinical Competency through Evidence Based Learning)

  • 이동엽
    • 대한통합의학회지
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    • 제2권2호
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    • pp.1-12
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    • 2014
  • Purpose : The purpose of this study was to investigate the effect that the academic achievement of the students about the evidence based learning investigates the learning utility value about and the request. Method : The agreement of college students explaining the purpose of research for 12 weeks against 17 students and investigate through a questionnaire. The level of academic achievement according to the sex and claim showed a characteristic with a percentage. An utility investigate the descriptive epidemiologic characteristic about the class of the evidence based learning. Result : The most of college students the level of academic achievement and requests the expected grade of the students about the evidence based learning wanted the 'high' grade of 9 persons, 'middle' grade of 8 persons in the part and the expectation for the class taken so much was high(p<.05). There was the significant different in the utility aspect in the need of the evidence based learning, homework solution, learning synergy effect improvement, and reference search ability improvement(p<.05). Conclusion : These finding revealed that the evidence based learning the satisfaction with class raises the improvement and utility value, and provided the need and the has to develop the educational model which the college students contentment raises an improvement after this opportunity for the new recognition.

중환자실 간호사의 근거기반 감염관리 지식과 수행 수준 및 영향 요인 (Level of Knowledge on Evidence-based Infection Control and Influencing Factors on Performance among Nurses in Intensive Care Unit)

  • 유재용;오의금;허혜경;최모나
    • 성인간호학회지
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    • 제24권3호
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    • pp.232-243
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    • 2012
  • Purpose: This study was to identify the level of knowledge and performances on evidence-based infection control and influencing factors on performance among nurses in intensive care unit. Methods: A descriptive cross-sectional survey design was used. Two hundred thirty-nine nurses at intensive care units were conveniently recruited from seven hospitals located in Seoul and Kyounggi province. Data were collected with a questionnaire survey about evidence-based infection control. Data were analyzed using SPSS/WIN 17.0 program. Results: Both level of knowledge (mean 9.15 out of 19) on preventing ventilator-associated pneumonia and central venous catheter induced bloodstream infection, and performance on evidence-based infection control (1.94 out of 4) were moderate. Performance of evidence-based practice for infection control was related to reading research articles regularly, professional satisfaction, and taken education course. Conclusion: These results indicate that systematic and organizational strategies for enhancing evidence-based infection control are needed to improve quality of intensive nursing care.

치유환경 연구문헌 고찰 및 근거중심디자인(Evidence-Based Design) 활성화에 관한 연구 - 미국 치유환경 연구사례를 중심으로 - (A Study on Healing Environments and Evidence-Based Design - Focused on Healthcare Environments in the United States -)

  • 박진규
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제17권1호
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    • pp.41-50
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    • 2011
  • This paper assesses the evidence of the built environments' impact on patients' and staff's well-being. It also introduces evidence-based design (EBD) and discusses barriers and solutions for promoting EBD. EBD is an informed approach to design by improving design decisions based on best available knowledge. Designers should provide psychologically and physically supportive environments to promote occupants' well-being. There is increasing evidence that a poorly designed environment elicits negative feelings and stress. Better design will lead to better outcomes especially when it applied to a vulnerable population such as patients, children, and the elderly. Due to high demands of promoting patients' health, healthcare providers and professional designers have been searching for evidence to create healing environments. EBD has been well received in healthcare facilities design and is expanding to other types of environmental design such as educational and commercial design. Design firms should consider EBD as a value-added component of design to meet current and future challenges. It is important for designers to realize that engaging in EBD is not a rejection of creativity, but a means by which to scrutinize their design projects. With critical literature reviews on healing environments, there is sufficient evidence that well-designed environments can promote patients' and medical staff's health outcomes.

근거중심 소아치과학의 개념과 응용 (EVIDENCE-BASED PEDIATRIC DENTISTRY : CONCEPTS AND APPLICATIONS)

  • 이광희
    • 대한소아치과학회지
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    • 제33권2호
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    • pp.269-280
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    • 2006
  • 연구 목적은 근거중심 소아치과학의 개념을 정립하고 그 응용 방법을 모색하는 것이었다. 근거중심 소아치과학의 정의는 '어린이와 청소년의 치과 진료에서 최고의 과학적 연구근거를 소아치과의사의 임상 기술, 그리고 어린이 환자 및 그 보육자의 가치와 통합하는 것'으로 가정하였다. 근거중심 소아치과학의 실행 방법을 조사하였고, 근거중심 소아치과학의 최신 결론을 선별하여 주제별로 정리하였으며, 근거중심 소아치과학 연구의 기본이 되는 체계적 고찰과 임상진료지침의 연구 방법을 분석하고, 개별 연구 방법으로서 무작위 대조 시험 등을 조사하였다. 근거중심 소아치과학이 발전하기 위한 기본 방향으로서, 근거중심 소아치과학의 필요성에 대한 인식 제고와 공감대 형성, 근거중심 소아치과학의 방법에 대한 교육, 소아치과학 문헌의 전산화, 체계적 고찰과 임상진료지침의 지속적 연구 개발 및 보급, 우리나라 소아치과학 근거의 생성, 소아치과 진료환경의 사회적 요인 개선 등이 제안되었다.

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병원 간호사의 근거중심 노인통증관리 지침에 대한 인지도와 수행도 (Nurses' Awareness and Performance about Evidence-based Pain Management in Older Adults)

  • 김은경;박명화
    • 성인간호학회지
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    • 제24권1호
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    • pp.20-30
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    • 2012
  • Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

행성 궤도의 모양에 관한 중학교 영재 학생들의 증거 기반 추론 (Middle School Gifted Students' Evidence-Based Reasoning about the Shape of a Planet's Orbit)

  • 오필석
    • 한국지구과학회지
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    • 제42권1호
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    • pp.118-131
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    • 2021
  • 본 연구의 목적은 중학교 영재 학생들이 수행한 증거 기반 추론의 특징을 조사하는 것이었다. 연구를 위한 자료는 수도권에 위치한 한 대학교의 영재 교육원에서 중학교 영재 학생들이 비대면 방식으로 진행한 탐구 과제를 통해 수집되었다. 학생들에게 수성의 최대 이각을 관측한 자료를 제공하고 이 자료를 이용하여 수성의 공전 궤도를 작도하게 하였다. 또, 작도 전에 수성의 궤도에 대한 자신의 가설을 진술하게 하였으며 작도 결과를 증거로 삼아 수성 궤도의 모양을 추론하게 하였다. 학생들이 제출한 보고서의 내용을 분석하여 수성의 공전 궤도 모양에 관한 판단 유형을 5가지로 분류하고 가설 및 증거에 관한 추론 유형을 4가지로 분류한 후, 판단 유형에 따른 증거 기반 추론의 특징을 정리하였다. 분석 결과를 토대로, 증거 기반 추론에서는 증거에 대한 적절한 해석이 중요하고, 이론과 증거의 조화가 핵심적인 역할을 하며, 복수의 가설을 상정하는 것이 유리할 수 있음을 논의하였고, 지구과학 교육을 위한 시사점을 제안하였다.