• 제목/요약/키워드: evidence-based guidelines

검색결과 348건 처리시간 0.042초

복강경 수술 환자의 수술 후 오심과 구토 관리를 위한 근거중심 실무 가이드라인 적용 효과 (Effect of Evidence-based Clinical Practice Guidelines for Promotion of Postoperative Nausea and Vomiting of Patients with Laparoscopic Hysterectomy)

  • 이성희;홍성정;김화선;전영훈
    • 성인간호학회지
    • /
    • 제27권5호
    • /
    • pp.481-492
    • /
    • 2015
  • Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.

양극성 장애의 약물치료 가이드라인 비교 (Comparative Review of Pharmacological Treatment Guidelines for Bipolar Disorder)

  • 진서연;김효영;김예슬;허채원;권보영;최보윤;이보배;이지예;권채은;문영도;;박지현
    • 한국임상약학회지
    • /
    • 제33권3호
    • /
    • pp.153-167
    • /
    • 2023
  • Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.

성인 발열 환자를 위한 근거기반 간호 지침 개발 및 평가 (Development and Evaluation of an Evidence-Based Nursing Protocol for Fever Management in Adult Patients)

  • 신용순;김성렬;유성희;김선화;김정희;김현정;나라;채지선;이혜진;안영희;김경옥
    • 성인간호학회지
    • /
    • 제25권3호
    • /
    • pp.250-262
    • /
    • 2013
  • Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

노인요양시설 거주 노인을 위한 한국형 근거기반 연하장애 간호 프로토콜 개발 (Development of Evidence-based Dysphagia Nursing Care Protocol for Nursing Home Residents)

  • 방활란;박연환
    • 근관절건강학회지
    • /
    • 제20권1호
    • /
    • pp.31-42
    • /
    • 2013
  • Purpose: The purpose of this study was to develop an evidence-based dysphagia nursing care protocol for nursing home (NH) residents in Korea. Methods: The protocol was developed based on international guidelines and literatures. After testing content validity by experts, the protocol was applied to the intervention group (n=35) for 4 weeks at one NH in December, 2011, whereas the control group (n=34) received routine care. Results: The protocol was composed of one-page algorithm and detailed guidelines. Algorithm pathway was organized in 3 parts, including screening dysphagia risk, grouping by dysphagia risk level, and assigning nursing care into each group. The nursing care included positioning, oral care, meal time care, diet modification, providing exercise and maneuver, and checking dysphagia signs and symptoms. The experts verified the content validity. Protocol was revised to fit NH practice after the participant observation. Clinical validity was established upon evaluating usefulness, appropriateness, and convenience of the protocol by NH nurses. Dysphagia risk of the intervention group was significantly decreased. Conclusion: Developed protocol will improve the quality of dysphagia care in nursing homes as it can serve as a consistent and integrated standard for nursing care of residents with dysphagia.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Advanced and Acute Heart Failure

  • Junho Hyun;Jae Yeong Cho;Jong-Chan Youn;Darae Kim;Dong-Hyuk Cho;Sang Min Park;Mi-Hyang Jung;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi ;Wook-Jin Chung;Byung-Su Yoo;Seok-Min Kang;Korean Society of Heart Failure
    • Korean Circulation Journal
    • /
    • 제53권7호
    • /
    • pp.452-471
    • /
    • 2023
  • The Korean Society of Heart Failure (KSHF) Guidelines provide evidence-based recommendations based on Korean and international data to guide adequate diagnosis and management of heart failure (HF). Since introduction of 2017 edition of the guidelines, management of advanced HF has considerably improved, especially with advances in mechanical circulatory support and devices. The current guidelines addressed these improvements. In addition, we have included recently updated evidence-based recommendations regarding acute HF in these guidelines. In summary, Part IV of the KSHF Guidelines covers the appropriate diagnosis and optimized management of advanced and acute HF.

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

  • 이흥범;문희
    • Tuberculosis and Respiratory Diseases
    • /
    • 제67권6호
    • /
    • pp.491-498
    • /
    • 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.

수용개작방법을 활용한 전신마취 수술 후 폐합병증 예방 간호실무지침 개발 (Development of the Nursing Practice Guidelines for Preventing Postoperative Pulmonary Complications using the Guideline Adaptation Process)

  • 최진주;김현정;강혜민;추희영;김경숙
    • 임상간호연구
    • /
    • 제27권2호
    • /
    • pp.187-198
    • /
    • 2021
  • Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.

International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy

  • Seung Joo Kang;Chung Hyun Tae;Chang Seok Bang;Cheol Min Shin;Young-Hoon Jeong;Miyoung Choi;Joo Ha Hwang;Yutaka Saito;Philip Wai Yan Chiu;Rungsun Rerknimitr;Christopher Khor;Vu Van Khien;Kee Don Choi;Ki-Nam Shim;Geun Am Song;Oh Young Lee
    • Clinical Endoscopy
    • /
    • 제57권2호
    • /
    • pp.141-157
    • /
    • 2024
  • Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

근거중심실무 연계 중환자간호 실습교육의 적용 및 효과 (Effects of Evidence Based Practice Integrated Critical Care Clinical Practicum)

  • 박명화
    • 한국간호교육학회지
    • /
    • 제17권3호
    • /
    • pp.346-354
    • /
    • 2011
  • Purpose: This study examines the effects of integrating Evidence Based Practice (EBP) into a critical care clinical practicum on nursing students' access and use of information resources and EBP competency. Methods: A one-group pretest-posttest design was used. Fifty senior nursing school students from a university participated. A critical care clinical practicum combined with EBP consisted of six full days of clinical practicum in intensive care units with EBP education. Group and individual training in EBP skills, lectures, small group discussion and conferences were provided. Data were analyzed using paired t tests for 50 participants. Results: The scores of evidence based practice competency increased significantly (p<.001) showing significant improvement in searching and classifying the evidence. Nursing students' access and use of research evidence improved (p=.004). Conclusion: This study showed that the integration of EBP into a clinical practicum was effective in improving accessibility and usefulness in research evidence such as guidelines and research articles, and increasing EBP competency in undergraduate students.

Issues Related to the Updated 2014 Korean Guidelines for Tuberculosis

  • Park, Jae Seuk
    • Tuberculosis and Respiratory Diseases
    • /
    • 제79권1호
    • /
    • pp.1-4
    • /
    • 2016
  • Tuberculosis (TB) remains a major public health problem in South Korea. The Joint Committee for the Development of Korean Guidelines for Tuberculosis published the Korean Guidelines for Tuberculosis in 2011 to provide evidence-based practical recommendations to health care workers caring for patients with TB in South Korea. After reviewing recent national and international scientific data on TB, the committee updated the Korean guidelines for TB in 2014. This article presents some practical issues related to the 2014 updated guidelines: namely use of the Mycobacterium tuberculosis-polymerase chain reaction assay and the Xpert MTB/RIF assay in the diagnosis of TB, as well as medical treatment for patients with multidrug-resistant TB.