• Title/Summary/Keyword: evidence-based guidelines

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Performance of Evidence-based Pain Assessment and Management Guidelines among Medical-Surgical Nurses (내·외과 간호사의 근거기반 통증사정 및 관리 가이드라인 수행도)

  • Kim, Heui Lyang;Song, Chi Eun;So, Hyang Sook
    • Korean Journal of Adult Nursing
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    • v.28 no.5
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    • pp.546-558
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    • 2016
  • Purpose: This study aimed at the effectiveness to investigate the performance of evidence-based pain assessment and management guidelines. Methods: Participants were 140 nurses at the med-surgical units. Data were collected in early July, 2014 using Registered Nurses Association of Ontario (RNAO) guideline (2007) revised and validated by Hong and Lee (2012) and analyzed by descriptive statistics, t-test, ANOVA using SPSS/WIN18.0. Results: The score of performance of pain assessment guideline was higher than the score of pain management. Categories with high score were pain screening, parameter of pain assessment, documentation, assessment of opioids side-effects, and record of pain caused intervention. Categories with low score were comprehensive pain assessment, multidisciplinary communication, establishing a plan for pain management, consultation and education for patients and their families, and education for nurse. Non-pharmacological management was the lowest one. Conclusion: Assessing and managing pain is a complex phenomenon. It might be useful if institutions host training programs to ensure that nurse are better able to understand and implement pain assessment and management. Since non-pharmacological management is less likely to be used by nurses it may be helpful to include these methods in a training program.

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.

Community Health Practitioners' Perception of Barriers to Research Utilization, Current Status and the Competence in Evidence based Practice (보건진료전담공무원의 간호연구 활용의 장애요인 및 근거기반실무 활동과 역량)

  • Song, Yeon Yi;So, Ae Young;Kim, Jin Soon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.12 no.2
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    • pp.29-44
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    • 2017
  • Purpose: The purpose of this study was to identify community health practitioners' (CHP) perception of barriers to research utilization, current status and competence in evidence-based practice (EBP). Methods: From all over the country, 126 CHP completed an e-mail survey. Results: The items with the highest barrier scores were that it is difficult to understand articles written in English and physicians will not cooperate with implementation. There were statistically significant differences in the scores for attitude toward EBP and knowledge in EBP by education level and nursing academic society membership status. When faced with a problem, the nurses usually use related regulations or asked a colleague for advice. Conclusion: Results indicate an awareness of the necessity of applying EBP, need to improve readiness to use EBP voluntarily and actively, and need to search for various factors that are barriers to research utilization. There is a need to develop and apply EBP training/education programs to find new evidence that might actually support previous practice for which nurses lack confidence. Guidelines that consider CHP task characteristics and barrier factors to research utilization should be developed.

Development of an Evidence-Based Protocol for Preventing Delirium in Intensive Care Unit Patients (중환자실 섬망예방을 위한 근거중심 간호중재 프로토콜 개발)

  • Moon, Kyoung Ja;Lee, Sun Mi
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.3
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    • pp.175-186
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    • 2010
  • Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.

Qualitative Assessment and Development of Level of Evidence and Strength of Recommendation Models in the Field of Physical Therapy in Korea (국내 물리치료분야에 대한 질적 평가와 근거 수준 및 권고 등급 모형 개발 방안)

  • Sung-Hyoun Cho;Jeong-Woo Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.231-242
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    • 2023
  • Purpose : This study aimed to identify ways to improve the quality of physical therapy research and ultimately review the current situation to improve evidence-based decision-making in physical therapy. Methods : For better evidence-based decision-making in physical therapy, researchers should review the quality assessment of articles in more detail and report their findings for valid and appropriate level of evidence and strength of recommendations. The level of evidence affects how well the findings are derived from well-designed literature. The evaluation of the evidence focuses primarily on the study design and the degree of bias that may compromise the validity of the findings. The final recommendation is based on a combination of the study design and literature quality. To uncover gems of information in each paper, a risk of bias assessment should be performed after the literature has been initially selected. Results : Researchers should consider the complexity of the intervention, appropriate grouping, and calculation of effect sizes for the intervention. Researchers conducting systematic reviews should provide a detailed description of the quality assessment performed and present a detailed analysis of their interpretation of the results. The results of systematic reviews and meta-analyses should be interpreted with caution and include a risk of bias assessment. Guidelines for the level of evidence and strength of recommendations should be developed and utilized more broadly to improve reporting practices in physical therapy. Conclusion : Researchers should be knowledgeable about the strengths and limitations of each study design and methodology. In the future, researchers will also need to improve their ability to critically evaluate their findings, given the potential for their results to influence clinical practice.

Evaluating of Validity on Peri-operative Hypothermia Management Evidence Based Guideline (저체온 관리 근거중심 가이드라인의 국내 타당성 검증)

  • Hong, Sung-Jung;Lee, Eunjoo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.1
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    • pp.331-343
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    • 2014
  • The purpose of this study was to evaluate the appropriateness and applicability of a evidence-based peri-operative hypothermia management guideline developed by NCC-NSC in Korea using expert group. The expert group was composed of 180 registered nurses in surgical units and recovery room, and physicians (surgeons and anesthesiologists) who had enough experiences and knowledgeable on the management of surgical patients. Validity of guidelines were evaluated in terms of appropriateness and applicability using 9 point scale. Most of the recommendations in the guideline received high score of above 6-8 point both in appropriateness and appropriateness. However, most of the recommendations were received significantly lower score in applicability than appropriateness. This research can be used as a step to develop more acceptable hypothermia management guideline for the patients undergoing abdominal surgery in Korean. In addition, further studies which identify the barriers that inhibit applicability of recommendations should be investigated.

Updates of Nursing Practice Guideline for Intravenous Infusion (정맥주입요법 간호실무지침 개정)

  • Gu, Mee Ock;Cho, Yong Ae;Eun, Young;Jung, Ihn Sook;Kim, Hyun Lim;Yoon, Hee Sook;Kim, Eun Hyun;Yoon, Ji Hyun;Chang, Hee Kyung
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.361-375
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    • 2017
  • Purpose: This study was conducted to update the existing nursing practice guideline for intravenous infusion guidelines according to the evidence-based practice guideline in South Korea. Methods: Guideline update process was performed using 22 steps according to the manuals developed by NICE and SIGN. Results: Updated nursing practice guidelines for the intravenous infusion were consisted of 23 domains and 322 recommendations. The number of recommendations in each domain were 4 for general instruction, 12 for vascular access device selection, 20 for site selection, 9 for insertion, 54 for stabilization, 21 for maintaining patency, 4 for blood sampling, 33 for exchange and removal, 28 for add-on device selection, 28, 72 for infusion related complications, 56 for infusion therapies, 7 for education, and 2 for documentation and report. There were 15.9% of A, 30.2% of B, 53.9% of C in terms of grade recommendations. A total of 178 (51.6%) recommendations were newly developed and 24 previous recommendations have been deleted. Conclusion: Updated nursing practice guideline for intravenous infusion was expected to be an evidence-based practice guideline for intravenous infusion in South Korea. This guideline is suggested to be disseminated to clinical nursing settings nationwide to improve the efficiency of intravenous infusion practice.

Adaptation of Enteral Tube Feeding (ETF) Nursing Practice Guideline (경장영양요법 간호실무지침 수용개작)

  • Choi, Eun Nyer;Song, Hosook;Choi, Jeong Eun;Seo, Ji Young;Kim, Heesoo;Nam, Kyung Hwa;Park, Min Jeong;Lee, Hyejin;Hwang, Myeong Jin;Park, Jee Won
    • Journal of Korean Critical Care Nursing
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    • v.6 no.2
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    • pp.12-23
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    • 2013
  • Purpose: This study was conducted to develop a Korean version of evidence-based enteral tube feeding (ETF) guidelines through adaptation of existing ETF guidelines. Methods: The guideline adaptation process was conducted into 24 steps according to a manual for guideline adaptation version 2.0 developed by NECA. Results: The adapted ETF nursing practice guideline was consisted of 9 domains and 20 recommendations, including confirmation of tube placement, risk of aspiration, assessment gastric residual volume, body positioning, treating feeding tube occlusion, administration rate, medication, tube flushes, and interruption of feeding. The results of the grading of recommendations assessment by expert penal showed that 8 recommendations in Grade A, 4 in grade B, and 8 in Grade C were emerged from the process. The range of content validity index scores by expert penal was 0.8-1.0. Conclusion: It is expected that the adapted ETF nursing practice guideline could be helpful for nurses to practice evidence-based ETF for their patients.

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Evidence-Based Clinical Practice Guideline for Fluid Therapy to Prevent Contrast-induced Nephropathy (조영제 유발 신장병증 예방을 위한 수액요법에 관한 근거기반 임상실무지침 개발)

  • Lee, Kyung Hae;Shin, Kyung Min;Lee, Hyeon Jeong;Kim, So Young;Chae, Jung Won;Kim, Mi Ra;Han, Min Young;Ahn, Mi Sook;Park, Jin Kyung;Chung, Mi Ae;Chu, Sang Hui;Hwang, Jung Hwa
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.1
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    • pp.83-90
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    • 2017
  • Purpose: This study was to develop evidence-based clinical practice guideline in order to prevent contrastinduced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). Methods: The guideline was developed based on the "Scottish Intercollegiate Guidelines Network (SIGN)". The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. Results: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. Conclusion: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.

Evaluating the NGCTM Evidence Based Guideline of Prompted Voiding for Use in Korea (미국 NGCTM 배뇨자극요법 근거중심 가이드라인의 국내 적용가능성 평가)

  • Park, Myonghwa;Kim, Myung Ae
    • Korean Journal of Adult Nursing
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    • v.17 no.4
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    • pp.622-634
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    • 2005
  • Purpose: The purpose of this study was to evaluate the applicability of the evidence based guideline for prompted voiding by Lyons & Specht (2001) in National Guideline $Clearinghouse^{TM}$ for use in Korea based on the experts' opinions. Method: The target expert group consisted of 8 registered nurses, 6 physicians, and 5 nursing professors who are experts in urinary incontinence. This study used a questionnaire survey. The appropriateness, applicability, and the present application of each recommendation in the guideline were analyzed with descriptive statistics using the SPSS program, with content analysis based on the experts' opinions. Result: The scores on each recommendation's appropriateness showed the high degree of agreement among nurses, physicians, and nursing professors. However, the recommendation for 'use of oxybutinin' showed the lowest score as 5.89. It was notable that the most recommendations scored lower for applicability compared with appropriateness. The reasons for lower scores for applicability were the lack of clinicians' knowledge of assessment and management, and the lack of resources in clinical settings in Korea. Conclusion: This study will augment the understanding of the actual urinary incontinence management in Korean clinical settings and can be used as the baseline data for further study of tailoring international guidelines into local and national clinical settings.

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