• 제목/요약/키워드: evidence-based practice

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한국 작업치료사들의 근거기반 치료(Evidence-Based Practice; EBP) : 인식도, 근거자원 사용과 방해요인 조사 (Evidence-Based Practice(EBP) Among Korean Occupational Therapists : Use of Resources, Perceptions, and Barriers)

  • 김정란;김선희;양노열
    • 재활치료과학
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    • 제1권2호
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    • pp.41-53
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    • 2012
  • 목적 : 본 연구는 한국 작업치료사들의 근거기반 치료(Evidence-Based Practice; EBP)에 대한 인식도, 임상적 의사결정에 사용하는 근거자원, EBP 실행을 방해하는 요인을 조사하고자 하였다. 연구방법 : 2009년 12월부터 3월까지 임상에 있는 작업치료사들에게 총 500부를 배부하였고, 그 중 회수된 160부(32%)를 기술통계를 통해 분석하였다. 결과 : 설문의 응답자는 남성보다 여성이 많았고, 치료경력이 5년 미만인 치료사가 전체의 90% 이상을 차지하였다. 응답자의 대부분은 EBP와 관련된 교육 경험이 없고(76%), 현재 실시하지 않는 것(55%)으로 나타났다. 또한 치료 시 활용하는 근거자원도 주관적인 판단이었다. 그러나 인식도 조사에서 EBP를 통해 작업치료사의 전문성이 향상될 수 있고(96%), 임상적인 판단에 도움을 준다고(88%) 응답하였다. 치료사의 대부분은 EBP 적용을 위해 도움을 줄 수 있는 개선책으로 근거자원 탐색을 위한 시간적인 여유 확보(90%)와 교육과정 참여가 필요(92%)였다. 이와 같은 결과는 임상 현장에서 EBP에 대한 적용 정도는 낮으나 인식도는 높은 것을 보여주어 향후 EBP에 대한 교육프로그램 활성화의 필요성을 간접적으로 제시하였다. 결론 : 한국 작업치료가 질 좋은 서비스를 제공하기 위해 적극적인 교육과정 개설과 강사 개발이 필요하고, 전국 대학의 작업치료전공 학생들이 근거기반의 교육을 받을 수 있도록 힘써야 할 것이다. 또한 작업치료사의 전문성을 향상시키기 위한 EBP가 조속히 이루어져 하고, 그에 교육프로그램과 그 효과성에 대한 연구가 끊임없이 이루어져야 할 것이다.

근거기반 임상실무지침: 장루간호 (Evidence-Based Nursing Practice Guideline: Ostomy Care)

  • 이윤진;박현숙;김민경;서희원;이미주;원은애;조가나
    • 임상간호연구
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    • 제26권2호
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    • pp.154-163
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    • 2020
  • Purpose: The aim of this study was to develop an evidence-based guideline for stoma management providing institutional policy, assessment, complications and follow-up care. Methods: The guideline adaptation manual consisting of 23 steps developed by the National Evidence-Based Healthcare Collaborating Agency was used for this study. It presents an overview of the process used to develop the guideline and lists specific recommendations from the guideline. Results: It provides 55 recommendations that include the following 8 topics: 1) Organization and policy recommendations, 2) Preoperative nursing; Ostomy education, stoma site marking, 3) Ostomy formation, 4) Postpoperative nursing; education, assessment, high output stoma management, 5) Selection of ostomy products, 6) Colostomy irrigation, 7) Stomal and peristomal complications, 8) Follow-up care after discharge. Conclusion: The guideline can be used to address stoma management in hospital settings. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patients' outcomes.

아토피피부염의 한의학 진료 지침 개발을 위한 사전 연구 (A study on the Development of Traditional Korean Medicine Clinical Practice Guideline for Atopic Dermatitis)

  • 윤영희;최인화
    • 한방안이비인후피부과학회지
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    • 제25권2호
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    • pp.38-48
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    • 2012
  • Background : The atopic dermatitis patient and their families are looking for safer herb-medicine treatments that possess therapeutic effects, but without the recurrence of symptoms and long-term harmful consequences that can result from other treatment. However, for many reasons, including methodological difficulties and lack of high quality study like randomized clinical study and systematic review, there are no consistent clinical guide line for atopic dermatitis in Traditional Korean Medicine. Objectives : Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. The purpose of this study was to develop Traditional Korean Medicine clinical practice guideline for atopic dermatitis Result : The future guide should be based on scientific evidence and include the followings: (1) diagnosis of atopic dermatitis (2) the pattern identification of atopic dermatitis (3) classification of Sasang Constitution (4) efficacy assessment (5) treatment guideline (6) education for patients and care givers Conclusion : The development of Traditional Korean Medicine clinical practice guideline for atopic dermatitis is needed.

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

  • 최은녀;송호숙;최정은;서지영;김희수;남경화;박민정;이혜진;황명진;박지원
    • 중환자간호학회지
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    • 제6권2호
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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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근거 기반 간호 실무지침 수용개작: 습기 관련 피부 손상의 예방과 관리 (Adaptation of the Evidence-Based Nursing Practice Guideline: Prevention and Management of Moisture Associated Skin Damage)

  • 백규원;박주희;김민경;김경선;전경옥;박수현;양원지;황지원
    • 임상간호연구
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    • 제24권3호
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    • pp.263-272
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    • 2018
  • Purpose: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. Results: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. Conclusion: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.

Roles, job market, and evidence into practice of health education professionals in the UK

  • Green, Jackie
    • 한국보건교육건강증진학회:학술대회논문집
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    • 한국보건교육건강증진학회 2009년도 추계학술대회 자료집
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    • pp.18-29
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    • 2009
  • This paper reviews the position of health promotion in England and, in particular, how structural change and reorganisation within the NHS, along with the emergence of multidisciplinary public health, have been a challenge to its identity. It draws lessons from recent experience to emphasise the distinctive contribution of health promotion to public health and the need for proper recognition and career progression for health promotion staff. It argues that the specification of competences should be informed by a health promotion discourse and that as well as defining skills these should also include the values and ethical principles of health promotion. It argues that practice should be evidence-based and health practitioners have a responsibility to draw critically on evidence and also to generate the type of evaluation evidence which would inform dissemination.

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근거 중심 치의학 - 2. 근거 수준과 비판적 평가

  • 홍순민
    • 대한치과의사협회지
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    • 제45권3호통권454호
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    • pp.169-181
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    • 2007
  • In this second part of series report on evidence-based dentistry, the level of evidence and the methods for critical appraisal are discussed. The epidemiologic studies, namely clinical studies have some bias per se, and the degree of bias is somewhat predetermined by the study design. The level of evidence can be defined as the reliability of the clinical study and it is dependent on the degree of bias. Thus, it is important to determine the type of the study and to understand its structure before critically appraising them. Systematic reviews of primary studies, randomized controlled trials, nonrandomized clinical trials, cohort studies, case-control studies, and case reports / series constitute the clinical studies and the level of evidence follows the order of the studies listed above. Critical appraisal is the most important procedure in evidence-based dentistry. It is done to determine the credibility of research papers and their usefulness in the clinician s own practice. Critical appraisal is consisted of multiple questions that are helpful for evaluating validity and usefulness of the studies concerning therapy, diagnosis, prognosis, and causation.

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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.

Practice-based Evidence for Health Promotion in Underserved Clients with Hypertension in Primary Health Care Settings

  • Hong, Woi-Hyun
    • 지역사회간호학회지
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    • 제26권4호
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    • pp.390-397
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    • 2015
  • Purpose: The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. Methods: Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. Results: The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). Conclusion: This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.

통증관리 근거중심 가이드라인의 국내 타당성 검증 - 복부수술 환자를 대상으로 - (Validation of a Translated Guideline on Pain Assessment and Management: Focused on Abdominal Surgery Patients)

  • 홍성정;이은주
    • 임상간호연구
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    • 제18권1호
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    • pp.159-170
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    • 2012
  • Purpose: This study was designed to examine the validity of the evidence-based guideline on pain developed by Registered Nurses Association of Ontario(RNAO) translated into Korean based on the experts' opinions. Methods: The panel consisted of experts of 60 registered nurses in surgical units, medical doctors and nursing managers who were experts in pain assessment and management. The validity of translated RNAO guideline was evaluated in terms of appropriateness, applicability, and utilization in current practice. Appropriateness and applicability of each recommendation were measured with 9 point scale, whereas utilization was measured by yes/no question. Data were analyzed by mean, standard deviation, and percent. The experts' opinions were analyzed by content analysis method. Results: In general, most of the recommendations in the guideline received above 7 point in appropriateness and applicability. However, above 20% of recommendations showed less than 50% of utilization rates in current practice. Conclusion: The reasons for low utilization of recommendations in current practice are in need for investigation. This study can be used for the development of guideline more acceptable in Korean health care settings and improve the quality of care for the abdominal surgery patients suffering from pain in Korea.