• 제목/요약/키워드: evidence-based practice

검색결과 543건 처리시간 0.029초

Development and evaluation of continuing education course in renal nutrition

  • Karavetian, Mirey;Rizk, Rana
    • Nutrition Research and Practice
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    • 제10권1호
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    • pp.99-107
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    • 2016
  • BACKGROUND/OBJECTIVE: Competent renal dietitians are crucial for better patient compliance and clinical outcomes, specifically in critical settings. The aim of this study was to develop and evaluate an evidence-based course in renal dietetics for dietitians working in health care systems where dietetic specialization is absent. SUBJECTS/METHODS: Fifteen licensed dietitians working with hemodialysis patients in Lebanon were randomly recruited to participate in the course. The latter was developed by the study's primary investigator, according to evidence-based practice guidelines, and focused on all aspects of renal nutrition. Total course duration was 28 hours spread over a 2 month period. Dietitians' knowledge in renal nutrition was tested pre- and post-training through a 23-item questionnaire; the total score was expressed in percentage (< 60% score indicated insufficient knowledge). Paired-samples t test was used for statistical analysis. RESULTS: Overall knowledge of the dietitians significantly improved post-training and reached satisfactory levels (pre: $38.75{\pm}17.20%$, post: $62.08{\pm}21.85%$). Sub-analysis of the change in the knowledge showed significant and satisfactory improvement only in 3 topics: 1) correct body weight use in calculations, 2) energy estimation method and 3) phosphorus management. Knowledge in the fluid management significantly improved but did not achieve a satisfactory level. CONCLUSION: The course significantly improved dietitians' knowledge in renal nutrition. If adopted as part of the continuing education of dietitians in countries that lack dietetic specializations, it may serve the first step towards improving health care practice.

외과적 수술 후 정맥혈전색전증 예방을 위한 근거기반 IPC(Intermittent Pneumatic Compression) 간호프로토콜의 수용개작 및 효과 (Adaptation and Effects of the Evidence-based IPC Nursing Protocol on Prevention of Postoperative Venous Thromboembolism)

  • 김남영;김은아;심재연;정순희;김혜영;장은희;신지혜
    • 간호행정학회지
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    • 제23권1호
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    • pp.63-75
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    • 2017
  • Purpose: This study was conducted to adapt the standardized evidence-based nursing protocol using the IPC (intermittent pneumatic compression) intervention to prevent venous thromboembolism in surgical patients. Further, an investigation was done to measure knowledge on prevention of venous thromboembolism, surrogate incidence of venous thromboembolism and to assess IPC compliance in the study patients compared with those in surgical patients who underwent IPC intervention due to previous clinical experience. Methods: An analysis was done of the nine modules suggested by National Evidence-based Healthcare Collaborating Agency (NECA) in the adaptation manual of the clinical practice guideline for protocol adaptation. A nonequivalent control group post test design as a quasi-experiment was used to verify the effect of the IPC protocol. Results: There was a significant difference in knowledge of prevention of venous thromboembolism, IPC application time after intervention and the number of IPC applications between the experimental group (n=50) using the IPC nursing protocol and the control group (n=49). However, the symptoms of deep vein thrombosis and pulmonary thromboembolism were not observed in either the experimental group or the control group after the intervention. Conclusion: Results confirm that the standardized IPC nursing protocol provides effective intervention to prevent venous thromboembolism in surgical patients.

대학도서관 사서의 근거기반실무 지식과 조직문화 인식이 혁신행동에 미치는 영향 (Effects of Knowledge of Evidence Based Practice and Organizational Culture on Innovation Behavior of University Librarians)

  • 김갑선
    • 한국도서관정보학회지
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    • 제52권1호
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    • pp.129-154
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    • 2021
  • 본 연구는 대학도서관 사서가 지각하는 근거기반실무 지식과 조직문화 인식유형이 혁신행동에 미치는 영향을 파악하기 위한 서술적 상관관계 연구이다. 연구결과는 다음과 같다: 근거기반실무 지식은 조직문화 인식, 혁신행동과 통계적으로 유의한 양적 상관관계가 있었다. 근거기반실무 지식이 높을수록 관계지향, 혁신지향, 업무지향의 조직문화 인식이 높은 것으로 나타났다. 근거기반실무 지식은 연령, 교육 정도, 고용 유형, 직위, 학술지의 정기적 읽기, 학술대회 참여 여부에서 유의한 차이가 있었다. 혁신행동에서 유의한 차이가 나타난 변인은 연령과 학술대회 참가 여부 이었다. 근거기반실무 지식에 영향을 미치는 변인은 교육정도, 학술지의 정기적 읽기로 나타났다. 혁신행위의 인식은 연령과 학회참석과 유의적 관계가 있었다. 대학도서관 사서의 혁신행동에 영향을 미치는 변인은 근거기반실무 지식, 혁신지향 조직문화, 위계지향 조직문화로 나타났다. 특히, 위계지향 조직문화 인식은 부정적 영향을 미치는 것으로 나타났다. 대학도서관 사서들의 혁신행동을 이끌어 내기 위해서는 소통과 협력의 혁신적 조직문화를 조성하며, 근거기반실무 적용을 위해 사서의 연구활용능력을 강화하고, 연구 관련 활동을 촉진하는 다양한 교육프로그램의 개발과 지원이 조직 및 도서관계 차원에서 필요하다.

항암화학요법을 받는 암 환자의 오심, 구토관리를 위한 환자용 지침 개발 (Development of Cancer Patient Guide for Nausea & Vomiting Management in Chemotherapy)

  • 이지은;박명화
    • 성인간호학회지
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    • 제22권6호
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    • pp.570-581
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    • 2010
  • Purpose: This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. Methods: The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their ' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. Results: 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. Conclusion: The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.

근거기반 정맥혈전색전증 예방 간호실무지침 개정 (Updates of Evidence-Based Nursing Practice Guideline for Prevention of Venous Thromboembolism)

  • 조용애;은영;이선희;전미양;정진희;한민영;김나리;허진형
    • 임상간호연구
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    • 제29권1호
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    • pp.24-41
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    • 2023
  • Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

A Study on the Evidence-Based Herbal Medicine

  • Park, Jin-Han;Cho, Young-Mook;Choi, Sun-Kyung;Kim, Na-Hyun;Lee, Ki-Taeg;Hong, Seung-Heon
    • Journal of Evidence-Based Herbal Medicine
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    • 제3권1호
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    • pp.9-18
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    • 2010
  • The use of complementary and alternative medicine (CAM) is currently widespread and appears to be growing. As an increasing proportion of the population turns to CAM therapies, whether singly or in combination with allopathic medicine, the need for quality research in this area is reinforced. Much of this research consists of clinical studies aim ed primarily at clinicians, yet challenges arising from poor methodological quality will occur w hen interpreting study findings and their implications. For clinicians to be effective consumers of the scientific literature, familiarization with the principles of evidence based medicine (EBM) is essential. The goal of this review is to introduce clinicians to the concept of critical appraisal of clinical studies and foster critical thinking when reading research articles in order to best evaluate and incorporate study findings into their daily practice.

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수용개작을 통한 뇌실외배액 간호 실무지침 개발 (Development of Nursing Practice Guideline for External Ventricular Drainage by Adaptation Process)

  • 정원경;이영희
    • 임상간호연구
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    • 제22권3호
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    • pp.294-304
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    • 2016
  • Purpose: This study was done to develop an evidence-based external ventricular drainage (EVD) nursing practice guideline in order to provide standardized nursing and prevent EVD related complications. Methods: We used the standardized methodology for nursing practice guideline adaptation developed by Korean Hospital Nurses Association for the guideline adaptation process in this study. Results: The newly developed EVD nursing practice guideline was adapted to the American Association of Neuroscience Nurses (AANN)'s clinical practice guideline which is 'Care of the patient undergoing intra-cranial pressure monitoring/external ventricular drainage of lumbar drainage.' There were 61 recommendations documented in the preliminary guideline all evaluated by 9 experts based on acceptability and applicability. The final practice guideline was composed of 3 domains with 57 recommendations. The three domains of nursing were the insertion, maintenance, and removal of the EVD. The number of recommendations in each domain was 8 in EVD insertions, 39 in EVD maintenance, and 10 in EVD removals. Of the 57 recommendations 3.5% were level 1, 31.5% were level 2, and 65% were level 3. Conclusion: The standardized practice guideline can improve nurses' performance and accuracy. It can also be used as the foundation for effective communication between all medical staff.

침 연구에 대한 한의사의 인식과 연구방향에 대한 조사 (Study for Clinicians' Perception on the Acupuncture Research and Ways to Symbiosis between Basic Research and Clinical Practice)

  • 김송이;채윤병;이향숙;고유미;이혜정;박히준
    • Korean Journal of Acupuncture
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    • 제29권2호
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    • pp.224-238
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    • 2012
  • Objectives : From mechanism studies using animal models to high-level evidence based research such as randomized controlled trials or systematic reviews, various acupuncture studies have been performed. Nevertheless, the current research appears insufficient to satisfy clinicians' needs. We aimed at investigating clinicians' perception on the translational research and suggesting ways of symbiosis between basic research and clinical practice. Methods : Data were collected using a web-based questionnaire made available to Korean medicine doctors who were informed through social networking service or e-mail. The survey participants indicated their awareness of acupuncture research and their thoughts on the applicability of research in practice. Results : Forty-seven clinicians completed the survey. While most respondents agreed that acupuncture research is very important, only 40% of them answered that the results of acupuncture research are useful to their own practice. In more than half of those who responded to the survey, the current acupuncture research is not viewed as reflecting clinical practice very much. Respondents agreed that acupuncture research should be based on clinical practice, and they recognized the need to collect valid clinical data from real-world practice. Also, as many as 77% of clinicians had no scruple to participate in research programs. Conclusions : There is no doubt among practitioners that acupuncture research is necessary. More importantly, practice-based research remains essential in order to feed-back research outcomes to clinical practice. Communications and academic exchanges between clinicians and researchers can mutually benefit research and practice with better information, resulting in symbiosis.

Complementary and Alternative Medicine in Clinical Practice Guideline for Insomnia

  • Kwon, Chang-Young;Suh, Hyo-Weon;Choi, Eun-Ji;Chung, Sun-Yong;Kim, Jong-Woo
    • 동의신경정신과학회지
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    • 제27권4호
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    • pp.235-248
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    • 2016
  • Objectives: The aim of this review was to investigate whether evidence of complementary and alternative medicine (CAM) was reflected in clinical practice guidelines (CPGs) for insomnia based on relevant clinical trials. Methods: We conducted a systematic search on domestic and international CPG databases and medical databases. In addition, we conducted manual searches of relevant articles. Three authors independently searched and selected relevant studies; any disagreement was resolved by discussion. We extracted and analyzed the following data: published language, country, development group, participants, interventions, presence or absence of recommendations for CAM, level of evidence, grade of recommendation for CAM, and methods of development. Results: We identified 8,241 records from domestic and international databases, and 22 CPGs were included. Eleven of the 22 CPGs mentioned CAM interventions including herbal medicine, relaxation, acupuncture moxibustion, Tai Chi, meditation, hypnosis, biofeedback, Tuina, and external herbal medicine. However, most of the CPGs indicated 'no recommendation' or 'weak recommendation' for CAM interventions. Only Valeriana dageletiana Nakai and relaxation were considered to have experimental evidence. Valeriana dageletiana Nakai was recommended for improvement of sleep latency, sleep maintenance, total sleeping time, and sleep cycle. Relaxation was recommended as effective intervention for relieving physical and psychological arousal. Conclusions: Despite systematic reviews and randomized controlled trials on CAM for insomnia, most of the CPGs for insomnia did not reflect the evidence obtained. Further CPGs for insomnia should be developed by considering the current advanced studies in the field of CAM.

Essentials of Physiotherapy after Thoracic Surgery: What Physiotherapists Need to Know. A Narrative Review

  • Ahmad, Ahmad Mahdi
    • Journal of Chest Surgery
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    • 제51권5호
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    • pp.293-307
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    • 2018
  • Physiotherapy has recently become an essential part of enhanced recovery protocols after thoracic surgery. The evidence-based practice of physiotherapy is essential for the effective management of postoperative patients. Unfortunately, only a small body of literature has discussed the rationale of the physiotherapy interventions that are routinely implemented following thoracic surgery. Nonetheless, we can integrate the available knowledge into our practice until new evidence emerges. Therefore, in this review, the principles of physiotherapy after thoracic surgery are presented, along with a detailed description of physiotherapy interventions, with the goals of enhancing the knowledge and practical skills of physiotherapists in postoperative care units and helping them to re-evaluate and justify their traditional practices.