• Title/Summary/Keyword: evidence-based practice

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Knowledge and Adherence to Evidence Based Practice Guidelines for Hemodialysis among Nurses in Dialysis Units (혈액투석실 간호사의 근거중심 혈액투석간호에 대한 지식과 수행도)

  • Chu, Hyesuk;Park, Myonghwa
    • Journal of Digital Convergence
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    • v.16 no.7
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    • pp.277-288
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    • 2018
  • This study was to investigate the level of knowledge and adherence to EBP guidelines for hemodialysis among nurses in dialysis units. Self-administered questionnaire was used that data were collected. The sample consisted of 173 nurses who worked in hemodialysis units located in three different district areas in Korea. Using SPSS/WIN 20.0, t-test, ANOVA and Scheff's analysis were performed. About 98.8% of nurses in dialysis units had received education mostly from dialysis conferences or symposium. The knowledge score for EBP was 15.77 (out of 23) on average. Subjects with more than 8 years of work experience, master degree and those working in tertiary hospital showed significantly higher scores. Despite that there are internationally acknowledge evidence based guidelines for hemodialysis, the actual adherence to guidelines varies by experience, education level and types of hospital. The findings of this study can be baseline data for further research into development of strategies to enhance knowledge of hemodialysis nurses and utilization of EBP guidelines.

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

  • Bang, Hwal Lan;Park, Yeon-Hwan
    • Journal of muscle and joint health
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    • v.20 no.1
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    • pp.31-42
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    • 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.

Job Performance by Advanced Practice Nurses in Korea (한국 전문간호사의 업무 성과)

  • Kim, Mijung;Kim, Yeong Kyeong;Shin, Sujin
    • Korean Journal of Adult Nursing
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    • v.26 no.6
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    • pp.630-641
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    • 2014
  • Purpose: The purpose of current study was to explore the positive outcomes of advanced practice nurse who have experienced the roles in their clinical settings. Methods: This study adopted a qualitative research design based on conventional content analysis. Participants were 16 nurse practitioners have been worked at hospitals or community centers. Data were collected via focus group interviews and analyzed using thematic analysis method. Results: Patients' aspect outcomes were "client-centered care in providing continuity", "providing trust based on expertise", "promoting skilled intervention in patient recovering", "blocking the negative consequences", "quality improvement: nursing becoming tighter", "providing total care for cases that require intensive care", "improving patients outcomes by total management", "increasing confidence in evidence-based professional nursing", "rising the satisfaction by cost-effective services", "providing skilled professional practice", and "providing comprehensive care related to covering various aspects". Other themes elicited also included "promoting efficacy by inter-related health professions supervising", "the expansion of specialized practice areas increase business efficiency", "formation of outside customers due to increasing the satisfaction with skilled nursing care", "filling in the emptying spaces of doctors by practicing reliable role to bridge", "attracting external customers through successful management of subjects", "increasing staff's satisfaction on the role to make a bridge between inside and outside doctors", "24 hours medical expertise of professional staff ready secured", and "low cost, same results, that is, cost-effective" in reference to health care resources aspect. Conclusion: These findings suggested that advanced practice nurses perceived various positive outcomes and provided basic data for outcome indicators of advanced practice nurses' role.

Development of a Pharmaceutical Care Service Model for Patients with Diabetes in Ambulatory Care Settings (외래환자 대상 당뇨병 약료서비스 모델 개발)

  • Yoon, Jeong-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.1
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    • pp.1-8
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    • 2017
  • The prevalence of diabetes and its related morbidity and mortality are being increased. Despite the advancement of evidence-based pharmacotherapy in the management of diabetes, many patients in our country do not achieve satisfied therapeutic outcomes. Pharmaceutical care service can be defined as a patient-centered clinical service provided by pharmacists to improve therapeutic outcomes and quality of life of patients, by identifying, and preventing or resolving drug-related problems (DRPs). Pharmaceutical care service is interdisciplinary team-based practice, and is provided through collaborative practice agreement (CPA) between one or more physicians and pharmacists. This article describes a model of pharmaceutical care service which can be adopted in our country for patients with diabetes in the ambulatory care settings. With the successful implementation of this service, clinical, economic, and humanistic outcomes of patients will be improved. Therefore, by actively implementing pharmaceutical care service, pharmacist should contribute to the promotion of patients' health and to the advancement of health care delivery system.

Background and Develpoment of Caries Management based on Risk Assesssment(CAMBRA) (임상가를 위한 특집 2 - 우식위험도 평가에 근거한 치아우식증 관리(CAMBRA)의 이론적 배경 및 발전 과정)

  • Cho, Young-Sik
    • The Journal of the Korean dental association
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    • v.52 no.8
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    • pp.464-471
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    • 2014
  • This article reviewed theological background and historicak development in dental caries management by risk assessment. Dental caries prevention and treatment according to CAMBRA model is patient-centered, risk-based, evidence-based practice. Team approach is necessary and clinician need to integrate science, practice and product. Dental hygienist take a important role in implementing CAMBRA. CAMBRA model could be incorporated into dental and dental hygiene education. Dentist and dental hygienist able to provide scientific and ethical care managing dental caries by risk assessment.

Preventive Strategies of Ventilator Associated Pneumonia

  • Kim, Jin-A;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.42-55
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    • 2009
  • Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

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Reassessing Statin Therapy in Elderly Dyslipidemia: A Literature Review

  • Lee, Kyung-Hwa
    • Perspectives in Nursing Science
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    • v.8 no.2
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    • pp.139-147
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    • 2011
  • Purpose: An integrative literature review was done to identify the best interventions for older adults with dyslipidemia in an effort to promote nursing involvement in the prevention of statin-induced symptoms (SIS). Such awareness could increase the capacity of interventions by geriatric nurses using evidence-based practices in the reassessment of statin therapy. Methods: CINAHL, Pubmed, and ProQuest were searched using these terms: dyslipidemia in, elderly, statins, adverse effects, and quality of life. Eleven articles fitting the inclusion criteria were identified and analyzed. Results: The findings indicate no evidence for the benefit of statin therapy for morbidity/mortality in a high-risk primary prevention set-up, specifically in the elderly population. Although SIS prevails among older adults, there are limited data that confidently support this observation along with nursing interventions specifically for the geriatric nursing community. Conclusion: Future research is necessary to shift nursing intervention with statin users (specifically in older adults) from an illness-based intervention to a preventive care plan to provide optimal care based on evidence. It is essential to involve self-reporting, cooperation, and communication with health care professionals, specifically with geriatric nurses. Additional studies are needed to further direct practice interventions in elderly statin users.

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The Impacts of Guideline for Digestives on Physicians' Prescription of GI medication (소화기관용약제 처방지침이 의사의 소화기관용약 처방률에 미치는 효과분석)

  • Kim, Dong-Sook;Park, Choon-Seon;Jang, Sun-Mee
    • Korean Journal of Clinical Pharmacy
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    • v.18 no.2
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    • pp.124-131
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    • 2008
  • The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

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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
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    • v.57 no.2
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    • pp.141-157
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    • 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.

Case Study on Osteology Practice at Human Anatomy Course: Focused on the Students in the Department of Biomedical Laboratory Science (인체해부학 수업에서 골학실습의 활용 사례 연구: 임상병리학과 학생을 중심으로)

  • Kim, Jin-Hee
    • The Journal of the Korea Contents Association
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    • v.16 no.4
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    • pp.144-152
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    • 2016
  • This study was conducted for the first time based on the evidence that cadaver practice is not easy in the university without medical school where cadaver dissection is not easy to look for. The purpose of this study was to evaluate the effect of osteology practice at human anatomy course for students at the freshman stage in college of health science without medical school. Both self report questionnaires and evaluation paper were analyzed depending on the course of higher education and gender. As a result of analysis, most students thought that osteology practice was interesting and it helped to understand of anatomy lecture. But students from liberal arts had poor understanding of bone's direction compared with students from natural sciences. And most students wanted to do cadaver dissectionafter osteology practice. In conclusion, osteology practice was recommended to student's expectation as well as education of gross anatomy in department of biomedical laboratory science, collage of health science without medical school. This study suggested that practice of gross anatomy should run parallel with lecture.