• Title/Summary/Keyword: national guidelines

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Validation of guidelines for field triage of injured patients for major trauma in patients of brain and spinal injury

  • Lee, Sung Kgun;Kang, Jeong Ho;Song, Sung Wook
    • Journal of Medicine and Life Science
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    • v.17 no.1
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    • pp.7-15
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    • 2020
  • The field triage guidelines have been widely implemented in the Korean trauma system. This study aimed to evaluate and validate whether it is reliable to use the field triage guidelines for predicting severe traumatic brain injury (TBI) and traumatic spinal injury (TSI) patients. This study retrospectively analyzed in-hospital cohort registries of all TBI and TSI patients, who visited the emergency department (ED) of the Jeju National University Hospital from 1 January 2013 to 31 December 2015. The primary outcome was defined as TBI and TSI patients with an injury severity score (ISS)>15. Secondary outcomes were defined as cases in which one or more of the following conditions: in-hospital death, ISS>15, admission to the intensive care unit, emergency surgery. We enrolled 14,889 TBI and TSI patients who visited ED, of which 7,966 (53.5%) were triage positive. The overall sensitivity, specificity and area under the curve (AUC) of the full cumulative field triage guidelines step's model (Step 1+3+4 criteria) for primary outcome were 82.8%, 47.0%, and 0.646, respectively. In the results for secondary outcomes, the specificity did not show a significant difference, but the sensitivity decreased to 66.5% and AUC to 0.568. The results of this study suggest that further optimization of the field triage guidelines is needed to identify high-risk TBI and TSI patients.

Path Analysis of Performance of Multidrug-Resistant Organisms Management Guidelines among Intensive Care Unit Nurses : With Focus on the Theory of Planned Behavior and Patient Safety Culture (중환자실간호사의 다제내성균 감염관리지침 수행에 영향을 미치는 요인에 관한 경로 분석 ; 계획된 행위이론과 환자안전문화를 중심으로)

  • Gu, Ji Eun;Ha, Yi Kyung;Hwang, Su Ho;Gong, Kyung Hee
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.89-100
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    • 2018
  • Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

A Fuzzy Logic for Autonomous Navigation of Marine Vehicles Satisfying COLREG Guidelines

  • Lee, Sang-Min;Kwon, Kyung-Yub;Joongseon Joh
    • International Journal of Control, Automation, and Systems
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    • v.2 no.2
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    • pp.171-181
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    • 2004
  • An autonomous navigation algorithm for marine vehicles is proposed in this paper using fuzzy logic under COLREG guidelines. The VFF (Virtual Force Field) method, which is widely used in the field of mobile robotics, is modified for application to the autonomous navigation of marine vehicles. This Modified Virtual Force Field (MVFF) method can be used in either track-keeping or collision avoidance modes. Moreover, the operator can select a track-keeping pattern mode in the proposed algorithm. The collision avoidance algorithm has the ability to handle static and/or moving obstacles. The fuzzy expert rules are designed deliberately under COLREG guidelines. An extensive simulation study is used to verify the proposed method.

Repetitive transcranial magnetic stimulation for neuropathic pain

  • Kim, Sooyoung;Lee, Eun Kyoung;Sohn, Eunhee
    • Annals of Clinical Neurophysiology
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    • v.24 no.2
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    • pp.53-58
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    • 2022
  • Noninvasive stimulation of the nervous system for treating chronic neuropathic pain has received attention because of its tolerability and relative efficacy. Repetitive transcranial magnetic stimulation (rTMS) is a representative method of noninvasive brain stimulation. Evidence-based guidelines on therapeutic use of rTMS have been proposed recently for several neurological diseases. These guidelines recommend treating neuropathic pain by applying high-frequency (≥ 5 Hz) rTMS to the primary motor cortex contralateral to the painful side. This review summarizes the mechanisms and guidelines of rTMS for treating neuropathic pain, and proposes directions for future research.

An Analysis on the Trend of International Export control Regimes in Nuclear Industry (원자력산업에서 국제 수출통제 체제에 대한 동향 및 대응방안)

  • Ryu Jae-Su;Lee Byeong-Uk;Yang Maeng-Ho;Lee Han-Myeong
    • Proceedings of the Korea Technology Innovation Society Conference
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    • 2004.05a
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    • pp.203-212
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    • 2004
  • International nuclear export control regimes have been continuously strengthening through revision of guidelines to prevent a horizontal nuclear proliferation. Recently, they have been trying to include sensitive technologies, information exchange on export permission and supply conditions to their guidelines. Therefore, this study analyzes current issues of the amended guidelines within international export control regimes and proposes a proper solution to effectively implement the national regulation.

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Management of Acute Otitis Media and Acute Sinusitis: Clinical Guidelines (급성 중이염 및 급성 부비동염의 치료: 가이드라인을 중심으로)

  • Jo, Dae Sun
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.100-107
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    • 2008
  • Acute otitis media and acute sinusitis are some of the most common antibiotic-prescribed diseases in childhood. Usually, with an accurate diagnosis, a 10-14 day course of antibiotics is recommended to cover common causative agents, including pneumococci. Establishment of management guidelines for these infectious diseases based on further study of the epidemiologic profile, antibiotic resistance, and clinical circumstances in Korea is needed.

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Prescribing Pattern and Safety Analysis of Nonsteroidal Anti-inflammatory Drug and Gastro- Protective Agent following Reimbursement Guidelines Relaxation (요양급여심사기준 완화에 따른 비스테로이드성 항염제 및 위장관 보호제 처방 변화 및 안정성 분석)

  • Han, Mi Hye;Noh, Eunsun;Nam, Jin Hyun;Lee, Sang Won;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.250-257
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    • 2017
  • Objective: The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costs is more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed. Methods: In this study, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent (GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. The incidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicine and medical costs related to osteoarthritis through mean and median. Results: There were 204,552 patients before the reimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribed with COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before the reimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%, respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The average medicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation, while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing no meaningful difference. Conclusion: The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinal adverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.

Analysis of Ethical Requirements for the Publication Guidelines of Oriental Medicine Journals in Korea (국내 한의학 관련 학술지 투고규정의 윤리기준 분석)

  • Kim, Yun-Young;Kwon, Ji-Hye;Lee, Si-Woo;Jang, Eun-Su;Yoo, Jong-Hyang
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.3
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    • pp.392-398
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    • 2012
  • This research aims to analyze the ethical requirements and to find the problems for the publication guidelines of oriental medicine journals. A total of 13 domestic journals, related to oriental medicine and registered in 'National Research Foundation of Korea' list, were selected for the analysis of ethical requirements. We inquired the revised year of the publication guideline and the status of ethics committee of selected journals. The ethical requirements of publication guidelines were evaluated by categorizing them into Institutional Review Board(IRB), Helsinki Declaration, Informed Consent, confidentiality and anonymity of subjects, and conflict of interest. In the case of revised year of the publication guidelines, the year of the most recently revised journal was 2011. However, the revised year of publication guidelines were not announced for three journals and a few journals haven't revised the publication guidelines since 2002. In the case of ethics committee status, four journals out of 13 journals maintained the ethics committee. In the result of ethical requirement analysis, nine journals included the information for confidentiality and anonymity of subjects, and four journals included the information for Helsinki Declaration and Informed Consent. However, only one journal included the information for IRB and conflict of interest. Recently, the importance of clinical researches has been increased to prove the effect of oriental medicine scientifically and objectively. The clinical researches should be considered in scientific side and ethical side as well, because they have potential risks to human subjects. In this sense, announcing the ethical requirements in the publication guidelines can be one way to secure the morality of researches. Thus, it is required to prepare correct publication guidelines and ethical requirements in oriental medicine journals.

Development of an evidence-based clinical imaging diagnostic guideline for implant planning: Joint recommendations of the Korean Academy of Oral and Maxillofacial Radiology and National Evidence-based Healthcare Collaborating Agency

  • Kim, Min-Ji;Lee, Sam-Sun;Choi, Miyoung;Ha, Eun Ju;Lee, Chena;Kim, Jo-Eun;Heo, Min-Suk
    • Imaging Science in Dentistry
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    • v.50 no.1
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    • pp.45-52
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    • 2020
  • Purpose: This study was conducted to develop an evidence-based clinical imaging diagnostic guideline for implant planning, taking into account efficacy, benefits, and risks. Materials and Methods: The guideline development process employed the adaptation methodology used for Korean clinical imaging guidelines(K-CIG). Core databases(Ovid-Medline, Ovid-Embase, National Guideline Clearinghouse, Guideline International Network) and domestic databases (KoreaMed, KMbase, and KoMGI) were searched for guidelines. The retrieved articles were analyzed by 2 reviewers, and articles were selected using well-established inclusion criteria. Results: The search identified 294 articles, of which 3 were selected as relevant guidelines. Based on those 3 guidelines, 3 recommendations for implant planning were derived. Conclusion: We recommend radiography or cone-beam computed tomography (CBCT) scanning for individual patients judged to require a cross-sectional image after reading of a panoramic X-ray image and a conventional intraoral radiological image. Various steps should be taken to raise awareness of these recommendations among clinicians and the public, and K-CIG should be regularly reviewed and revised.