• Title, Summary, Keyword: Guideline adherence

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Adherence to Clinical Guideline for Endotracheal Suction in ICU Nurses (중환자실 간호사의 기관내 흡인 임상지침 수행 현황)

  • Yang, Eunjung;Shin, Hyunsook
    • Journal of East-West Nursing Research
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    • v.23 no.1
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    • pp.53-62
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    • 2017
  • Purpose: This study aimed to evaluate the adherence to the clinical guideline for endotracheal suction in nurses working at intensive care units (ICU) and to identify the characteristics of nurses with good adherence. Methods: This study was a descriptive study to evaluate the pattern of adherence and its related factors to endotracheal suction. One hundred fifty five nurses working at ICU participated in this study. We used a questionnaire developed based on American Association for Respiratory Care (AARC) guidelines and other associated factors from previous studies. Results: Around half of the participants reported that their adherence to the clinical guideline was poor. Items deviated from the recommended guideline were reasons for initiating a suctioning, applied suction pressure ranged from 20 to 200mmHg, and applied catheter size from 6 to 17 french. Other factors deviated were the depth of inserted catheter, and inappropriate use of normal saline instillation. The most significant factor was related to hospital; the misused or misled clinical protocol. Conclusions: The adherence to the clinical guidelines of the endotracheal suction in ICU nurses was not appropriate, which might contribute to the patient health outcomes. More enhanced continuing education as well as hospital regulation is warranted.

Stress and Self Care Guideline Adherence in Students with Influenza A (H1N1) (신종인플루엔자 감염학생의 스트레스와 자가치료지침 수행)

  • Park, Jin-Hee;Kang, Jeong-Hee;Kim, In-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.17 no.2
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    • pp.277-286
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    • 2011
  • Purpose: This study examined levels of stress and adherence to self care guidelines in elementary and middle school students who were infected with the influenza A (H1N1) virus in 2009. Method: A total of 649 students from J city participated in the survey. Stress was measured with the Impact of Event Scale-Revised which was developed by Weiss and Marmar (1997) and translated by Eun and colleagues (2005). Adherence to self care guidelines was measured with the scale developed by the authors based on the self care recommendations from Korea Centers for Disease Control and Prevention. Result: Levels of stress and adherence to self care guidelines were higher in elementary school students. However, the severity of participants' stress was less than moderate. The adherence level was significantly different depending on status of taking an antiviral agent, health education and self care education regarding the virus infection. Conclusion: Findings suggest that effects of health education under the national crisis situation due to influenza A (H1N1) virus pandemic were helpful. More in-depth study is needed to understand and to improve middle school students' self care behaviors.

The Association between the Adherence to Dietary Guidelines for Breast Cancer Survivors and Health-related Quality of Life among Korean Breast Cancer Survivors (한국 유방암 경험자들의 유방암 식사지침 수행 정도와 건강관련 삶의 질의 연관성)

  • Song, Sihan;Youn, Jiyoung;Park, Myungsook;Hwang, Eunkyung;Moon, Hyeong-Gon;Noh, Dong-Young;Lee, Jung Eun
    • Korean Journal of Community Nutrition
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    • v.20 no.2
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    • pp.129-140
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    • 2015
  • Objectives: We examined the association between the adherence to dietary guidelines for breast cancer survivors and health-related quality of life in a cross-sectional study of Korean breast cancer survivors. Methods: A total of 157 women aged 21 to 79 years who had been diagnosed with stage I to III breast cancers according to the American Joint Committee on Cancer (AJCC) and had breast cancer surgery at least 6 months before the baseline were included. We used a Korean version of the Core 30 (C30) and Breast cancer 23 (BR23) module of the European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC-QLQ), both of which have been validated for Koreans. Participants were asked about their adherence to dietary guidelines for breast cancer survivors, suggested by the Korean breast cancer society, using a 5-point Likert scale. We summed dietary guideline adherence scores for each participant and calculated the least squares means of health-related quality of life according to dietary guideline adherence scores using the generalized linear model. Results: Breast cancer survivors who had higher adherence to dietary guidelines for breast cancer survivors had lower constipation scores than those with lower adherence (p for trend=0.01). When we stratified by the stage at diagnosis, this association was limited to those who had been diagnosed with stage II or III breast cancers. Also, sexual functioning scores increased significantly with increasing adherence scores of dietary guidelines among those with stage II or III breast cancers (p for trend < 0.001). However, among those who had been diagnosed with stage I, higher scores of dietary guidelines were associated with higher scores of pain (p for trend=0.03) and breast symptoms (p for trend=0.05). Conclusions: Our study suggested that the health-related quality of life levels of breast cancer survivors are associated with the adherence to dietary guidelines and may differ by the stage of the breast cancer.

Large Variation in Clinical Practice amongst Pediatricians in Treating Children with Recurrent Abdominal Pain

  • van Kalleveen, Michael W.;Noordhuis, Elise J.;Lasham, Carole;Plotz, Frans B.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.3
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    • pp.225-232
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    • 2019
  • Purpose: To evaluate intra- and inter-observer variability and guideline adherence amongst pediatricians in treating children aged between 4 and 18 years referred with recurrent abdominal pain (RAP) without red flags. Methods: The first part of the study is a retrospective single-center cohort study. The diagnostic work-ups of eight pediatricians were compared to the national guidelines. Intra- and inter-observer variability were examined by Cramer's V test. Intra-observer variability was defined as the amount of variation within a pediatrician and inter-observer variability as the amount of variation between pediatricians in the application of diagnostic work-up in children with RAP. Prospectively, the same pediatricians were requested to provide a report on their management strategy with a fictitious case to prove similarities in retrospective diagnostic work-up. Results: A total of 10 patients per pediatrician were analyzed. Retrospectively, a (very) weak association between pediatricians' diagnostic work-ups was found (0.22), which implies high inter-observer variability. The association between intra-observer diagnostic was moderate (range, 0.35-0.46). The Cramer's V of 0.60 in diagnostic work-up between pediatricians in the fictitious case implied the presence of a moderately strong association and lower inter-observer variability than in the retrospective study. Adherence to the guideline was 66.8%. Conclusion: We found a high intra- and inter-observer variability and moderate guideline adherence in daily clinical practice amongst pediatricians in treating children with RAP in a teaching hospital.

Relationship between Knowledge and Adherence to Self-management Guidelines, and Influencing Factors of Adherence for Hemodialysis Patients (혈액투석 환자의 지식과 교육 요구도, 자가-관리 방침 순응과의 일치도 및 자가-관리 방침 순응의 영향 요인 분석)

  • Park, Ji-Suk;Lee, Hyun-Suk;Lee, Soo-Youn;Im, Hye-Bin;Oh, Hyun-Soo
    • The Korean Journal of Rehabilitation Nursing
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    • v.14 no.1
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    • pp.39-46
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    • 2011
  • Purpose: This study was to examine the relationships between knowledge with same sub-areas of education needs and adherence to self-management guidelines, and to investigate the factors that influence adherence. Method: One hundred eleven patients with terminal stage of kidney failure were conveniently selected from a university hospital in Incheon. Results: The level of knowledge was high, with a mean score of 15.25. The level of adherence to self-management guidelines was low, with a mean score of 64.53. The patients' education needs were high. The significant influencing factors on adherence were gender, educational level, and two sub-areas of knowledge, 'exercise and daily life' and 'follow-up care and treatment'. Conclusion: Relationships between knowledge, education needs, and adherence should be further examined before developing and implementing intervention programs for adherence to treatment guideline in hemodialysis patients.

The prevalence of obesity and the level of adherence to the Korean Dietary Action Guides in Korean preschool children

  • Choi, Yuni;You, Yeji;Go, Kyeong Ah;Tserendejid, Zuunnast;You, Hyun Joo;Lee, Jung Eun;Lee, Seungmin;Park, Hae-Ryun
    • Nutrition Research and Practice
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    • v.7 no.3
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    • pp.207-215
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    • 2013
  • The objective of this study was to investigate the associations between the prevalence of overweight and obesity and the degree of adherence to the Korean Dietary Action Guides for Children (KDAGC). In a cross-sectional study based on a child care center-based survey in Seoul, Korea, we collected parental-reported questionnaires (n = 2,038) on children's weight and height, frequency of fruit and vegetable consumption, and the quality of dietary and activity behaviors based on the 2009 KDAGC Adherence Index (KDAGCAI) which was developed as a composite measure of adherence to the KDAGC. Overweight and obesity were determined according to age- and sex-specific BMI percentile from the 2007 Korean national growth chart. Associations were assessed with generalized linear models and polytomous logistic regression models. Approximately 17.6% of Korean preschool children were classified as overweight or obese. Obese preschoolers had lower adherence to the KDAGCAI compared to those with lean/normal weight. Preschoolers with a high quality of dietary and activity behaviors had a 51% decreased odds ratio (OR) of being obese (highest vs. lowest tertile of KDAGCAI-score, 95% CI 0.31, 0.78; P = 0.001); the associations were more pronounced among those who were older (P = 0.048) and lived in lower income households (P = 0.014). A greater frequency of vegetable consumption, but not fruit, was associated with a borderline significant reduction in the prevalence of obesity. Our findings support the association between obesity prevention and high compliance with the Korean national dietary and activity guideline among preschool children.

Relationship between adhering to dietary guidelines and the risk of obesity in Korean children

  • Yu, Soo Hyun;Song, YoonJu;Park, Mijung;Kim, Shin Hye;Shin, Sangah;Joung, Hyojee
    • Nutrition Research and Practice
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    • v.8 no.6
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    • pp.705-712
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    • 2014
  • BACKGROUND/OBJECTIVES: Dietary guidelines for Korean children were released in 2009. The goal of the present study was to examine diet quality in terms of adherence to these dietary guidelines as well as explore the association between guideline adherence and risk of obesity in Korean children. SUBJECTS/METHODS: Children aged 5-11 years (mean age = 8.9 years old, n = 191, 80.6% girls) were recruited from a university hospital in Seoul, Korea. Adherence to dietary guidelines for Korean children was calculated using the Likert scale (1-5), and children were then categorized into low, moderate, and high groups based on adherence scores. Obesity or being overweight was determined based on an age- and gender-specific percentile for body mass index (BMI) of the 2007 Korean National Growth Charts. Diet quality was evaluated from 3 days of dietary intake data. RESULTS: Children in the high adherence group were characterized by significantly lower BMI percentiles and paternal BMIs as well as higher percentages of fathers with a high level of education and higher household incomes compared to those in the low or moderate group. Children in the high adherence group consumed significantly higher amounts of milk and dairy products, were less likely to consume lower than the EAR of phosphorus and iron, and had higher NARs for calcium, phosphorus, iron, zinc, and MAR than those in low groups. The ORs for obesity ($BMI{\geq}95^{th}$ percentile) or being overweight including obesity ($BMI{\geq}85^{th}$ percentile) were significantly lower in the high adherence group compared to the low adherence group (OR: 0.33, 95% CI = 0.13-0.82, P for trend = 0.019; OR: 0.26, 95% CI: 0.11-0.61 P for trend = 0.002). CONCLUSIONS: Korean children who adhered to dietary guidelines displayed better diet quality and a reduced risk of obesity.

Quality indicators for cervical cancer care in Japan

  • Watanabe, Tomone;Mikami, Mikio;Katabuchi, Hidetaka;Kato, Shingo;Kaneuchi, Masanori;Takahashi, Masahiro;Nakai, Hidekatsu;Nagase, Satoru;Niikura, Hitoshi;Mandai, Masaki;Hirashima, Yasuyuki;Yanai, Hiroyuki;Yamagami, Wataru;Kamitani, Satoru;Higashi, Takahiro
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.83.1-83.10
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    • 2018
  • Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

Correlation between Intake of Dietary Fiber and Adherence to the Korean National Dietary Guidelines in Adolescents from Jeonju

  • Park, Sunmi;Na, Woori;Kim, Misung;Kim, Eunsoo;Sohn, Cheongmin
    • Preventive Nutrition and Food Science
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    • v.17 no.4
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    • pp.254-260
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    • 2012
  • This study surveyed dietary intake and adherence to the Korean national dietary guidelines in Korean adolescents. To elucidate basic data for use in nutrition education, which aims to improve adolescent compliance with the national dietary guidelines and to increase the intake of dietary fiber, we evaluated the sources of fiber in adolescent diets. This study included 182 male and 212 female students from 2 middle schools in the Jeonju province. From November 15~20, 2011, we surveyed the students for general characteristics, adherence to the Korean national dietary guidelines, and dietary intake. Dietary fiber intake was $16.57{\pm}6.95$ g/day for male students and $16.14{\pm}7.11$ g/day for female students. The food groups that contributed most to dietary fiber intake were (in descending order) cereals, vegetables, seasoning, and fruits. The fiber-containing food items consumed most were cabbagekimchi, cooked rice, instant noodles, and cabbage. Based on adherence to the Korean national dietary guidelines, the vegetable-based intake of dietary fiber in groups 1 (score 15~45), 2 (score 46~52), and 3 (score 53~75) were $4.41{\pm}2.595$ g/day, $4.12{\pm}2.692$ g/day, and $5.49{\pm}3.157$ g/day, respectively (p 0.001). In addition, the total intake of dietary fiber varied significantly among the three groups (p 0.001) as follows: Group 1, $14.99{\pm}6.374$ g/day; Group 2, $15.32{\pm}6.772$ g/day; and Group 3, $18.79{\pm}7.361$ g/day. In this study, we discovered that adherence to the Korean national dietary guidelines correlates with improved intake of dietary fiber. Therefore, marketing and educational development is needed to promote adherence to the Korean national dietary guidelines. In addition, nutritional education is needed to improve dietary fiber consumption through the intake of vegetables and fruits other than kimchi.

Medication Injection Safety Knowledge and Practices among Health Service Providers in Korea

  • Lee, Hyeong-Il;Choi, Ji-Eun;Choi, Sol-Ji;Ko, Eun-Bi
    • Quality Improvement in Health Care
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    • v.25 no.1
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    • pp.52-65
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    • 2019
  • Purpose: Outbreaks resulting from medication injections have recently been on the rise in Korea despite various established guidelines. The objective of this study was to assess the degree to which healthcare professionals are aware of safe injection practice guidelines and to account for the adherence to and the deviation from safe injection guidelines formulated by healthcare providers. Methods: In November 2016, a cross-sectional anonymous questionnaire covering general characteristics of injections, patient safety culture, awareness of safe injection practices, and adherence to and barriers to safe injection guidelines was issued to healthcare providers who administer medication injections or manage and supervise these injections (N=550). Multivariate logistic regression analysis via enter method was performed to define the influencing factors of adherence of safe injection practices. Results: On average, respondents adhere to 17 of the 24 guidelines. Multivariate logistic regression found that those who were more likely to adhere to safe injection guidelines either underwent a patient safety training experience within the last year, provided care in a setting characterized by a highly developed patient safety culture, or were employed as physicians or nurses, as opposed to some other type of care provider. Barriers to safe injection guidelines were attributable to; thoughts of waste to discard leftover medicine, provisions that made adherence cumbersome, a weak culture of compliance, and insufficient amounts of injectable medicine, products, and education. Conclusions: The results of this study indicate that controllable factors like training experience of healthcare providers and patient safety culture were positively associated with adherence to safe injection practices. It was suggested that the training of healthcare providers on safe injection practices be a continuous process to promote patient safety. Additionally, there should be an increased focus on developing and implementing policies to improve patient safety culture from a prevention rather than post-management perspective.