• 제목/요약/키워드: 근거기반 임상실무

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인공호흡기 관련 폐렴의 예방을 위한 근거기반 간호실무지침 개발 (Development of Evidence-Based Nursing Practice Guideline for Prevention of Ventilator-Associated Pneumonia)

  • 김화영;류세앙
    • 한국콘텐츠학회논문지
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    • 제21권10호
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    • pp.630-644
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    • 2021
  • 본 연구는 인공호흡기 관련 폐렴 예방을 위한 근거기반 간호실무지침을 개발하고자 수행되었다. 한국보건의료연구원의 하이브리드 방법에 따라 근거기반 간호실무지침을 개발하고 유효성을 검증한 방법론적 연구이다. 주제와 핵심 질문은 문헌 검토와 전문가 인터뷰를 통해 도출하였고, 핵심 질문과 관련된 권고안은 체계적 검색과 선정에 의한 기존 가이드라인을 분석하여 수렴하였으며, 미해결 핵심 질문과 관련된 권고안은 체계적고찰과 메타 분석을 통해 새로 개발하였다. 개발된 권고안은 RAND에 의한 유효성 검증과 간호실무지침 초안은 AGREE II에 의한 방법론적 질평가를 수행하였다. 9개 범주의 44개 권고안으로 구성된 최종 간호실무지침의 임상타당성은 중환자실 간호사 122명을 대상으로 평가하였다. 최종 개발된 인공호흡기 관련 폐렴 예방을 위한 근거기반 간호실무지침은 방법론적 타당성과 내용타당도가 검증되었고 우리 간호실무 환경에 적합하여 중환자 간호실무의 질적 향상에 기여할 수 있을 것으로 기대된다.

한국어판 간호대학생의 근거기반실무 측정도구(S-EBPQ)의 타당도 및 신뢰도 검증 (Validity and Reliability of the Korean Version of Student Evidence-Based Practice Questionnairs(S-EBPQ))

  • 김선경
    • 산업융합연구
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    • 제18권1호
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    • pp.35-43
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    • 2020
  • 본 연구는 Upton, Scurlock-Evans 와 Upton 이 개발한 간호대학생의 근거기반실무 측정도구(S-EBPQ)를 한국어로 번안하고 신뢰도와 타당도를 검증하기 위해 수행되었다. 근거기반실무에 대한 학습 경험과 임상실습 경험이 있는 간호대학생 209명의 자료를 데이터 분석에 활용하였다. 구성타당도를 위한 탐색적 요인분석결과 기존의 도구와 동일한 4 요인, 21 문항이 확인되었다. 도구의 설명력은 67% 였고 도구 전체의 신뢰도는 .927 이였다. 한국어판 S-EBPQ는 우리나라 간호대학생의 근거기반실무 역량을 평가하는데 활용될 수 있을것이다. 또한 도구를 활용하여 우리나라 간호대학의 근거기반실무 교육 프로그램이 효과를 평가하는데 활용 될 수 있을것이며 이는 간호교육의 질 향상에 기여할 것으로 기대된다.

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.

상급종합병원 신규간호사와 프리셉터 간호사의 근거기반실무에 대한 신념, 간호실무지침에 대한 중요도와 수행도 (Belief in Evidence-Based Practice, Awareness of Importance and Performance of Nursing Practice Guidelines among Novice Nurses and Preceptors in a Tertiary General Hospital)

  • 서주희;은영
    • 임상간호연구
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    • 제29권2호
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    • pp.149-162
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    • 2023
  • Purpose: This study was to investigate the belief in evidence-based practice, awareness of importance and performance of intravenous infusion and pressure ulcer evidence-based practice guidelines among nurses in a tertiary general hospital. Methods: The subjects of this study were 217 nurses working in a tertiary general hospital. Data collection was performed between February 11 and February 25, 2022. Data analysis was conducted descriptive statistics, t-test, hierarchical regression analysis, and Importance-Performance Analysis. Results: The mean score of belief for evidence-based practice among novice nurses was 3.34 out of 5, while preceptor nurses scored a mean of 3.41 out of 5. There was no significant difference in belief scores between novice nurses and preceptor nurses (t=-1.21, p=.227). The factors influencing the performance of evidence-based practice guidelines for intravenous infusion were belief in evidence-based practice (β=.14, p=.009) and importance of intravenous infusion (β=.51, p<.001), and the factors influencing the performance of evidence-based practice guidelines for pressure ulcer were belief in evidence-based practice (β=.15, p=.002) and importance of pressure ulcer (β=.65, p<.001). Importance-Performance Analysis of the evidence-based practice guidelines of two groups were used to identify common and different items. Conclusion: To improve the performance of evidence-based practice guidelines, it is necessary to enhance the evidence-based practice belief and importance of evidence-based practice guidelines. In particular, evidence-based practice should be provided to improve nursing quality through education on items of low-importance and low-performance and items of high-importance but low-performance guidelines identified through Importance-Performance Analysis.

입원환자의 급성 악화 신속대응 가이드라인 개발 (Development of Guidelines for Raid Response to Acute Deteriorating of Hospitalized Patients)

  • 이하늬;박정숙
    • 한국콘텐츠학회논문지
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    • 제22권10호
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    • pp.359-373
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    • 2022
  • 본 연구는 입원환자들의 급성 악화 시 신속한 대응을 위한 근거 기반 가이드라인을 개발하고자 수행되었다. 가이드라인 개발을 위해 기존의 가이드라인을 검색하였고, 총 13편이 선정되어 가이드라인에 대한 Appraisal of guidelines for research and evaluation (AGREE II) 도구를 활용한 질 평가, 최신성 평가, 권고 내용 비교표를 통한 내용 및 권고안의 근거평가, 권고의 수용성 및 적용성 평가를 수행하였다. 본 가이드라인은 신속대응체계의 개념 모형에 따라 관리, 인식, 활성화, 대응, 평가에 대한 권고로 구성되어 있다. 전문가 16명에게 가이드라인 초안의 적절성, 적용 가능성, 효과성에 대한 평가와 적용 여부에 대한 검토를 통해 최종적인 평가 결과를 반영하여 130개의 권고를 확정하였다. 가이드라인의 실무 적용성 평가를 위해 임상 현장에서 신속대응 업무를 수행하는 간호사를 대상으로 실무 적용성을 파악한 결과, 가이드라인에 대한 전체 실무 적용성 평균은 5점 만점에 4.41±0.78점으로 지침 내용에 대한 실제 임상 업무에서의 적용성이 높은 것으로 나타났다.

국내 근거기반 임상간호실무지침의 주제 선정 (Topics for Evidence-Based Clinical Nursing Practice Guidelines in Korea)

  • 구미옥;조명숙;조용애;정재심;정인숙;박정숙;김혜정;은영
    • 임상간호연구
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    • 제17권3호
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    • pp.307-318
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    • 2011
  • Purpose: This study was to identify topics for evidence-based clinical nursing practice guidelines in Korea. Methods: Data were collected from 330 staff nurses from 10 general hospitals and 53 nurses in charge of nursing education in 110 hospitals with over 500 beds. Using open questions, the nurses identified activities which could not be verified, which lacked consistency among nurses, clinical units and/or hospitals, which were not based on the up-to-date knowledge and which needed reform. The data were analysed by content analysis using a qualitative methodology. Results: Collected data consisted of 1882 clinical topics, which were classified into 50 topics, 207 mid-categories, and 456 sub-categories. The most frequent topics in order of frequency were medications, central line management, intravenous injections, urinary catheterization, perioperative nursing care, skin tests, pressure ulcer care, blood transfusions, laboratory examination-culture, respiratory care which were performed routinely in clinical setting by staff nurses. Conclusion: The research findings indicate the urgent need to develop evidence-based clinical nursing practice guidelines related to these research findings. Further research is needed to identify topics related to health promotion, and symptom/management of health problem.

근거기반 중심정맥 주입요법 간호실무지침 개정 (Updates of Evidence-Based Nursing Practice Guidelines for Central Venous Infusion Therapy)

  • 임경춘;정재심;김경숙;김현림;김현정;김동연;이미정;이주현
    • 임상간호연구
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    • 제29권1호
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    • pp.42-55
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    • 2023
  • Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

간호대학생의 신체적 억제대 사용 관련 간호실무 예측 요인 (Factors Influencing Nursing Practices of Physical Restraints Use by nursing students)

  • 하선미
    • 한국산학기술학회논문지
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    • 제22권4호
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    • pp.529-537
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    • 2021
  • 신체적 억제대 사용은 많은 논란이 되고 있음에도 불구하고 여전히 임상실무에서 환자안전사고 예방을 위해 입원 중인 환자에게 흔히 사용되고 있다. 따라서 미래의 간호사가 될 간호대학생이 생각하는 신체적 억제대 사용과 관련된 지식, 태도, 인식 및 간호실무 정도를 확인하고, 신체적 억제대 사용 관련 간호실무 예측 요인을 확인하기 위해 서술적 조사연구를 시행하였다. 자료 수집은 2020년 1월 2일부터 1월 20일까지 2곳의 간호대학생 144명을 대상으로 자가 보고식 설문지를 통해 시행되었다. 자료 분석은 기술적 통계, t-test, one-way ANOVA, Pearson correlation coefficients, multiple regression을 사용하였다. 연구결과 간호대학생의 신체적 억제대 사용에 대한 지식점수는 평균 11.55±2.81점, 태도점수는 평균 60.01±7.24점, 인식점수는 평균 59.97±10.68점, 간호실무 점수는 평균 38.04±4.15점 이었으며, 간호실무와 지식, 태도, 인식 모두 유의한 양의 상관관계가 있었다. 다중 회귀분석을 통한 신체적 억제대 사용과 관련된 간호실무에 영향을 미치는 요인으로는 인식(β=.23, p=.005), 태도(β=.21, p=.009) 순으로, 이들 전체 변수의 설명력은 13%였다. 본 연구에서 신체적 억제대 사용 관련 간호실무에 가장 중요한 예측 요인은 신체적 억제대 사용에 대한 인식으로, 간호대학생이 신체적 억제대를 올바르게 인식하여 추후 간호사가 되었을 때 임상실무에서 올바르게 사용할 수 있도록 하기 위한 근거기반의 교육 중재 프로그램의 개발과 적용이 필요하겠다.

중소병원 간호사의 근거기반 통증 관리 지식과 수행 및 근거기반 실무에 대한 태도 (Nurses' Evidence-Based Pain Management Knowledge, Performance and EBP Attitude in Small-medium Sized Hospitals)

  • 홍인화;은영
    • 한국임상보건과학회지
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    • 제3권4호
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    • pp.476-489
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    • 2015
  • Purpose. The purpose of this study was to investigate the evidence-based pain management knowledge, performance and Evidence-Based Practice(EBP) attitude of nurses at small-medium sized hospitals. Methods. The sample of this study were 214 nurses. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation and stepwise multiple regression using SPSS/Win 21.0 Results. Evidence-based pain management knowledge score averaged $3.95{\pm}0.43$, with significant differences depending on clinical experiences. Performance score averaged $3.77{\pm}0.51$. EBP attitude score averaged $3.21{\pm}0.57$, and significant differences were evident depending on hospital division and clinical setting. Evidence-based pain management knowledge and EBP attitude were significant predictors of evidence-based pain management performance. Conclusions. This result indicates that education and training programs to facilitate evidence-based pain management knowledge, performance, and EBP attitude are needed among nurses.

근거기반 욕창간호 실무지침 개정 (Updates of Evidence-Based Nursing Practice Guidelines for Pressure Injury)

  • 김정윤;박경희;박옥경;박주희;이윤진;황지현
    • 임상간호연구
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    • 제29권1호
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    • pp.12-23
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    • 2023
  • Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.