• Title/Summary/Keyword: 근거 중심

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Effects of Evidence Based Practice Integrated Critical Care Clinical Practicum (근거중심실무 연계 중환자간호 실습교육의 적용 및 효과)

  • Park, Myong-Hwa
    • The Journal of Korean Academic Society of Nursing Education
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    • v.17 no.3
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    • pp.346-354
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    • 2011
  • Purpose: This study examines the effects of integrating Evidence Based Practice (EBP) into a critical care clinical practicum on nursing students' access and use of information resources and EBP competency. Methods: A one-group pretest-posttest design was used. Fifty senior nursing school students from a university participated. A critical care clinical practicum combined with EBP consisted of six full days of clinical practicum in intensive care units with EBP education. Group and individual training in EBP skills, lectures, small group discussion and conferences were provided. Data were analyzed using paired t tests for 50 participants. Results: The scores of evidence based practice competency increased significantly (p<.001) showing significant improvement in searching and classifying the evidence. Nursing students' access and use of research evidence improved (p=.004). Conclusion: This study showed that the integration of EBP into a clinical practicum was effective in improving accessibility and usefulness in research evidence such as guidelines and research articles, and increasing EBP competency in undergraduate students.

Development of Drought Risk Map : Case Study For Gyengsang-do (가뭄위험지도 개발 : 경상도 지역을 중심으로)

  • Park, Jong Yong;Yoo, Ji Young;Choi, Minha;Kim, Tae-Woong
    • 한국방재학회:학술대회논문집
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    • 2011.02a
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    • pp.46-46
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    • 2011
  • 가뭄은 인간이 극복하기 힘든 자연재해로 사회, 경제, 환경등에 막대한 피해를 가져온다. 따라서, 이를 극복하기 위해 지속적인 가뭄 모니터링이 필요한데, 현재 가뭄의 모니터링은 대부분 기상학적 인자를 고려한 가뭄지수의 심도에 의해 이루어지고 있다. 본 연구는 이러한 가뭄모니터링 방법을 좀 더 현실적으로 개선시키고자 가뭄심도를 근거로 가뭄발생 빈도와 가뭄발생 시 취약인자의 선정을 통해 가뭄위험평가기법을 제안하였다. 이를 위해 가뭄의 위험정도를 정량화하고 가뭄발생으로 인해 발생 가능한 피해 요소들을 정량화하여 가뭄재해지수(Drought Hazard Index)와 가뭄취약성지수(Drought vulnerability Index)를 산정하고, 두 지수의 결합으로 가뭄위험지수(Drought Risk Index)를 산정하였다. 가뭄재해지수는 가뭄지수 EDI를 바탕으로 가뭄심도에 따른 발생확률을 근거로 산정하였으며, 가뭄취약성지수는 가뭄 발생 시 취약한 인자를 선정하여 이를 지수화 하였다. 가뭄위험평가의 적용을 위해 2001년의 경상도 지역의 가뭄을 평가하였다. 가뭄위험지수를 바탕으로 경상도 지역의 가뭄의 위험정도를 평가할 수 있는 가뭄위험지도를 작성한 결과 경상북도 지역이 경상남도 지역보다 가뭄발생빈도와 취약정도가 컸음을 확인할 수 있었으며, 경상도 내륙지방을 중심으로 가뭄의 위험이 높음을 확인할 수 있었다.

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Validation of a Translated Guideline on Pain Assessment and Management: Focused on Abdominal Surgery Patients (통증관리 근거중심 가이드라인의 국내 타당성 검증 - 복부수술 환자를 대상으로 -)

  • Hong, Sung Jung;Lee, Eunjoo
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.159-170
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    • 2012
  • Purpose: This study was designed to examine the validity of the evidence-based guideline on pain developed by Registered Nurses Association of Ontario(RNAO) translated into Korean based on the experts' opinions. Methods: The panel consisted of experts of 60 registered nurses in surgical units, medical doctors and nursing managers who were experts in pain assessment and management. The validity of translated RNAO guideline was evaluated in terms of appropriateness, applicability, and utilization in current practice. Appropriateness and applicability of each recommendation were measured with 9 point scale, whereas utilization was measured by yes/no question. Data were analyzed by mean, standard deviation, and percent. The experts' opinions were analyzed by content analysis method. Results: In general, most of the recommendations in the guideline received above 7 point in appropriateness and applicability. However, above 20% of recommendations showed less than 50% of utilization rates in current practice. Conclusion: The reasons for low utilization of recommendations in current practice are in need for investigation. This study can be used for the development of guideline more acceptable in Korean health care settings and improve the quality of care for the abdominal surgery patients suffering from pain in Korea.

Evaluating the NGCTM Evidence Based Guideline of Prompted Voiding for Use in Korea (미국 NGCTM 배뇨자극요법 근거중심 가이드라인의 국내 적용가능성 평가)

  • Park, Myonghwa;Kim, Myung Ae
    • Korean Journal of Adult Nursing
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    • v.17 no.4
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    • pp.622-634
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    • 2005
  • Purpose: The purpose of this study was to evaluate the applicability of the evidence based guideline for prompted voiding by Lyons & Specht (2001) in National Guideline $Clearinghouse^{TM}$ for use in Korea based on the experts' opinions. Method: The target expert group consisted of 8 registered nurses, 6 physicians, and 5 nursing professors who are experts in urinary incontinence. This study used a questionnaire survey. The appropriateness, applicability, and the present application of each recommendation in the guideline were analyzed with descriptive statistics using the SPSS program, with content analysis based on the experts' opinions. Result: The scores on each recommendation's appropriateness showed the high degree of agreement among nurses, physicians, and nursing professors. However, the recommendation for 'use of oxybutinin' showed the lowest score as 5.89. It was notable that the most recommendations scored lower for applicability compared with appropriateness. The reasons for lower scores for applicability were the lack of clinicians' knowledge of assessment and management, and the lack of resources in clinical settings in Korea. Conclusion: This study will augment the understanding of the actual urinary incontinence management in Korean clinical settings and can be used as the baseline data for further study of tailoring international guidelines into local and national clinical settings.

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Nurses' Access & Use of Information Resources and Barriers & Competency of Evidence Based Practice (간호사의 정보자원 접근 및 활용정도와 근거중심실무 장애요인 및 역량)

  • Yi, Ji-Eun;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.23 no.3
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    • pp.255-266
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    • 2011
  • Purpose: The purpose of this study was to explore nurses' access and use of information resources and to identify the barriers and competency to evidence based practice (EBP). This study used descriptive method to identify baseline data for the purpose of developing strategies for establishing EBP in clinical nursing practice. Methods: Participants in this study were 278 nurses from five hospitals in Daegu and Kyungsangbukdo. The data were collected by self administered questionnaires and SPSS/WIN 15.0 program was used to analyze the data with descriptive statistics, t-test, Pearson's correlation coefficients, and ANOVA. Results: Nurses reported $^*most$ frequently using paper and human resources. The mean score of barriers was $3.02{\pm}0.41$, and competency was $2.70{\pm}0.50$. The reported competency was correlated with nurse factors (r=-.31, p<.001) organization factors (r=-.20, p<.001) and research factors (r=-.12, p<.040) as the barriers to evidence based practice. Conclusion: To promote competency in EBP and to decrease the barriers, it would be necessary to develop the organizational culture that encourages nurses to be involved in research activities. In addition, the development of systemic methods to introduce and establish an education program for facilitating EBP in the clinical settings is needed.

Nurses' Awareness and Performance about Evidence-based Pain Management in Older Adults (병원 간호사의 근거중심 노인통증관리 지침에 대한 인지도와 수행도)

  • Kim, Eun-Kyoung;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.24 no.1
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    • pp.20-30
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    • 2012
  • Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

Development, Application and Evaluation of the Evidence-based Nursing Practice Guideline for Hemodialysis in the Patients with Risk of Bleeding (출혈위험이 있는 신부전환자의 혈액투석을 위한 근거중심 간호실무 가이드라인 개발과 적용 및 평가)

  • Kim, Su-Mi
    • The Journal of Korean Academic Society of Nursing Education
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    • v.16 no.1
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    • pp.150-155
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    • 2010
  • Purpose: The purpose of this study is to develop evidence-based nursing practice guidelines for hemodialysis in the renal failure patients with risk of bleeding and to evaluate the guidelines by applying it to the practice. Method: Referring to the SIGN, the first draft for guidelines was developed based on the advices and recommendations obtained from the procedure of critical literature analysis. Then, the draft was modified by the procedures of the expert group evaluation and pilot application to the practice. The final draft was evaluated by the expert group using AGREE instrument. Result: The first draft of guidelines was developed through 8 stages of process and was evaluated by seven experts in terms of the appropriateness, applicability, and effectiveness using a 9 point scale. The mean score of 11 items was 7.90 or above. The quality of the final draft was evaluated by 5 experts using the AGREE instrument. The mean standard score was 73.0% or above in the 19 items. Conclusion: The clinical guidelines developed by this research can be utilized as systematic and scientific guidelines for hemodialysis in the renal failure patients with risk of bleeding. In addition, the research can contribute to improving care services.

Nurses' Usage of Clinical Practice Guideline and Demand of Evidence Based Clinical Practice Guideline (간호사의 임상실무지침서 사용현황과 근거중심 임상실무지침서 요구도 조사)

  • Ha, Mi Suk;Park, Myong Hwa
    • Korean Journal of Adult Nursing
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    • v.18 no.4
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    • pp.582-592
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    • 2006
  • Purpose: The purpose of this study was to offer the baseline data for developing a systematic and high quality of clinical practice guideline by exploring how nurses utilize clinical guidelines and what they need for. Method: This study has been done with 242 nurses of a university hospital in Daegu using a self-administered questionnaire. The instrument used in this study was developed by researchers based on the results of the previous studies. Data analysis was done with SPSS 11.0 Program. Results: Nurses felt that clinical guidelines were not sufficiently disseminated to update their clinical knowledge education. Nurses showed the strong demand for developing clinical practice guidelines with the newest and systematic evidence. However, a relatively low number of nurses knew evidence-based nursing and evidence-based clinical guidelines. Conclusion: It is necessary to develop an educational program for evidence-based nursing and an evidence-based nursing clinical practice guideline for nurses and to explore the strategies for development and dissemination of evidence-based clinical practice guidelines to solve the urgent and frequent clinical problems.

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Development and Evaluation of e-EBPP(Evidence-Based Practice Protocol) System for Evidence-Based Dementia Nursing Practice (근거중심 치매 간호실무를 위한 e-EBPP 시스템 개발 및 평가)

  • Park, Myonghwa
    • Korean Journal of Adult Nursing
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    • v.17 no.3
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    • pp.411-424
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    • 2005
  • Purpose: The purpose of this study was to develop and evaluate e-EBPP(Evidence-based Practice Protocol) system for nursing care for patients with dementia to facilitate the best evidence-based decision in their dementia care settings. Method: The system was developed based on system development life cycle and software prototyping using the following 5 processes: Analysis, Planning, Developing, Program Operation, and Final Evaluation. Result: The system consisted of modules for evidence-based nursing and protocol, guide for developing protocol, tool for saving, revising, and deleting the protocol, interface tool among users, and tool for evaluating users' satisfaction of the system. On the main page, there were 7 menu bars that consisted of Introduction of site, EBN info, Dementia info, Evidence Based Practice Protocol, Protocol Bank, Community, and Site Link. In the operation of the system, HTML, JavaScript, and Flash were utilized and the content consisted of text content, interactive content, animation, and quiz. Conclusion: This system can support nurses' best and cost-effective clinical decision using sharable standardized protocols consisting of the best evidence in dementia care. In addition, it can be utilized as an e-learning program for nurses and nursing students to learn use of evidence based information.

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Use of Web-Based Evidence-based Clinical Practice Guidelines for Patients following Gastrectomy: Effects on Body Temperature, Shivering, Perceived Thermal Comfort, and Satisfaction with Temperature Management (웹기반 체온 관리 근거중심 간호실무 가이드라인이 위절제술 환자의 체온, 전율, 체온 불편감, 체온 관리 만족도에 미치는 효과)

  • Hong, Sung-Jung;Lee, Eunjoo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.2
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    • pp.112-122
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    • 2014
  • Purpose: The purpose of this study was to examine the effects on body temperature, shivering, and perceived thermal comfort of web-based evidence-based practice guideline for patients undergoing gastrectomy. Methods: Eighty patients scheduled for gastrectomy were recruited and assigned to the control or experimental group by sequential order. Before collecting data from the experimental group, a systematic educational program on evidence-based guidelines was provided to the nurses as well anesthesiologists. Data were analyzed using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature from the induction of anesthesia until four hours after surgery compared to the control group. In addition, the levels of thermal comfort as well as satisfaction with thermal management were significantly higher in the experiment group. Conclusion: Use of evidence-based guidelines was effective in maintaining body temperature, lowering sensitivity to shivering, and promoting perceived thermal comfort. Therefore, adoption of evidence-based interventions in nursing practice is recommended.