• 한국치위생학회지
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• 제20권5호
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• pp.717-731
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• 2020

Objectives: The purpose of this study was to develop applicable standards for clinical dental hygiene practice in Korea and to evaluate their validity. Methods: Based on the standards for clinical dental hygiene practice developed in the United States and Canada, the standards were adapted to be applicable in Korea. The validity of the standards was evaluated by a self-writing questionnaire among 14 professors and 10 clinicians using a developed tool for evaluating the standards. A focus group interview was additionally conducted for clinicians to increase the validity of the standards. Descriptive statistics and Mann-Whitney test were performed using SPSS 25.0. To analyze the content of the focus group interviews, content analysis was conducted. Results: The standards for clinical dental hygiene practice consisted of five elements of professionalism for dental hygienists and a total of 28 items to perform the five stages of dental hygiene process of care (assessment, diagnosis, planning, implementation, and evaluation) and included conceptual meaning, clinical significance, and application methods with examples for each item. Conclusions: The standards for clinical dental hygiene practice developed in this study could contribute to standardizing dental clinical practices provided by dental hygienists. It is necessary to consistently improve the standards that are highly practical, to prevent oral diseases and maintain oral health of the public, based on the results of this validity evaluation.

• 임상간호연구
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• 제18권1호
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• pp.39-51
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• 2012

Purpose: Thisstudy was conducted with an aim to get a kind of prioritiesin developing the evidence-based nursing practice guidelines in fields. Methods: This study utilized a two-round Delphi surveys from November to December, 2010 with self-administered questionnaires which had a scale ranged from 0 to 9. A total of 95 head nurses working at the forty different general hospitals was asked to evaluate the priorities in four criteria; patient coverage, certainty, improvement in patient outcome and in nursing practice (first round) and 65 head nurses were asked to decide the importance of the criteria afterwards (second round). Results: The relative importance of 4 criteria was 22.3% in patient coverage, 26.5% in certainty, 23.5% in improvement of patient outcome, and 27.7% in improvement of nursing practice as the results of the 1st round and 20.6%, 26.6%, 24.8%, and 28.0% for the 2nd round, respectively. Top five nursing practices showed high scores after considering the relative importances of the 4 criteria were medication, intravenous therapy, checking vital sign, pain management, and diagnostic test or procedures care. Conclusion: It is recommended to take into account of the priorities that were found in this study when someone intends to develop a evidence-based nursing practice guideline.

• 임상간호연구
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• 제17권2호
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• pp.262-274
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• 2011

Purpose: To identify the effects of clinical practicum reinforcement program on nursing student's clinical competency and satisfaction in the ICU. Methods: The study utilized a quasi-experimental pretest-posttest research design. The participant was 76 senior nursing students, who were engaged in two week-long clinical practicum in ICU at the C university hospital in a G city, Korea. The clinical practicum reinforcement program was applied to the experimental group (n=39), while the control group (n=37) was involved in the conventional practicum program. The collected data were analyzed using descriptive analysis, $x^2$/Fisher's exact test, and t-test, ANCOVA with SPSS/WIN 18.0 program. Results: After 2 weeks' clinical practicum, the experimental group showed a statistically significant increase in the clinical performance abilities by self evaluation, when compared to the control group. Clinical instructor's evaluation on the student's clinical performance revealed that the experimental group showed higher level in nursing activity than that of the control group (p<.001). However, there was no significant difference between the two groups in terms of the satisfaction on the clinical practicum program except the learning guidance and the evaluation. Conclusion: The clinical practicum reinforcement program is an effective one for improving the student's clinical competency.

• 임상간호연구
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• 제19권1호
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• pp.128-142
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• 2013

Purpose: This study was conducted to adapt the previously developed intravenous infusion guidelines with good quality for development of the evidence-based intravenous infusion nursing practice guideline in Korea. Methods: Guideline adaptation process was conducted according to guideline adaptation manual version 2.0 developed by NECA (Kim, Kim et al., 2011) which consisted of three main phases, 9 modules including a total of 24 steps. Results: Adapted intravenous infusion nursing practice guideline was consisted of 19 domains and 180 recommendations. The domains and number of recommendations in each domain were: general guide, 4; assessment, 1; vascular access device selection, 4;site selection, 14;site preparation, 5;site care, 29; maintaining patency, 11; blood sampling via vascular access, 4; vascular access device exchange and removal, 9; add-on device selection, 27; infusion related complications, 63; education, 7; and documentation and report, 2. There were 11.9% of A, 28.4% of B, 58.7% of C in grade of recommendations. Conclusion: Adapted intravenous infusion nursing practice guideline is expected to contribute providing an evidence based practice guides for intravenous infusion. The guideline is recommended to be disseminated to nurses nationwide to improve the efficiency of intravenous infusion practice.

• 임상간호연구
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• 제23권1호
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• pp.83-90
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• 2017

Purpose: This study was to develop evidence-based clinical practice guideline in order to prevent contrastinduced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). Methods: The guideline was developed based on the "Scottish Intercollegiate Guidelines Network (SIGN)". The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. Results: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. Conclusion: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.

• Journal of Preventive Medicine and Public Health
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• 제19권2호
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• pp.193-202
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• 1986

공중보건 일반의사들의 업무수행 정도와 진료, 예방 및 보건증진 사업 수행에 필요한 기본적인 수기의 수행능력을 평가하고 그들의 업무 수행능력을 향상시키기 위한 교육 개선 방안을 마련하기 위하여 1982년과 1983년에 배치된 공중보건 일반의사들 가운데 남부 4개도(경북, 경남, 전북, 전남)에서 출신학교별로 비슷한 비율로 120명을 무작위로 뽑아 1984년 1월 9일에서 2월 10일 사이에 설문지를 이용한 집단면담을 하였다. 면담에 응한 97명 가운데 본 조사에 필요한 자료를 제시할 수 있었는 86명으로 부터 얻은 자료를 분석하였다. 보건지소의 진료실적은 2종 보험실시 지역이 1일 평균 $30{\sim}40$명으로 환자가 많으나 그외 지역은 $3{\sim}4$명으로 매우 저조하였다. 또한 예방 및 보건증진사업을 적극적으로 추진한다고 답한 사람은 조사대상자의 2%에 불과했다. 63가지 기본적인 임상수기 가운데서 자신있게 할 수 있다고 한 사람이 50%이상인 것은 근육주사, 정맥주사, 외상치료와 같이 간단한 것으로 12가지에 불과했고 임산부관리, 응급환자처치, 예방 및 보건증진 사업등에 필요한 수기에 자신이 있는 사람은 10%도 못 되었다. 국립보건원에서 실시하고 있는 공중보건 일반의사들의 실무교육이 현지 사정과 맞지 않는것이 많아 실무에 큰 도움이 안 된다고 했으며, 도립병원이나 지방 종합병원에서 받은 임상수련이 실무에 많은 도움이 된다고 한 사람은 38.8%였으며, 별도움이 안된 이유 가운데 전문의가 없거나 있어도 무관심하여 수련지도가 부족한 탓이라고 한 사람이 48.4%로 가장 많았다. 공중보건일반의 실무교육은 교육내용을 실무종사자들의 의견을 수렴하여 현지 사정에 맞도록 개선해야할 것이며, 실무종사자들 가운데 유능한 사람을 강사로 활용하고, 국립보건원에 모아 교육시키는 것보다 전국을 몇개의 지역으로 나누어 지방에서 교육을 시키는것이 효과적일 것이다. 임상실습은 4개월이 적당할 것으로 생각되며, 수련기간 동안에 필수적으로 익혀야 할 수기를 수첩으로 만들어 실습사실을 지도전문의에게 확인 받게하며, 보건사회부에서는 수련지도에 관한 지침을 마련하여 수련병원에 배부하고 수련상황을 평가하도록 한다. 최소한 기본 4과에 전문의를 갖춘 병원을 수련병원으로 선정하여야 할 것이다. 공중보건 일반의사들이 현지에서 당면하는 문제해결을 도우고 사업추진을 위한 동기를 유발하기 위해 보수교육이 필요하며 이를 위해 보건사회부는 재정 및 행정적 지원을 하는 것이 좋겠다. 도를 몇개지역으로 나누어 지역마다 지도위원회를 구성하여 공중보건 일반의사들을 순회지도 하고 자문에 응하도록 하는 것이 좋을 것으로 생각된다.

• 임상간호연구
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• 제20권3호
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• pp.337-347
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• 2014

Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

• 임상간호연구
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• 제20권1호
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• pp.1-14
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• 2014

Purpose: Addressing current status of nursing handoff provides information as to where to change practice for improvement in patient care. The aim of this study was to develop nursing a handoff practice guideline and standardsfor Korean hospitals. Methods: A questionnaire was used to collect data in a cross-sectional survey with 207 head nurses and 697 nurses working in general hospitals. Results: The practice guideline consisted of 2 items on purpose of handoff, 5 items on policy, 3 on environment, 5 on process, 7 on content, 3 on evaluation, and 1 on the function of education, for a total 26 of items. Standard instruction was developed related to Patients, Assessment, Situation, Safety concerns, Background, Actions, and Recommendations. Conclusion: The findings of this study indicate that the guideline can be applied in real nursing practice to improve the effectiveness of handoff procedures. It can be used to guide nurses to follow the standardized content, which presents patient details clearly. The guideline provides consistency and structure for the information that is handed over.

• 임상간호연구
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• 제29권1호
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• pp.24-41
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• 2023

Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

• 디지털융복합연구
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• 제14권11호
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• pp.469-479
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• 2016

본 연구는 대학병원 임상간호사를 대상으로 환자안전문화에 대한 인식과 안전간호활동에 미치는 영향을 파악하기 위한 서술적 조사연구이다. 자료는 2015년 9월 1일부터 10월 1까지 하였다. 수집된 자료는 SPSS 23.0을 이용하여 t-test, ANOVA, Pearson correlation coefficients, stepwise multiple regression으로 분석하였고, 사후분석은 Scheffe' test로 하였다. 그 결과 대상자의 환자안전문화에 대한 인식은 5점 만점에 $3.30{\pm}.22$점이었고, 안전간호활동은 5점 만점에 평균 $3.89{\pm}.44$점이었으며, 환자안전문화에 대한 인식은 환자안전간호활동과의 양의 상관관계(r=.364, p=.000)가 나타났다. 또한 안전간호활동에 간호사의 총 경력, 직위, 직속관리자/책임자, 의사소통 절차, 사건보고 빈도가 영향을 받으며, 38.6%의 설명력이 있는 것으로 나타났다. 따라서 안전간호활동을 증진시키기 위해서는 적절한 경력자 관리, 조직간 원활한 의사소통, 자발적 사건보고를 할 수 있는 실무지침과 효과적인 교육프로그램 개발이 필요하다.