• Title/Summary/Keyword: CARE guidelines

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Inverse association of improved adherence to dietary guidelines with metabolic syndrome: the Seoul Metabolic Syndrome Management program

  • Ham, Dongwoo;Cho, YoungYun;Park, Mi-Suk;Park, Yun-Sug;Kim, Sun-Young;Seol, Hye-Min;Park, Yoo Mi;Woo, Sunok;Joung, Hyojee;Lim, Do-Sun
    • Nutrition Research and Practice
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    • v.14 no.6
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    • pp.621-636
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    • 2020
  • BACKGROUND/OBJECTIVES: The Seoul Metabolic Syndrome Management (SMESY) program is a 1-yr lifestyle modification program targeting metabolic syndrome (MetS) in Seoul residents. This study investigated the associations between adherence to dietary guidelines and MetS among the SMESY program participants. SUBJECTS/METHODS: Data of 54,385 participants aged 20-64 yrs who completed the SMESY program in 2015, had information on adherence to dietary guidelines, and were not medicated for diabetes, hypertension, or dyslipidemia were analyzed. Participants underwent MetS screening and completed a lifestyle questionnaire including adherence to 10 dietary guidelines before and after participation. Participants were classified according to the number of MetS risk factors at baseline (MetS group, ≥ 3; risk group, 1-2; healthy group, none). Adherence to dietary guidelines was determined from the number of "yes" responses regarding the fulfillment of each guideline on ≥ 5 days/week. Multiple logistic regression was used to evaluate associations between newly diagnosed MetS and changes in adherence to dietary guidelines. RESULTS: In the MetS group, MetS prevalence decreased after the SMESY program (men, -41.9%p; women, -48.7%p), and all risk factors were significantly improved (P < 0.0001). All groups exhibited improved adherence to all dietary guidelines after participation (P < 0.0001). In the MetS group with positively changed adherence scores, the MetS prevalence decreased by -44.1%p for men and -49.5%p for women, whereas the prevalence in those with negative changes decreased by -38.1%p for men and -48.6%p for women. In the risk group, those with positively changed adherence scores had significantly decreased odds ratios (ORs) for newly diagnosed MetS compared with those with negative changes (OR, 0.70; 95% confidence interval [CI], 0.61-0.80 for men; OR, 0.88; 95% CI, 0.79-0.99 for women). CONCLUSIONS: The SMESY program may effectively reduce the risk of MetS among adults with risk factors by improving adherence to dietary guidelines.

Adaptation of Evidence-based Surgical Wound Care Algorithm

  • Han, Jung-Yeon;ChoiKwon, Smi
    • Journal of Korean Academy of Nursing
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    • v.41 no.6
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    • pp.768-779
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    • 2011
  • Purpose: This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. Methods: This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. Results: A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ${\leq}$.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. Conclusion: The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

The Effects of Patient Surveillance on Nurses' Adherence to Peripheral Catheter Management Guidelines (환자감시가 간호사의 말초혈관 카테터 관리지침 이행에 미치는 영향)

  • Jung, Bok-Sun;Lee, Hae-Jung
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.2
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    • pp.169-181
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    • 2009
  • Purpose: The purpose of this study was to examine the effect of patient surveillance on nurses' adherence to the guidelines on peripheral vascular catheter management. Method: A one group time series design was used. Seventy six nurses participated in the study. The data were collected from October 1 to November 4, 2008. Result: The effects of patient surveillance were significant on nurses' average adherence rates to the guidelines estimated by observers and by themselves, and the levels of nurses self recognition on the importance of the guidelines. In addition, overall occurrence rates of phlebitis tend to decrease after patients surveillance. Even though 33 nurses didn't follow the guidelines perfectly, most patients did not provide feedbacks to the nurses' non-adherence. Among the nurse participants, 36.8% answered that patient surveillance was acceptable. Conclusion: This study found that patients with peripheral catheters could positively influence nurses' adherence to the catheter management guidelines. Therefore, inviting patients in nursing activities could benefit to the quality of patients care. However, it seems essential to create an environment fostering nurses' acceptance of the patients' surveillance. Further research warrants the potential benefits of the patient's participations in nursing activities.

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Child Care in the Covid-19 Era: Operation and Tasks of Child Care Centers (코로나19 시대의 보육: 어린이집의 운영 실태와 과제)

  • Shin, Nary;Kim, Sanglim;Lee, Joo-Yeon;Song, Seung-Min;Baek, Sunjung
    • Korean Journal of Childcare and Education
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    • v.17 no.2
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    • pp.1-27
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    • 2021
  • Objective: Covid-19 is changing many aspects of child care programs. The objective of this study was to explore how the pandemic and mitigation efforts affected the experiences and practices at child care centers in the summer of 2020. Methods: Focus group interviews and mobile surveys were conducted with principals and teachers of child care centers in August and September 2020. Descriptive statistics including frequency distributions, means and standard deviations and mean differences were used to analyze the survey data with SPSS 22.0. Results: It was found that each sector of child care settings experienced different difficulties and had various needs. Young children's lack of energy, child care teachers' workload and stress, and principles' efforts to interrupt transmission of the infectious disease based on insufficient government guideline and supports were revealed as the main experiences. Conclusion/Implications: The Covid-19 pandemic has had a tandem of influences on daily life at child care centers. As policy makers consider additional guidelines or supports measures to prevent the infection and spread of Covid-19 at child care centers, long-term as well as short-term plans at various levels should be considered to meet the unique needs of child care programs.

Secondary Analysis on Ventilator-Associated Pneumonia and Pressure Injury

  • Hyun, Sookyung;Moffatt-Bruce, Susan;Newton, Cheryl;Kaewprag, Pacharmon
    • International Journal of Advanced Culture Technology
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    • v.6 no.3
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    • pp.211-215
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    • 2018
  • Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

Assessing Needs for Practical Training in Intensive Care Unit to Enhance Nursing Education: A Focus Group Interview

  • Park, Sunah;Kim, Bokyoung
    • Journal of Korean Critical Care Nursing
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    • v.17 no.2
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    • pp.55-70
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    • 2024
  • Purpose : The demand for skilled critical care nurses and the significant impact of the practice-readiness gap underscore the need for educational programs bridging nursing education and clinical practice. This would ensure safe, high-quality patient care and a stable workforce. This study aimed to explore the educational needs of critical care nurses to develop an essential nursing education program for nursing students, addressing the practice-readiness gap they may encounter as new nurses. Methods : The study espoused a qualitative approach by utilizing focus group interviews conducted in South Korea in April and May 2022. A total of 11 nurses participated in the study. Data were collected from three focus groups, each consisting of three to four nurses from intensive care units. Focus group interviews were conducted using a semi-structured questionnaire. Content analysis was performed on the interview data using thematic analysis. Ethical approval for the study was obtained from the institutional review board. Results : Nursing education programs in intensive care units should prioritize fundamental nursing competencies such as basic nursing and physical examinations. Participants' critical care nursing education needs were categorized into four main themes: holistic nursing competency, advancement of practical education, skilled communication, and systematic critical care nursing education. Conclusion : The study's findings provide valuable insights and guidelines for developing critical and intensive care nursing education programs tailored for nursing students.

Evaluation of Applications of Adaptation of the Evidence-Based Nursing Practice Guidelines Patients with Acute Stroke (급성 뇌졸중 환자 대상 근거중심 간호 가이드라인 수용개작의 적용 평가)

  • Song, So-Lee;Cho, Myoung-Sook;Kim, Ji-Hyun;Han, Yun-Kyang;Yan, Hye-Min
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.1
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    • pp.87-97
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    • 2012
  • Purpose: This study was done to evaluate nursing guidelines for patients with acute stroke, developed by adapting the guidelines of Registered Nurses Association of Ontario, Canada to clinical settings on a large scale and evaluating the effectiveness as a research study. Method: The general characteristics of the 319 patients and the effectiveness of guideline application were evaluated in terms of structure, process, and outcome using questionnaires on the guidelines application with reference to the medical records of patients with acute stroke hospitalized on a ward of the stroke center of S General Hospital in Seoul. Results: Structures as a guidance system for assessment were consistent with the recommendations. With respect to the process of the guidelines, for items on nursing assessment, improved performance was found to be statistically significant. For outcomes of the guidelines, complications occurred in 8 patients (5.3%) prior to application of the guidelines and 11 patients (6.5%) after application of the guidelines, but this result was not statistically significant (p=.841). Conclusion: The results of the study indicate that for the effectiveness of the guidelines, accessibility to the guidelines and effectiveness of quality improvement need to be evaluated, in addition to complications of a stroke.

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

  • Gu, Mee Ok;Cho, Myoung Sook;Cho, Yong Ae;Jeong, Jae Sim;Jeong, Ihn Sook;Park, Jeong Sook;Kim, Hea Jeong;Eun, Young
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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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.