• Title/Summary/Keyword: Clinical Practice Guidelines

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

  • Lim, Kyung Choon;Jeong, Jae Sim;Kim, Kyeong Sug;Kim, Hyun Lim;Kim, Hyun Jeong;Kim, Dong Yeon;Lee, Mi Jeong;Lee, Joohyun
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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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.

The Need for Clinical Practice Guidelines in Usage of Mahuang in Weight Loss (마황의 안전성에 대한 논란과 비만 치료에 있어서 마황 사용 지침의 필요성)

  • Jang, In-Soo;Yang, Chang-Sop;Hwang, Eui-Hyoung
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.1
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    • pp.23-29
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    • 2007
  • Background : Mahuang (Ephedra sinica) has been used widely to treat respiratory disease in traditional medicine for over thousands years. Mahuang preparations contain approximately $0.75{\sim}1%$ ephedrine alkaloids. Recently in North America, the Eephedra alkaloids has aroused a controversy due to its adverse effects in those using whole extracts as "dietary supplements" for weight loss or athletic performance enhancement. Objective : To discuss the need for clinical practice guidelines on the use of Mahuang. Results and Conclusion : It is widely assumed that Mahuang is one of the useful medicines and is safe for human body. Most of scientific literatures support that the safety of Mahuang prescription in common dosage. However, it has been claimed that there were some warnings and apprehensions about the harmfulness of Mahuang as dietary supplements. This article does not negate the fact that it is necessary to pay more attention for use of Mahuang in clinical situations. We assert that the establishment of clinical practice guideline on the use of Mahuang, which is based on scientific materials and consensus, is required in traditional medicine.

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Diagnosis and Management of Acute Otitis Media and Otitis Media With Effusion (급성 중이염과 삼출성 중이염의 진단과 치료)

  • Jang, Seong Hee
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1283-1294
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    • 2005
  • The American Academy of Pediatrics and American Academy of Family Physicians developed the clinical practice guideline on the management of acute otitis media. The American Academy of Pediatrics, American Academy of Family Physicians, and American Academy of Otolaryngology-Head and Neck Surgery developed the clinical practice guideline on the diagnosis and management of otitis media with effusion. These two guidelines provide evidence-based recommendations.

Clinical Practice Guidelines for Hepatocellular Carcinoma: Current and Future Perspectives (간암 진료가이드라인의 현재와 전망)

  • Bo Hyun Kim;Joong-Won Park
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.21-28
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    • 2016
  • Hepatocellular carcinoma (HCC) is rather unique. Most of HCC patients have underlying chronic liver diseases with or without cirrhosis and the prognosis of HCC depends on the liver function, as well as the tumor extent. Non-invasive diagnosis of HCC can be made with certain risk factors and specific imaging findings (e.g. hypervascularity). Patients with HCC can receive surgical resection, radiotherapy, and systemic chemotherapy as other solid malignancies. HCC has more treatment options such as liver transplantation, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). A variety of practice guidelines for HCC has been published by many academic societies. Different healthcare systems and availability of resources also affect the practice guidelines; therefore, practice guidelines have similarities and dissimilarities. Herein, we review the current status of practice guidelines for HCC and future perspectives for the improvement of guidelines are also discussed.

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Clinical Year in Review 2014: Critical Care Medicine

  • Lee, Jeong Moon;Lee, Heung Bum
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.1
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    • pp.6-12
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    • 2014
  • Severe sepsis is the most common cause of death among critically ill patients in non-coronary intensive care units. In 2002, the guideline titled "Surviving Sepsis Campaign" was published by American and European Critical Care Medicine to decrease the mortality of severe sepsis and septic shock patients, which has been the basis of the treatment for those patients. After the first revised guidelines were published on 2008, the most current version was published in 2013 based on the updated literature of until fall 2012. Other important revised guidelines in critical care field such as 'Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit' were revised in 2013. This article will review the revised guidelines and several additional interesting published papers of until March 2014, including the part of ventilator-induced lung injury and the preventive strategies.

A Study on Clinical Status for Development of Clinical Practice Guidelines for Sasang Constitutional Medicine Symptomatology (사상체질병증 임상진료지침 개발을 위한 임상 현황 조사연구)

  • Cho, IL-Hyun;Kwon, Jin-Hyeok;Lee, Eui-Ju;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.4
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    • pp.29-44
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    • 2020
  • Objectives We surveyed clinical status of Sasang Constitutional Medicine (SCM) for preparation of adaptation of Clinical Practice Guidelines for Sasang Constitutional Symptomatology. Methods We emailed Google survey form to Doctors of Korean Medicine registered the Association of Korean Medicine on 10/13/2020 and 10/21/2020 and closed survey 10/23/2020. We got a data of 654 cases, removed a case of error, analyzed data of 620 responses by frequency analysis Results and Conclusions Out of 620 respondents, 499 have answered that they refer to or make use of SCM. SCM is mainly applied in the field of treatments using Herbal Medicine. Doctors of Korean Medicine participated in survey of SCM, they think Diseases of digestive system are the most effectively treated by the methods of SCM. Sasang Constitutional Symptomatology most frequently observed are Soeumin Congestive Hyperpsychotic symptomatology, Soyangin Chest-Heat congested Symptomatology, Taeeumin Liver Heat-based Interior Heat disease. The diseases that are mainly applied by SCM are 'Diseases of digestive system' for Soeumin, 'Diseases of digestive system' for Soyangin, 'Diseases of respiratory system' for Taeeumin and 'not applicable' for Taeyangin. The important diagnostic methods of SCM are Inspection-listening and smelling examination-Inquiry-Palpation and survey. In the majority of cases, Prescription of Herbal medicine is used by adding or subtracting some herbal medicine from the original prescription suggested in the oriental medical classics and Saam acupuncture method is the most frequently used for the acupuncture therapy. Diet therapy is the most frequently used for the method of prevention and care.

Review of the Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition (2017 과민성장증후군의 임상진료지침 개정안 소개)

  • Jung, Hye-Kyung
    • The Korean Journal of Gastroenterology
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    • v.72 no.5
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    • pp.252-257
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    • 2018
  • This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS.

Good Clinical Practice in Neonatal Clinical Research (신생아 임상연구에서의 Good Clinical Practice)

  • Park, Min-Soo
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.119-122
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    • 2008
  • Clinical research is a necessity, not an option, for developing better and new medicines and therapeutic modalities. But in the course of clinical research, there are rules and guidelines that should be followed to ensure the due respect for persons, beneficence, and justice for persons who voluntarily participate in the research as described in the Belmont Report. Good Clinical Practice (GCP) is an "international scientific and ethical quality standard for designing, conducting, recording, and reporting" clinical trials. The main purposes of GCP would be to protect rights, safety, and well-being of trial subjects, in compliance with the principles of Declaration of Helsinki, and to assure that the data obtained from clinical trials are credible. In order to achieve these, investigators must be fully aware of the meanings as well as actual procedures involved in the research and should make the best effort to comply with GCP. For those individuals who belong to vulnerable populations, such as neonates, in addition to the general principles of GCP, further measures to ensure added protection should be implemented. It is our duty to develop and provide better care through clinical research even for neonates. But in doing so, we have to make sure that the importance of protecting the rights, safety, and well-being of the subjects supersede the interests of science and society.