• Title/Summary/Keyword: Clinical evidence

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Effects of Critical Thinking Disposition, Digital Literacy, and Nursing Informatics Competence on the Competency in Evidence-Based Practice among Clinical Nurses (간호사의 비판적 사고성향, 디지털리터러시, 간호정보역량이 근거기반실무역량에 미치는 영향)

  • Park, Sang Un;Choi, So Young
    • Journal of Korean Clinical Nursing Research
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    • v.30 no.1
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    • pp.1-10
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    • 2024
  • Purpose: This study aimed to investigate the competency in evidence-based practice, critical thinking disposition, digital literacy, and nursing informatics competence, and to identify the factors influencing the competency in evidence-based practice among nurses. Methods: The participants in this study were 196 nurses from a university hospital in J-city. Data were collected from December 1 to December 30, 2023. The collected data were analyzed with the SPSS 26.0 program using descriptive statistics, independent t-test, one-way analysis of variance, Scheffé test, Pearson's correlation coefficients, and multiple regression analysis. Results: The results showed that the factors influencing the competency in evidence-based practice included nursing informatics competence, critical thinking disposition, digital literacy, and having a master's degree. The participants with a master's degree demonstrated higher competency in evidence-based practice compared to those with a three-year degree or a four-year degree, and a total explanatory power was 53.1%. Conclusion: In this study, critical thinking disposition, digital literacy, and nursing informatics competence were influential factors in competency of evidence-based practice. Therefore, a variety of intervention programs should be developed to enhance the impact of these factors on nurses' competency in evidence-based practice.

Evidence-based Pharmaceutical Policy-making; A Challenging Task? Vivid Voices from Korean Experts (근거중심 의약품 정책 결정; 극복하기 어려운 과제인가? 한국 전문가의 생생한 의견)

  • Lee, Iyn-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.3
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    • pp.185-196
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    • 2013
  • This study aims to explore the difficulties of evidence-based pharmaceutical policy-making in the Korean context where several pharmaceutical policies were introduced within a short period. Semi-structured in-depth interviews were performed with eight experts in the Korean pharmaceutical arena. The key challenge in Korean situation might be the apparent lack of available evidence caused by the limited resources, the lack of policy consistency and coordination ability in the authorities and distrust across stakeholders. To build an evidence-based tradition, it is essential to resolve the tangible lack. At once, more fundamental changes seem to be required in the intangible policy environments.

Development and Evaluation of an Evidence-based Nursing Protocol for Postoperative Nausea and Vomiting (근거기반의 수술 후 오심·구토 관리 프로토콜의 개발 및 임상적 평가)

  • Oh, In Ohg;Yoo, Jae Yong;Oh, Eui Geum
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.86-97
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    • 2017
  • Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

Suggestions for developing Korean Medicine Clinical Practice Guideline for Allergic Rhinitis - Based on 2018 Chinese Clinical Practice Guideline (알레르기 비염 한의표준임상진료지침 방향 제언 - 2018 중국 임상진료지침을 바탕으로)

  • Kang, Jeong-In;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.4
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    • pp.130-140
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    • 2019
  • Objective : The purpose of this study is to examine the treatment of allergic rhinitis introduced in the Chinese guideline, and to find out the direction of evidence-establishment and applicability in developing Korean Medicine clinical practice guideline for allergic rhinitis. Method : We studied Traditional Chinese Medicine treatment of allergic rhinitis introduced in the 2018 Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. The treatment are classified into three categories; herbal medicines, acupuncture and the others. And we compared this guidelines with other guidelines for how they differ in description of the database, evidence of level, and strength of recommendation. Results : Herbal medicines are presented based on syndrome differentiation. The basic acupoints for allergic rhinitis are introduced as follows; Fengchi(GB20), Yingxiang(LI20), Feishu(BL13) and Taiyuan(LU9). And in comparison with other guidelines for allergic rhinitis, the Chinese guideline showed lack of description in the database, evidence of level, and strength of recommendation, though they used evidence-based models. Conclusions : Clinical practice guideline projects are also underway in Korea for benefit expansion and improving quality of medical services. It is important to develop guidelines which should be evidence-based and reflect Korean medical environment.

Structural Model of Evidence-Based Practice Implementation among Clinical Nurses (임상간호사의 근거기반실무 실행 구조모형)

  • Park, Hyunyoung;Jang, Keum Seong
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.697-709
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    • 2016
  • Purpose: This study was conducted to develop and test a structural model of evidence-based practice (EBP) implementation among clinical nurses. The model was based on Melnyk and Fineout-Overholt's Advancing Research and Clinical Practice through Close Collaboration model and Rogers' Diffusion of Innovations theory. Methods: Participants were 410 nurses recruited from ten different tertiary hospitals in Korea. A structured self-report questionnaire was used to assess EBP knowledge/skills, EBP beliefs, EBP attitudes, organizational culture & readiness for EBP, dimensions of a learning organization and organizational innovativeness. Collected data were analyzed using SPSS/WINdows 20.0 and AMOS 20.0 program. Results: The modified research model provided a reasonable fit to the data. Clinical nurses' EBP knowledge/skills, EBP beliefs, and the organizational culture & readiness for EBP had statistically significant positive effects on the implementation of EBP. The impact of EBP attitudes was not significant. The dimensions of the learning organization and organizational innovativeness showed statistically significant negative effects on EBP implementation. These variables explained 32.8% of the variance of EBP implementation among clinical nurses. Conclusion: The findings suggest that not only individual nurses' knowledge/skills of and beliefs about EBP but organizational EBP culture should be strengthened to promote clinical nurses' EBP implementation.

Korean Clinical Practice Guideline for the Treatment of Depressive Disorder(II) (한국형 우울증 임상진료지침 개발(II))

  • Kang, Rhee-Hun;Kim, Soo-Young;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.219-225
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    • 2006
  • Depression has been causing huge direct and indirect losses to people's health because of its high prevalence, various clinical patterns, drug reaction and diverse courses different among individuals, but its treatment has not been systematic but dependent on individual clinicians' experience and knowledge. To correct this problem, it has been highly necessary to develop clinical guidelines defined as "systematically developed statements to assist practitioners' and patients' decisions about appropriate healthcare for specific clinical circumstances." Currently, countries throughout the world are making efforts to establish evidence-based guidelines among different levels of guidelines and to evaluate and test them. Although such efforts have been unsatisfactory in Korea because of several constraints including lack of high-quality RCT, the Korean Depression Clinical Practice Guideline has started to develop evidence-based guidelines, which are established through strictly designed processes. Thus, the present study purposed to review methods adopted in the development processes and to present the processes of developing the evidence-based guidelines clearly and transparently.

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Panax ginseng: An Overview of the Clinical Evidence

  • Ernst, Edzard
    • Journal of Ginseng Research
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    • v.34 no.4
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    • pp.259-263
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    • 2010
  • This overview is focused on Panax ginseng, one of the most commonly used herbal remedies. The currently available data regarding its clinical efficacy is somewhat confusing, despite the fact that many clinical trials and systematic reviews have been published. The risks of Panax ginseng seem to be only minor. Numerous mechanisms of action have been described. Future studies of this fascinating herbal remedy seem warranted but they should overcome the methodological limitations of the previous research.

Clinical Practice Guideline for acupuncture in Post-stroke urinary retention (뇌졸중후 요저류에 대한 침치료 임상진료지침)

  • Lee, Ji-Won;Lee, Eui-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Lim, Sung-Min;Cho, Chung-Sik;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.37 no.1
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    • pp.1-9
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    • 2016
  • Objectives: Objectives : This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with Post-stroke Urinary Retention; PSUR. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUR compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: 4 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUR. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as SP6, CV3, CV6, CV4, SP9, BL28, BL23, BL22, KI3 or BL67, for 15-30 minutes. 20-140Hz frequency and 10-20 minutes of treatment is suggested if electro-acupuncture treatment is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for PSUR.

Complementary and Alternative Medicine in Clinical Practice Guideline for Insomnia

  • Kwon, Chang-Young;Suh, Hyo-Weon;Choi, Eun-Ji;Chung, Sun-Yong;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.235-248
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    • 2016
  • Objectives: The aim of this review was to investigate whether evidence of complementary and alternative medicine (CAM) was reflected in clinical practice guidelines (CPGs) for insomnia based on relevant clinical trials. Methods: We conducted a systematic search on domestic and international CPG databases and medical databases. In addition, we conducted manual searches of relevant articles. Three authors independently searched and selected relevant studies; any disagreement was resolved by discussion. We extracted and analyzed the following data: published language, country, development group, participants, interventions, presence or absence of recommendations for CAM, level of evidence, grade of recommendation for CAM, and methods of development. Results: We identified 8,241 records from domestic and international databases, and 22 CPGs were included. Eleven of the 22 CPGs mentioned CAM interventions including herbal medicine, relaxation, acupuncture moxibustion, Tai Chi, meditation, hypnosis, biofeedback, Tuina, and external herbal medicine. However, most of the CPGs indicated 'no recommendation' or 'weak recommendation' for CAM interventions. Only Valeriana dageletiana Nakai and relaxation were considered to have experimental evidence. Valeriana dageletiana Nakai was recommended for improvement of sleep latency, sleep maintenance, total sleeping time, and sleep cycle. Relaxation was recommended as effective intervention for relieving physical and psychological arousal. Conclusions: Despite systematic reviews and randomized controlled trials on CAM for insomnia, most of the CPGs for insomnia did not reflect the evidence obtained. Further CPGs for insomnia should be developed by considering the current advanced studies in the field of CAM.

Using evidence-based medicine in terms of practical insurance medicine (보험의학 실무 영역에서 근거중심의학적 접근 방법)

  • Lee, Sinhyung
    • The Journal of the Korean life insurance medical association
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    • v.32 no.1
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    • pp.8-14
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    • 2013
  • Evidence-based medicine(EBM) or evidence-based health care has been used in clinical medicine. Recently, it also has been applied to areas of social medicine such as independent medical examination. Insurance medicine is one of social medicine, as for it's role is maintenance of sound insurance system or for insured of life insurance. Practical application of EBM to the insurance medicine are; confirming question, finding evidence, and evaluation that selected evidence is best or not in terms of practical aspect.

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