• 제목/요약/키워드: Clinical evidence

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수용개작방법을 활용한 욕창간호 실무지침 개발 (Development of Pressure Ulcer Management Guideline by Adaptation Process)

  • 정인숙;김신미;정재심;홍은영;임은영;서현주;박경희;홍용은;황지현
    • 임상간호연구
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    • 제20권1호
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    • pp.40-52
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    • 2014
  • Purpose: This study was done to develop an evidence-based nursing clinical practice guideline (PU CPG) for pressure ulcer prevention and management in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by Gu et al. (2012) which consists of three main phases and 9 modules including a total of 24 steps. Results: The newly developed PU CPG included the introduction, pressure ulcers, summary of recommendations, recommendations, references, appendices, and glossary. The total number of recommendations was 148 in 4 sections (organizational policy, assessment, pressure ulcer prevention and management, and education) and 16 domains. Of the recommendations 4.7% were graded A, 16.9%, B, and 78.4%, C. Conclusion: Results indicate that this new PU CPG is an evidence-based practice guidance for pressure ulcer prevention and management and can be recommended for dissemination and utilization by nurses nationwide to improve the quality of pressure ulcer prevention and management. Regular revision is recommended.

아동의 말초정맥주사 관리를 위한 근거기반 간호 프로토콜 개발 (Development of an Evidence-Based Nursing Protocol for Management of Peripheral Catheters in Children)

  • 최희강;강미정;강현주;김은혜;방경숙
    • 임상간호연구
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    • 제22권1호
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    • pp.56-67
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    • 2016
  • Purpose: The purpose of this study was to develop an evidence-based nursing protocol for peripheral intravenous catheter management in hospitalized children. Methods: The preliminary protocol of this study was developed based on domestic and foreign guidelines, research, a survey and an analysis of medical records in a university hospital. It is a methodological research to develop evidence-based nursing protocol of peripheral intravenous catheter management verified by content validity by a group of specialists and users. Results: The specialists' verification of validity in the preparatory protocol had a CVI level of 0.94 and the propriety and conveniency of users had an average of $3.0{\pm}0.52$. The final evidence-based nursing protocol was composed of 5 areas (education, dressing and fixation, maintenance and replacement, observation and record, and coping to complication) with 46 specific recommendations. Conclusion: Based on domestic and foreign research and guidelines verified by specialists and users, the findings in this study provide a simple, applicable and evidence-based nursing protocol for peripheral intravenous catheter management in hospitalized children. By the clinical application of this protocol, nurse tasks in managing peripheral intravenous catheter can be performed with more scientific evidence and be standardized.

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

  • 박명화;김명애
    • 성인간호학회지
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    • 제17권4호
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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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한방소아과학회지에 출판된 임상연구논문에 대한 분석 (Trend Analysis of Clinical Studies Published in the Journal of Pediatrics of Korean Medicine)

  • 양두화;박장경;성현경;성수현
    • 대한한방소아과학회지
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    • 제32권4호
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    • pp.141-162
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    • 2018
  • Objectives The purpose of this study is to provide evidence of traditional Korean medicine treatment in children and adolescents by reviewing previous studies published in the journal of pediatrics of Korean medicine. Methods We have reviewed clinical studies of children and adolescents in the journal of pediatrics of Korean medicine from 2008 to 2017. Results Eighty-seven clinical studies of children and adolescents were reviewed. Total number of patients were 1644 in the studies. Among these, top 5 most commonly reported diseases in children and adolescents were atopic dermatitis, growth, autism, juvenile idiopathic arthritis and obesity. The most common intervention to treat those was taking herbal medicine. Most of the clinical studies showed effectiveness of this approach in treating children and adolescents. Conclusions More double-blinded randomized controlled clinical trials of Korean medicine interventions treating children and adolescents are needed to establish evidence-based treatment.

급성 허혈성 뇌졸중에서 항혈전제 치료의 최신 가이드라인 개정과 근거에 대한 고찰 (Review of Updated Guidelines and Evidence for Antithrombotic Therapy in Acute Ischemic Stroke)

  • 백수희
    • 한국임상약학회지
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    • 제34권2호
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    • pp.79-99
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    • 2024
  • Background: There was an important revision of the Korean Clinical Practice Guideline for Stroke (KCPGS) for antithrombotic therapy in patients with acute ischemic stroke in 2022. This review is to provide an updated information in this revision. Methods: The revision history by year after the first announcement was examined for each topic, focusing on antithrombotic therapy during acute phase which was revised in 2022. We compared before and after the revision, and investigated the clinical outcomes presented as evidence. It was also compared with the current U.S. guidelines. Results: The major changes about antiplatelet therapy are a clause stating that dual antiplatelet therapy with clopidogrel and aspirin initiated within 24 hours from the stroke onset and maintained for up to 21-30 days is recommended as an acute treatment, as well as the clause that antithrombotic therapy may be initiated within 24 hours after intravenous thrombolytics and that the use of glycoprotein IIb/IIIa receptor antagonists can be considered in highly selected patients as rescue therapy taking into account of benefit and risk. The change to the use of anticoagulants is that it may be reasonable to start oral anticoagulant between 4 and 14 days after stroke onset for patients with acute ischemic stroke and atrial fibrillation. Conclusions: It will be helpful in improving health outcomes for clinical pharmacists to be aware of the latest information for antithrombotic therapy and to actively use it in pharmaceutical care of stroke patients.

Pectorobrachioepicondylaris musculoaponeurotic band: case description with evidence of median nerve compression

  • Ana Carrera;Arada Chaiyamoon;Francisco Reina;Joe Iwanaga;Aida Cateura;Miguel Angel Reina;Jose Ramon Sanudo;R. Shane Tubbs
    • Anatomy and Cell Biology
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    • 제56권2호
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    • pp.280-284
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    • 2023
  • Upper limb muscle variations can be encountered on imaging or at surgery. We report an unusual muscle and band found during routine dissection of the arm in a cadaver. This case is described and salient literature reviewed. A band was found that traveled from the insertion of the pectoralis major tendon distally and obliquely toward the medial intermuscular septum and medical epicondyle. Fibers of the brachialis were found to interdigitate into the band. A tunnel was formed that carried the median nerve and brachial vessels. Evidence of median nerve compression was observed. We considered this an example of a pectorobrachioepicondylaris muscle. However, some can lead to clinical presentations. Although the significance of the case reported herein is not certain, signs of median nerve compression were identified. We believe that the term pectorobrachioepicondylaris bests describes the muscle reported herein and that our case represents a previously unreported variant of this muscle.

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

  • 이지은;박명화
    • 성인간호학회지
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    • 제23권3호
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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.

근거기반 욕창간호 실무지침 개정 (Updates of Evidence-Based Nursing Practice Guidelines for Pressure Injury)

  • 김정윤;박경희;박옥경;박주희;이윤진;황지현
    • 임상간호연구
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    • 제29권1호
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    • pp.12-23
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    • 2023
  • Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.

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

  • 박명화
    • 성인간호학회지
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    • 제17권3호
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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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Rhinovirus and childhood asthma: an update

  • Song, Dae Jin
    • Clinical and Experimental Pediatrics
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    • 제59권11호
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    • pp.432-439
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    • 2016
  • Asthma is recognized as a complex disease resulting from interactions between multiple genetic and environmental factors. Accumulating evidence suggests that respiratory viral infections in early life constitute a major environmental risk factor for the development of childhood asthma. Respiratory viral infections have also been recognized as the most common cause of asthma exacerbation. The advent of molecular diagnostics to detect respiratory viruses has provided new insights into the role of human rhinovirus (HRV) infections in the pathogenesis of asthma. However, it is still unclear whether HRV infections cause asthma or if wheezing with HRV infection is simply a predictor of childhood asthma. Recent clinical and experimental studies have identified plausible pathways by which HRV infection could cause asthma, particularly in a susceptible host, and exacerbate disease. Airway epithelial cells, the primary site of infection and replication of HRV, play a key role in these processes. Details regarding the role of genetic factors, including ORMDL3, are beginning to emerge. This review discusses recent clinical and experimental evidence for the role of HRV infection in the development and exacerbation of childhood asthma and the potential underlying mechanisms that have been proposed.