• The Journal of Korean Medicine
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• v.39 no.4
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• pp.30-39
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• 2018

Introduction: The aim of this study protocol is to share and disclose the methodology used to develop an evidence-based clinical practice guideline (CPG) of therapeutic interventions used in Korean medicine for patients with stroke. Methods: The CPG development process will consist of two phases. In phase I, a development committee will be established, and they will decide the key questions to be answered. A systematic review and meta-analysis will be performed to answer these key questions by searching relevant randomized controlled trials and systematic reviews. Draft recommendations will be developed according to the evidence level and recommendation grades primarily determined using the GRADE methodology. Panels comprised of external experts will be formed, and surveys and a face-to-face meeting will be conducted to reach a consensus on the recommendations. A preliminary guideline will be created after final review by the development committee. In phase II, we will conduct clinical trials and economic analysis to supplement the lack of evidence found in the phase I. Conclusion: The CPG is expected to help doctors practicing Korean medicine in clinics or hospitals with making decisions based on the most reliable evidence, ultimately leading to the provision of optimal care for patients with stroke.

• Journal of Korean Academy of Nursing
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• v.45 no.3
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• pp.357-366
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• 2015

Purpose: This study was done to develop an evidence-based incontinence care protocol through an adaptation process and to evaluate the effects of the protocol. Methods: The protocol was developed according to the guideline of adaptation. A non-randomized controlled trial was used for testing the effects of the new Incontinence Care Protocol. A total of 120 patients having bowel incontinence with Bristol stool type 5, 6, and 7 and admitted to intensive care units were recruited to this study. The newly developed incontinence care protocol was used with patients in the experimental group and conventional skin care was given to patients in the control group. Outcome variables were incontinence-associated dermatitis (IAD) severity, pressure ulcer occurrence and severity. Results: The experimental group had significantly less severe IAD (t=6.69, p <.001), lower occurrence of pressure ulcers (${\chi}^2=7.35$, p =.007), and less severity of pressure ulcers (Mann-Whitney=86.00, p =.009) than the control group. Conclusion: Use of this incontinence care protocol has the effects of preventing pressure ulcers and inhibiting worsening of IAD and pressure ulcers. Therefore, this incontinence care protocol is expected to contribute to managing IAD and pressure ulcers.

• Journal of Korean Critical Care Nursing
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• v.2 no.2
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• pp.5-17
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• 2009

Purpose: The purpose of this study was to investigate the current humidification state of incubator, the factors disturbing high humidification and to establish the evidence-based nursing protocol to maintain it. Methods: The subjects were 15 infants who were born with extremely low birth weight (ELBW) from May to October, 2007, and data were collected during the first 3 days and analyzed with SPSS WIN program. Results: The goal of humidity level in incubator was 95%, but mean humidity levels were 89.7%(1st day), 91.9%(2nd day), and 91.8%(3rd day)(p<0.001). The disturbing factors were opening frequency and duration of incubator door and window by caregivers. The handling of infants by nurses and doctors happened more frequently during the first day. Especially, nurses handled them more often than others, but the duration of opening during the invasive procedures by doctors was longer than others. The opening frequency had negative correlation with duration(r=-.779, p<.01). Conclusion: So the evidence-based protocol for maintaining high humidity in incubator for ELBW infants during the first 3 days and next 2 days was made. Furthermore we need to educate NICU nurses and doctors about minimal handling.

• Korean Journal of Exercise Nutrition
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• v.23 no.3
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• pp.29-38
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• 2019

[Purpose] Effective nutritional intervention can help reduce the risk of nutritional problems and improve athletic performance in adolescents. The five A's (assess, advise, agree, assist, and arrange) model is widely used as the theoretical framework for advice on nutrition, smoking, drinking, and physical activity and it recommends that practitioners in primary health care promote behavior change to facilitate positive outcomes. This model has also been useful in understanding the underlying processes of behavior change. This study aimed to develop both a novel evidence-based nutritional intervention protocol, rooted in sound nutritional theory, and a customizable nutritional intervention program to support sustainable healthy eating, enhance nutrient intake, and improve athletic performance in adolescent athletes. [Methods] In this study, we adapted the 5 A's behavioral change model and motivational interview to develop a theoretical framework to help adolescent athletes change their behavior and achieve their goals. [Results] During each step of the 5 A's protocol, a customized nutritional intervention protocol was developed by nutrition experts for each of adolescent athletes. Each plan was developed to improve the eating habits of adolescent athletes through group education and counseling. All nutritional counseling sessions were designed to enable participants to apply nutritional knowledge and practical action plans to their training and competition conditions to enable each of them to achieve individual athletic goals and facilitate self-management. [Conclusion] A theoretical and evidence-based nutritional intervention protocol was developed to identify and address obstacles to healthy dietary habits in adolescent athletes. This could be used as the basis for further studies aimed at improving nutrient intake and athletic performance in adolescent athletes.

• Journal of Korean Clinical Nursing Research
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• v.24 no.3
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• pp.356-362
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• 2018

Purpose: This study was a retrospective cohort study to evaluate the effect of evidence-based guidelines for catheter dysfunction among hemodialysis patients, Success rate and bleeding complications in catheterization were examined. Methods: We performed a retrospective cohort study, including 94 patients with catheter dysfunction who were receiving hemodialysis at a university hospital; 55 in the control group and 39 in the protocol group. This protocol was composed of the catheter dysfunction assessment, conservative management of catheter dysfunction, drug management of catheter dysfunction, catheter function test and maintenance management. Data were analyzed with a Chi-square test and t-test using SPSS/WIN 23.0 program. Results: The patency rate of the protocol group was significantly higher than that of the control group. The rate of bleeding complications was not statistically significant for either the control group or the protocol group before or after application. Conclusion: The application of the guidelines effectively increased the patency rate of the catheter without bleeding complications. It is hoped that this guideline can be disseminated to nurses nationwide to improve the efficiency of catheter function for hemodialysis patients.

• Korean Journal of Adult Nursing
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• v.24 no.1
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• pp.20-30
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• 2012

Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

• Perspectives in Nursing Science
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• v.8 no.2
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• pp.129-138
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• 2011

Purpose: The purpose of this study was to identify the current status of evidence-based research, education, and practice, and to suggest a directions for the future development of evidence-based nursing. Methods: To examine the current status of evidence-based nursing research, experimental research among studies published in the Journal of Korean Academy of Nursing from 2008 to 2010 were analyzed. We suggested a direction for the future development of evidence-based research based on the analysis and literature reviews. We also suggested a direction for the future development of evidence-based education and practice based on literature reviews. Results: The results showed that designs and methods of studies were insufficient to use evidences derived from the studies in terms of evidence-based research, and experimental studies consistent with themes were found to be deficient. In the future, the methods and rationale for the design of experimental studies need to be clearer In addition, a test for intervention effects through repetitive studies and a connection between the intervention effects and a protocol for clinical practice will be required. In terms of evidence-based education, curriculum revision and development of teaching methods including contents related to evidence-based practice and research methodology in undergraduate and graduate programs will be required. Evidence-based practice in Korea was less actively done than with that of foreign countries. Some large hospitals have recently attempted systemic activities to promote evidence-based nursing practice in clinical settings. To activate evidence-based practice, the perception of nurses for evidence-based practice needs to be changed and support for education and administration of the program is required. Also, evidence-based practice guidelines, protocols, and assessment tools need to be developed. Conclusion: Evidence-based nursing in Korea is in the process of evolving. To realize evidence-based nursing, we need to develop nursing science based on evidences of closer communication and cooperation in terms of nursing research, education, and practice.

• Journal of Korean Critical Care Nursing
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• v.4 no.2
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• pp.47-60
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• 2011

Purpose: The purpose of this study was to develop a standardized education protocol for peritoneal dialysis patients. Methods: First, the demand for education was investigated from the 27 patients on peritoneal dialysis and 16 guardians, and later, the standardized nursing education protocol has been developed through the comprehensive literature review and the critical analysis of the related studies. Contents validity and applicability have been tested through the expert group survey. Results: The standardized peritoneal dialysis nursing education protocol with 9 areas and 20 items has been developed. The content validity for timing and duration, contents, method, and place of education proposed by the protocol were all above than 0.8. In terms of the applicability of the protocol, the experts scored between 4.20 to 4.93 for all items except one. The item on home visit education acquired the lowest applicability score, because there might exist potential restrictions in visiting patient's home. Conclusion: The standardized education protocol developed in this study turned out to be adequate by representing high content validity for all items and the applicability also was high except the item on home visit education. Further researches to test the effects of this education protocol should be done.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.4
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• pp.203-213
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• 2023

Objectives This study aimed to develop a Korean medicine (KM) clinical practice guideline for myofascial pain syndrome (MPS) via the collaboration of clinical and methodological experts. Methods The study will include an initial survey to establish a common understanding of MPS. To develop the clinical guideline, a multidisciplinary development group was formed. The group will finalize the clinical questions based on a preliminary draft. The GRADE methodology is going to be applied to determine the level of evidence and grading of the recommendations. Finally, approval from the relevant medical societies will be obtained. Results A protocol for developing a KM clinical guideline for MPS was presented. Before finalizing the clinical key questions, a literature search was conducted according to the protocol, and a draft of 19 clinical key questions was established. Conclusions An evidence-based KM clinical guideline for MPS is expected to contribute to the management of MPS. This may also serve as a reference for the development of other KM clinical practice guidelines in the future.

• The Korean Journal of Emergency Medical Services
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• v.27 no.2
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• pp.79-89
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• 2023

Purpose: This study aimed to develop a standardized protocol of systematic and explicit roles and procedures for paramedics for the maternal and newborn management during prehospital emergency delivery situations. Methods: This study is a methodological study with detailed step-by-step items proposed by an expert group based on evidence from a literature review. The content validity of the proposed preliminary prehospital emergency delivery protocol was verified before the final protocol was confirmed. Results: All 23 detailed items of the preliminary protocol met the reference cut-off (CVI value of 0.8 or higher). After considering, revising, and supplementing expert opinions for each of the 23 items 23 detailed in the proposed protocols, four steps were confirmed. The steps included five items for the management of the imminent mother, 10 items for delivery progress, five items for newborn management, and three items for postpartum management of the mother. Conclusion: This study's findings may serve as reference for developing future specialized training programs for paramedics, to ensure enhanced competence in prehospital emergency delivery situations. The protocol should be reviewed and revised periodically to ensure currency.