• Title/Summary/Keyword: Evidence-based protocol

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Nursing Protocols of Cold Application in Different Medical Institutions in Korea (전국 의료기관의 냉 요법 실무지침 및 임상간호사의 냉 요법 실무 현황)

  • Shin, Yong Soon
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.3
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    • pp.355-365
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    • 2015
  • Purpose: The purpose of this study was to evaluate nursing protocols for superficial cryotherapy in different medical institutions. Methods: The study was conducted with a cross-sectional descriptive design. The medical institutions including general hospitals, hospitals, and geriatric hospitals were randomly selected. A total of 435 nurses from 126 institutions completed a questionnaire. Data were collected from December 2014 to June 2015. Results: Forty-two institutions (39.5%) had nursing protocol for cryotherapy. The nurses reported that durations of cold application were 2 minutes to 5 hours. Frequently used cold therapy devices in order of frequency were frozen gel packs, ice packs, and frozen IV fluid bags. There were variances in the duration of cold application according to the types of institution ($x^2=7.78$, p=.020) and nursing units ($x^2=26.42$, p<.001). In addition, intervals of cold application were different according to the nursing units (x=12.23, p=.032). There were differences in cold application instruments by regional groups (x=70.38, p<.001). Most of the nurses (95.6%) responded that national nursing protocol for superficial cryotherapy were needed. Conclusion: There were difficulties in providing consistent nursing interventions because of the practical differences and absence of evidence-based guidelines for cryotherapy. The researchers recommend that basic studies with various instruments be conducted and proper nursing protocols be developed for cryotherapy.

Protocol for management of odontogenic keratocysts considering recurrence according to treatment methods

  • Titinchi, Fadi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.5
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    • pp.358-360
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    • 2020
  • The management of odontogenic keratocysts (OKC) remains a hotly debated topic in oral and maxillofacial surgery. Despite numerous studies and systematic reviews on treatment options, there is a lack of consensus and no accepted protocol on the management of OKC. Hence, the aim of this study was to briefly summarize all large systematic reviews in the literature on the management of OKC and formulate an evidence-based management protocol. Data from five large systematic reviews were combined to calculate the mean recurrence rate for each technique. Decompression followed by enucleation along with adjuvant methods such as application of Carnoy's solution and peripheral ostectomy can result in very low recurrence and is an acceptable first line treatment. The surgical approach should be determined by lesion size, patient age, proximity to vital structures, accessibility, soft tissue/cortical perforation, and if the lesion is recurrent.

A systemic review of literature in clinical practice research for nursing students

  • Kim, Jungae
    • International Journal of Advanced Culture Technology
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    • v.10 no.3
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    • pp.39-46
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    • 2022
  • This study is an attempted content analysis study to analyze recent studies on clinical practice of nursing college students to identify problems with clinical practice and provide evidence for desirable clinical practice. For data collection, a total of 14 papers published in academic journals between 2017 and 2021 were selected. The analysis method was performed according to the systematic review reporting guidelines presented by Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) group. As a result of the analysis, two themes, Four sub-themes, and seventeen concepts were derived, and the clinical practice study of nursing college students showed the necessity of standardized clinical practice protocol regulations for nursing college students and respect for patient human rights. Based on the above research results, it is proposed to prepare a nursing and clinical practice protocol that can clearly present the role of nursing college students during clinical practice.

A Generous Cooperative Routing Protocol for Vehicle-to-Vehicle Networks

  • Li, Xiaohui;Wang, Junfeng
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.10 no.11
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    • pp.5322-5342
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    • 2016
  • In vehicle-to-vehicle (V2V) networks, where selfishness degrades node activity, countermeasures for collaboration enforcement must be provided to enable application of a sage and efficient network environment. Because vehicular networks feature both high mobility and various topologies, selfish behavior judgment and establishment of a stable routing protocol become intensely challenging. In this paper, a two-phase-based generous cooperative routing protocol (called GEC) is presented for V2V networks to provide resistance to selfishness. To detect selfish behaving vehicles, a packet forwarding watchdog and an average connection rate based on the multipath weight method are used, where evidence is gathered from different watchdogs. Then, multihop relay decisions are made using a generous cooperative algorithm based on game theory. Finally, through buffering of the multiple end-to-end paths and judicious choice of optimal cooperative routes, route maintenance phase is capable of dealing with congestion and rapidly exchanging traffic. Specifically, it is proved that the GEC is theoretically subgame perfect. Simulation results show that for V2V networks with inherently selfish nodes, the proposed method isolates uncooperative vehicles and is capable of accommodating both the mobility and congestion circumstances by facilitating information dissemination and reducing end-to-end delay.

Preventive Strategies of Ventilator Associated Pneumonia

  • Kim, Jin-A;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.42-55
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    • 2009
  • Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

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Management of complex surgical wounds of the back: identifying an evidence-based approach

  • Zolper, Elizabeth G.;Saleem, Meher A.;Kim, Kevin G.;Mishu, Mark D.;Sher, Sarah R.;Attinger, Christopher E.;Fan, Kenneth L.;Evans, Karen K.
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.599-606
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    • 2021
  • Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

A Prospective Case Series Protocol for Clinical Pathway of Carpal Tunnel Syndrome (손목터널증후군의 한의표준임상경로 임상시험 프로토콜)

  • Park, Hye-Jin;Kim, Hyun-Tae;Park, Sun-Young;Heo, In;Hwang, Man-Suk;Shin, Byung-Cheul;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.4
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    • pp.73-82
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    • 2022
  • Objectives The purpose of this study is to develop a case study protocol to complete final version of Korean medicine clinical pathway (CP) by applying Korean medicine CP based on carpal tunnel syndrome Korean medicine clinical practice guidelines developed by clinical experts to clinical field. Methods After applying previously developed CP, 10-point Likert scale questionnaires on satisfaction of CP, appropriateness and improvement on out patient department (OPD) treatments are carried out in the 2nd week of OPD treatment. An open-ended questionnaire is also carried out to ask if there is any requirement to be added or improved among CP interventions. Results Final version of CP is going to be completed based on the questionnaire, excluding articles of which average or median value is less than 5 from 10-point Likert scale. Conclusions This evidence-based case study protocol is expected to contribute development of carpal tunnel syndrome clinical pathway.

Hip and Finger Degenerative Arthritis Case Series Protocol for Applying Korean Medicine Clinical Pathway (퇴행성관절염(고관절, 수지관절염) 한의표준임상경로 적용연구 프로토콜)

  • Suzy Han;Yejin Hong;Dongwoo Nam;Jeongrok Kim;Changwoo Seon;Seojeong Ha;Minjeong Kim
    • Korean Journal of Acupuncture
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    • v.41 no.1
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    • pp.1-6
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    • 2024
  • Objectives : The aim of this study is to set out case series study protocol to complete clinical pathway (CP) of hip and finger degenerative arthritis by applying CP, based on Korean medicine clinical practice guideline developed by clinical experts, to clinical field. Methods : The treatments included Manual acupuncture, acupoint injection, electroacupuncture, laser acupuncture, cupping, moxibustion, chuna, and physiotherapy. They were conducted in the 2nd week of admission and 4th week of out patient department (OPD) days. We carried out 10-point Likert scale questionnaires on the clinical usefulness and the satisfaction of patients and staff after applying CP. Appropriateness and improvement on patients were conducted using a 10-point Likert scale. An open-ended questionnaire was also conducted to ask if there was any requirement to be added. Results : In past research studies, there were no related studies about Korean medicine CP on hip and finger degenerative arthritis. Final version of CP is going to be completed based on the questionnaire. Conclusions : This evidence-based case series study protocol is expected to contribute development of hip and finger degenerative arthritis.

Successful remission with L-CHOP for primary mediastinal B-cell lymphoma in a young Maltese dog

  • Chang, Seiyoung;Kim, Hakhyun;Kang, Ji-Houn;Kang, Byeong-Teck;Chang, Dongwoo;Na, Ki-Jeong;Yang, Mhan-Pyo
    • Journal of Biomedical and Translational Research
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    • v.19 no.4
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    • pp.140-145
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    • 2018
  • A one-year-old, intact female, Maltese dog was presented with a history of anorexia and regurgitation. Thoracic radiographs and ultrasonography scans suggested an abnormal mass in the cranial mediastinal region, and computed tomography confirmed the origin of this mass. Ultrasound-guided fine needle aspiration cytology showed the presence of intermediate to large lymphoid cells showing mitotic figures. B-cell lymphoma was confirmed by the result of a polymerase chain reaction assay for antigen receptor rearrangement, therefore the patient was diagnosed with primary mediastinal large B-cell lymphoma (PMBL). The patient underwent L-CHOP (L-asparaginase, cyclophosphamide, doxorubicin, vincristine, prednisolone)-based chemotherapy, and showed complete tumoral remission from the beginning of chemotherapy. Seventytwo weeks after the completion of chemotherapy, the patient is still alive without any evidence of metastasis or relapse. A standardized treatment protocol has yet to be established for primary mediastinal lymphoma in dogs. This case report describes the complete remission of PMBL by an L-CHOP-based chemotherapy protocol in a young Maltese. Clinicians should consider that L-CHOP based chemotherapy may be useful against PMBL in dogs.

Current Research for Complementary and Alternative Medicine for Cancer - Based on the Data of MEDLINE - (보완대체의학의 암치료 연구 현황 - MEDLINE을 중심으로 -)

  • Kwon, Chang-Hyun;Yoo, Hwa-Seung;Lee, Yeon-Weol;Cho, Chong-Kwan
    • Journal of Korean Traditional Oncology
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    • v.10 no.1
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    • pp.57-74
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    • 2005
  • Objectives : Many cancer patients use therapies promoted as literal alternative and complementary medicine to conventional medical care. So the health provider has to guide it by appropriate clinical guideline. The purpose is to indicate the international research tool of korean medical oncology for related investigators and help to make the clinical guideline for korean oncology. Method : We reviewed complementary and alternative therapies for cancer and cancer-related symptoms by searching MEDLINE, and using the name and synonyms of the therapy. Publications on complementary medicine were identified by searching the Cochrane Library. Results and Conclusion : Most complementary and alternative medicine used by cancer patients have demonstrable, important benefits, including decreased symptoms and better quality of life. We have to standardize the scientific research protocol for korean oncology and build evidence based medicine in the future.

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