• 제목/요약/키워드: Management clinical practice

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간호분야 실무지침의 수용개작 방법론에 따른 경장영양 실무지침의 개발 (Development of Nursing Practice Guidelines on Enteral Tube Feeding using the Guideline Adaptation Process)

  • 조용애;은영;구미옥;조명숙;박명화;김경숙;김정연
    • 임상간호연구
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    • 제20권2호
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    • pp.147-161
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    • 2014
  • Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

간호대학생의 아동간호학 임상실습 자가평가 분석 (Nursing Students' Self-evaluation Analysis on Pediatric Nursing Clinical Practice)

  • 이영은;박선영;최은아;김은영
    • 디지털융복합연구
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    • 제15권9호
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    • pp.355-364
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    • 2017
  • 본 연구는 아동간호학 임상실습을 경험한 간호대학생의 학습역량 성취도와 임상실습 만족도 그리고 서술형 총평의 분석을 통해 아동간호학 임상실습 학습성과 달성 전략의 기초자료를 제공하기 위하여 시도되었다. 대상자는 B광역시 K대학교의 간호학과 4학년으로 2016년 2월 24일부터 동년 6월 24일까지 아동간호학 실습을 마친 총 115명 이었다. 수집된 자료는 SPSS 18.0 프로그램 및 내용분석으로 결과를 도출하였다. 간호대학생의 학습역량 성취도와 임상실습 만족도는 높게 나타났으며 연령에 따른 학습역량 성취도는 유의한 차이가 있었다. 그리고 아동간호학 임상실습을 통해 '제한된 실습경험에 대한 아쉬움' 등을 보고하였다. 따라서 간호대학생들의 아동간호학 임상실습 학습 목표를 달성하기 위해 기술영역의 학습역량 성취도를 증진시키고, 실습기관에 대한 만족도를 향상시킬 수 있는 임상실습 전략이 필요하다고 본다.

국내 임상진료지침의 개발 현황 (An Investigation of Current Status of the Clinical Practice Guidelines in Korea)

  • 천부순;이영숙
    • 한국임상약학회지
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    • 제25권3호
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    • pp.178-186
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    • 2015
  • Objective: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. Method: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. Results: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. Conclusion: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.

한국의 지역약국에서 국제통용 우수약무기준의 약료서비스 제공을 어렵게 하는 주요 장애요인의 분석: 설문조사 연구 (The Major Barriers to Provision of Pharmaceutical Care Service in Compliance with Internationally Recognized Good Pharmacy Practice Standards in Community Pharmacies in Korea: A Questionnaire Survey)

  • 박세정;신현택
    • 한국임상약학회지
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    • 제24권4호
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    • pp.272-281
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    • 2014
  • Objective: The provision of pharmaceutical care service in compliance with good pharmacy practice (GPP) standards is important, but there is lack of studies to investigate the barriers that significantly hinder community pharmacies in Korea from adhering to the standards. This study was aimed to identify the major barriers to provision of pharmaceutical care service in compliance with the proposed pharmacy practice standards which have been developed based on the GPP standards recommended jointly by WHO and FIP. Methods: Questionnaires reviewed by the expert committee were posted for 32 days on the website which is most frequently accessed by community pharmacists. The respondents completed them by checking the scores (Max=5, Min=1) for major barriers to provision of pharmaceutical care service focusing on patient information management and drug use review process in prescription fillings. The answered scores were automatically collected using online data processing. Mean differences between scored data were assessed by ANOVA. Results: Total 321 pharmacists participated in the survey. Results indicated that 'difficulty of diagnosis identification' (m=3.92, SD=1.21), 'lack of time' (m=3.48, SD=1.22) and 'lack of updated clinical information' (m=3.17, SD=1.10) were the major barriers to provision of pharmaceutical care service in patient information management. The main barriers to drug utilization review were 'lack of time' (m=3.32, SD=1.21), 'lack of updated clinical information' (m=3.11, SD=1.17), and 'negative feedbacks or refusals from prescribers' (m=3.00, SD=1.38). There were significant differences among the groups by location, employed number of pharmacists and acceptability to the proposed GPP standards. Conclusion: Difficulties in managing patient clinical information and lack of time were found to be the major barriers in providing pharmaceutical care services in community pharmacies in Korea. Further research is recommended to determine ways to reduce these barriers in order to provide quality pharmaceutical care service that is in compliance with the internationally recognized GPP guidelines.

간호대학생의 성역할정체감에 따른 임상실습스트레스와 임상수행능력 (Nursing College Students' Clinical Practice Stress and Clinical Competence by their Gender Role Identity)

  • 박명남
    • 디지털융복합연구
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    • 제18권12호
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    • pp.401-412
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    • 2020
  • 본 연구는 간호대학생의 성역할정체감에 따른 임상실습스트레스, 임상수행능력의 차이와 관계를 파악하기 위해 시도되었다. 경남 J시의 2개 대학교 간호학과 학생 450명을 대상으로 2020년 6월 1일부터 30일까지 설문조사를 실시하였으며 최종 417명의 자료가 분석되었다. 수집된 자료는 기술통계, χ2검정, t-test, ANOVA, Scheffe 검증, 상관관계, 위계적 회귀분석으로 분석하였다. 연구결과, 간호대학생의 성역할정체감은 미분화 유형(34.3%)이 가장 많았으며 임상수행능력은 성역할정체감에 대해 유의한 차이가 있었으나(F=20.98, p<.001), 임상실습스트레스는 유의한 차이가 없었다(F=1.56, p=.199). 임상수행능력은 남성성 지수(r=.397, p<.001)와 여성성 지수(r=.325, p<.001)와는 정적 상관이 있었지만, 임상실습스트레스(r=.061, p=.217)와는 유의한 상관이 없었다. 성역할정체감은 임상수행능력에 유의한 영향요인으로 나타났다(F=6.67, p<.001). 따라서 임상실습교육 전 간호대학생의 성역할정체감을 확인하고 임상수행능력의 향상을 위한 중재가 필요할 것이다.

경력단절 간호사의 재취업교육 프로그램 개발과 운영 (The Development and Management of a Re-entry Program for Inactive Registered Nurses)

  • 정정숙;차영남;김근곤;박선영
    • 한국간호교육학회지
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    • 제14권2호
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    • pp.232-243
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    • 2008
  • Purpose: The study was aimed to suggest a model re-entry program into the job market for inactive registered nurses, based on the development and management of a program and the evaluation of its efficiency. Method: The participants in the program were 82 inactive nurses and the development and evaluation of the program followed ADDIE. To develop the program, general characteristics and demand on re-entry into the job market were investigated. Satisfaction level of the program and confidence in nursing practice were measured to evaluate it. Result: Participants were 45 years old, had 6 years' clinical experience, and had 14 inactive career years on average. The program included basic and core education courses, and a clinical course. The participants were satisfied with its management, and 80.3 percent of them agreed with the need for the program. Also, clinical sites and instructors in the clinical course were satisfactory. Participants gained high confidence in nursing practice skills. Conclusion: The study showed the goal of the program was accomplished by motivating inactive nurses for re-entry to the work force and enhancing capability in duty. The program needs standardizing, and field adaptability should be strengthened through clinical practice. An evaluation tool for the program has to be developed.

이상지질혈증의 국내 및 국외 치료 가이드라인 비교 (Current Guidelines on the Management of Dyslipidemia)

  • 최윤정;이송;김주영;이경은
    • 한국임상약학회지
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    • 제27권4호
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    • pp.276-283
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    • 2017
  • Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

병원 의사결정지원시스템의 서비스 품질이 경영성과에 미치는 영향 : K대병원 사례 중심으로 (A Study on the Effects of the Service Quality of Hospital's Decision Support System on Management Performance : the Case of K-University Hospital)

  • 박진희;권두순;이미영
    • Journal of Information Technology Applications and Management
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    • 제21권2호
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    • pp.81-98
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    • 2014
  • Recently, due to external environment like the changes in health policy and various healthcare accreditations, along with hospital's internal efforts to improve the quality of medical services, demands for the development of medical information systems are increasing. Some examples are clinical information like DUR (Drug Utilization Review), CVR (Critical Value Report), and automatic benefit processing by treatment purposes, or hospital DSS (Decision Support System) on overall medical practice. Such systems act as a guide in making clinic judgments during practice or in other medical practice, and their effects on the medical treatment improvements are being proven by previous studies. In the reality of increasing attention in the effects of medical treatment improvement, studies related to hospital DDS were mostly focused on clinical, technical, and engineering points of view, and studies focusing on the user viewpoint are very limited. In order to verify the effects of DSS on practice improvements and hospital's management performance, this study used a research model constructed to verify how SERVQUAL of hospital DSS affects hospital management performance in BSC (Balanced Score Card) point of view. To empirically verify the research model, a questionnaire was conducted on the basis of "K-University Hospital's DSS" on clinicians and hospital employees related to system development, and the relationships between the factors were analyzed through path analysis. As a result of path analysis, excluding reactivity, tangibility, confidence, reliability, empathy among service qualities, had partially significant effects on management performance factors (learning and growth, internal process, financial affairs). This study is to prepare the theoretical ground on the management performance analysis of hospital DSS, and suggest the service quality of the system that should be considered in the planning and development stages for improved system.

간호대학생의 첫 임상실습 전·후 간호역량과 전공만족도의 차이 (A comparative study Nursing competency and Major satisfaction between Nursing college students before and after their First Clinical Practice)

  • 김은재;이외선
    • 디지털융복합연구
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    • 제19권7호
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    • pp.237-243
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    • 2021
  • 본 연구는 간호대학생의 첫 임상실습 전·후 간호역량과 전공만족도의 차이를 파악하여 효율적인 임상실습 교육운영을 위한 기초자료로 활용하고자 시도되었다. 단일군 사전·사후 설계로 자료수집은 2019년 2월 18일부터 4월 23일까지 간호대학생 201명을 대상으로 8주간 임상실습 전·후 이루어졌다. 수집된 자료는 SPSS/Win 23.0을 이용하여 빈도, paried t-test, 피어슨 상관관계, 회귀분석으로 분석하였다. 연구결과 첫 임상실습 후 간호역량은 실습 전보다 증가하였으나 유의하지 않았고(t=-1.73, p=.084), 간호역량의 하위요인 중 교육능력(t=-1.97, p=.050)과 윤리적 실무능력(t=-209, p=.038)은 유의하게 증가한 것으로 나타났으며, 전공만족도는 유의하게 증가한 것으로 나타났다(t=-2.45, p=.015). 임상실습 후 전공만족도의 하위요인인 일반만족, 관계만족 및 인식만족이 간호역량과 정의 상관관계가 있는 것으로 나타났으며 간호역량에 미치는 영향을 분석한 결과 인식만족이 간호역량을 9.9%로 설명하는 것으로 나타났다. 그러므로 간호역량을 향상 시킬 수 있는 임상실습 교육과정 개편 및 전공만족도 중 인식만족을 향상 시킬 수 있는 프로그램 개발 및 효과검증이 필요하다.