• Korean Journal of Adult Nursing
• /
• v.25 no.3
• /
• pp.250-262
• /
• 2013

Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

• Journal of muscle and joint health
• /
• v.20 no.1
• /
• pp.31-42
• /
• 2013

Purpose: The purpose of this study was to develop an evidence-based dysphagia nursing care protocol for nursing home (NH) residents in Korea. Methods: The protocol was developed based on international guidelines and literatures. After testing content validity by experts, the protocol was applied to the intervention group (n=35) for 4 weeks at one NH in December, 2011, whereas the control group (n=34) received routine care. Results: The protocol was composed of one-page algorithm and detailed guidelines. Algorithm pathway was organized in 3 parts, including screening dysphagia risk, grouping by dysphagia risk level, and assigning nursing care into each group. The nursing care included positioning, oral care, meal time care, diet modification, providing exercise and maneuver, and checking dysphagia signs and symptoms. The experts verified the content validity. Protocol was revised to fit NH practice after the participant observation. Clinical validity was established upon evaluating usefulness, appropriateness, and convenience of the protocol by NH nurses. Dysphagia risk of the intervention group was significantly decreased. Conclusion: Developed protocol will improve the quality of dysphagia care in nursing homes as it can serve as a consistent and integrated standard for nursing care of residents with dysphagia.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.14 no.1
• /
• pp.29-43
• /
• 2007

Purpose: This study was done to develop a pain management protocol for nursing home patients with dementia and to examine effects of the protocol on pain assessments and interventions by the nurses and on pain relief signs in the patients. Method: The six steps in the protocol development and the examination of effect are outlined. Three rounds using the Delphi technique and one group pretest-posttest design experiment were developed. Design issues, such as sample selection and sample size, are addressed in relation to the study protocol. Results: After implementation of the pain management protocol, there were significant changes nursing actions including frequency of number of physical examinations, utilization of pain assessment tools, and request to doctors for discomfort management and there were significant changes in frequency in the number of verbal and physical expressions of pain, and emotional patterns. Conclusion: This is the first pain management protocol for patients with dementia in Korea. However, more study will be needed to determine the methodological strength and necessary revisions for the protocol.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.20 no.4
• /
• pp.345-358
• /
• 2013

Purpose: The purpose of this study was to develop a protocol that would help prevent accidents, apply physical restraints properly, and reduce the use of physical restraints in nursing homes. Method: A review of the literature and analysis of existing statutes and regulations were used to develop the preliminary protocol. To test the validity of this preliminary protocol, ten experts were selected from academia and clinical practice to review the protocol. The initial protocol was finalized after it had been reviewed by experts and tested for clinical validity in five different nursing homes. Result: The protocol consists of objectives, definitions and accident probability assessment, principle of using physical restraints, monitoring and documentation of physical restraints. Conclusion: The findings of this study can be used as guidelines to focus on preventing accidents arising out of use of physical restraints, assessing the probability of accidents, and reducing the use of physical restraints through preventive interventions. This will be helpful to prevent ethical, physical, or psychological problems arising from use of physical restraints and to protect the rights of elderly people in nursing homes.

• The Korean Journal of Rehabilitation Nursing
• /
• v.19 no.2
• /
• pp.118-127
• /
• 2016

Purpose: This study was to develop an evidence-based clinical practice protocol of physical restraints by adaptation process for patients with a geriatric hospital. Methods: Protocol adaptation process was conducted in accordance with manual for guideline adaptation version 1.0 by ADAPTE collaboration. Results: The adapted physical restraint protocol was consisted of 3 domains and 37 recommendations. The number of recommendations in each domain were: 7 nursing assessment, 19 nursing intervention, and 11 nursing evaluation. More than half (56.8%) of the recommendations were rated as grade B, 37.8% as grade C, and 5.4% were rated as grade D. Conclusion: The adapted physical restraint protocol is expected to contribute as an evidence-based clinical practice protocol for healthcare workers in geriatric hospitals for reducing and improving efficiency of appropriate physical restraints use.

• Journal of Korean Clinical Nursing Research
• /
• v.22 no.1
• /
• pp.56-67
• /
• 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.

• Journal of Korean Academy of Nursing Administration
• /
• v.15 no.2
• /
• pp.203-215
• /
• 2009

Purpose: In order to improve resuscitation rate of CPR through providing qualitative nursing while performing CPR in hospital ward and to enhance quality of emergency nursing in the ward, the author embarked on the research as a way of developing ventricular fibrillation protocol about CPR. Method: Collected data were analyzed by using the SPSS/PC14.0 program while the routes of final protocol developed in this research are as follows. Result: Based on analysis results of literature study and CPR electronic hospital records, a total of 22 items and 53 specific contents were confirmed through the gathering of opinions from panels, and the allotment of roles and tasks with a standard of 2 nurses was designated. As the result of specialists' verification on validity, the final protocol composed of a total of 23 items and 45 specific contents was confirmed. At the result of the pertinency evaluation of confirmed protocol, it was evaluated as relatively pertinent with its average score 2.89-3.32. Conclusion: The protocol developed in this research is seen as to contribute to nurses participating in CPR to avoid the overlapping of tasks and to develop CPR through effective teamwork of medical teams by presenting clear roles and tasks.

• Journal of Korean Clinical Nursing Research
• /
• v.29 no.1
• /
• pp.75-84
• /
• 2023

Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion: This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

• Journal of Korean Academy of Nursing
• /
• v.53 no.3
• /
• pp.275-294
• /
• 2023

Purpose: This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol. Methods: The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol's effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses' outcome variables were evaluated using a questionnaire. Results: First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001). Conclusion: This protocol may help prevent infections and pressure injuries in patients, and improve nurses' satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

• Journal of Korean Critical Care Nursing
• /
• v.9 no.1
• /
• pp.27-39
• /
• 2016

Purpose: The purpose of this study lies in investigating nursing and medical staff perceptions on the importance of surgical patient safety protocol, teamwork, and patient safety culture, and how their grasp of the factors affects the degree of their performance of the protocol. Methods: A survey was conducted on 249 nurses and medical staff participating in the operating rooms of one higher general hospital in Seoul, using a 5-point scale self-reported questionnaire. Logistic regression analyses were used. Results: Operating room nurses yielded the highest scores on both the importance of the patient safety protocol and its performance. In patient safety culture, the operating medical staff yielded significantly higher scores than those of operating room nurses. Perception of the importance of the patient safety protocol and teamwork had a significant effect on the nurses' complete performance of the protocol. Conclusion: It is important to create a safety culture, where all the staff can actively and freely communicate with one another through team-based training programs. By enhancing teamwork and patient safety culture, it will be possible to establish the surgical patient safety protocol and to improve the performance of the protocol by health professionals.