• Title/Summary/Keyword: Practice guidelines

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A Teleological Interpretation of a Doctor's "Guidance" for Physical Therapist (물리치료사에 대한 의사의 "지도"의 목적론적 해석)

  • Lee, Ju-Il
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.2
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    • pp.147-156
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    • 2018
  • PURPOSE: The law pertaining to medical service technologists does not discuss the scope and limits of doctors' guidelines. My paper aims to discuss these topics. METHODS: This study was based on a review of literature and an analysis of judicial precedents. RESULTS: Physical therapists have often noted the need for independent practitioners in their articles on health care. Their continued discussions on professional and educational differences have centered round this issue, but their ideas have not been accepted. Practitioners have continued to interpret doctors' guidelines in hospitals without discussing their scope. However, the Supreme Court presented a meaningful decision outlining the conceptual limits and the scope of medical practice. The court suggested, basing its interpretation in the goal of clarifying the concept of medical activities smoothly, was to follow a specific judgment on the levels of education, testing, and professionalism. CONCLUSION: The role of physical therapists is expanding in this country, in order to meet the needs of the ultra-aged society. Education is already responding to rising training needs. By dividing the doctors' guidelines into indirect and direct types, if there's no medical risk near or around the health center or hospital, it is a good idea to allow the management of physical therapy partially, while understanding the scope and limitations of these guidelines clearly. A teleological interpretation of the law is especially relevant, and can be implemented immediately by the authoritative interpretation on part of the health authorities without any legal amendments.

Current Status of Patient Safety Regulations, Guidelines and Support Mechanisms in Korean Hospitals

  • Lee, Jae Ho;Kim, Jeong Eun;Kim, Suk Wha;Lee, Sang Il;Jung, Yoen Yi;Kim, Moon Sook;Jang, Seon Mi
    • Perspectives in Nursing Science
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    • v.10 no.2
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    • pp.158-166
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    • 2013
  • Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

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Comparative Review of Pharmacological Treatment Guidelines for Bipolar Disorder (양극성 장애의 약물치료 가이드라인 비교)

  • Seoyeon Chin;Hyoyoung Kim;Yesul Kim;;Bo-young Kwon;Boyoon Choi;Bobae Lee;Jiye Lee;Chae-Eun Kwon;Yeongdo Mun;Kaveesha Fernando;Ji Hyun Park
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.3
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    • pp.153-167
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    • 2023
  • Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.

Development of antibiotic prescription guidelines for antibiotic prescription quality management (항생제 처방 질 관리를 위한 항생제 처방 지침의 개발)

  • Kim, Hyesung;Oh, Jeongkyu
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.45-54
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    • 2017
  • The purpose of this article is to cope with the abuse of antibiotics in the clinic, to determine the necessity of antibiotic administration, to share information on the selection and proper use of appropriate antibiotics, and to increase the appropriateness of antibiotic prescription through continuous monitoring. In line with the latest research and guidelines trends of various agencies, we will supplement the antibiotic prescription guidelines and use them for the treatment in Apple Tree Dental Hospital. Specially, by history taking and the penicillin allergy test, amoxicillin is prescribed as a primary selective antibiotic for 1 day. The complaints and treatment effects of the first antibiotic should be evaluated at the next visit. If the primary antibiotic was ineffective, we replaced it with a broad-spectrum antibiotic. If there was no improvement in symptoms, the patient would be referred to upper grade hospital. The staff of the Apple Tree Dental Hospital regularly monitored and educated antibiotic prescriptions. The current guidelines should be supplemented continually and positively affect the abuse of antibiotics and the habit of dental practice.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Definition and Diagnosis

  • Jae Yeong Cho ;Dong-Hyuk Cho;Jong-Chan Youn;Darae Kim;Sang Min Park;Mi-Hyang Jung;Junho Hyun;Jimi Choi;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Byung-Su Yoo;Seok-Min Kang;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • v.53 no.4
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    • pp.195-216
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    • 2023
  • The Korean Society of Heart Failure guidelines aim to provide physicians with evidence-based recommendations for diagnosing and managing patients with heart failure (HF). In Korea, the prevalence of HF has been rapidly increasing in the last 10 years. HF has recently been classified into HF with reduced ejection fraction (EF), HF with mildly reduced EF, and HF with preserved EF (HFpEF). Moreover, the availability of newer therapeutic agents has led to an increased emphasis on the appropriate diagnosis of HFpEF. Accordingly, this part of the guidelines will mainly cover the definition, epidemiology, and diagnosis of HF.

Clinical Dilemmas for the Diagnosis and Treatment of Helicobacter pylori Infection in Children: From Guideline to Practice

  • Susanne Jenneke Van Veen;Elvira Ingrid Levy;Koen Huysentruyt;Yvan Vandenplas
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.5
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    • pp.267-273
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    • 2024
  • Helicobacter pylori infection is often acquired in early childhood. While most infected children remain asymptomatic, H. pylori can cause chronic gastritis, gastric ulceration, and, in the long term, gastric cancer. This article aimed to review different diagnostic and treatment options and discuss the challenges associated with applying the current guidelines in the real world. Relevant articles published from 2015 to August 2023 in the English language in PubMed and Medline electronic databases were extracted using subject headings and keywords of interest to the topic. References of interest in the selected articles were also considered. Invasive and noninvasive diagnostic tests have advantages but also disadvantages and limitations according to the clinical setting and age of the child. Guidelines recommend not performing diagnostic testing in children with long-lasting or recurrent abdominal complaints or cases of a family history of severe disease caused by H. pylori. However, parents regularly consult with the explicit demand to test for H. pylori because of them or a close family member experiencing severe gastric disease caused by H. pylori. In some situations, it may be challenging for the healthcare professional to stick to evidence-based guidelines and not consider "patient-centered care," with the risk of putting a trustful relationship in danger. Physicians may find it challenging not to perform diagnostic tests for H. pylori and prescribe eradication treatment in specific clinical settings when maintaining a trusting patientphysician relationship by applying this "patient-centered care" method when evidence-based guidelines recommend differently.

Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach

  • Lee, Jun Haeng;Kim, Jae G.;Jung, Hye-Kyung;Kim, Jung Hoon;Jeong, Woo Kyoung;Jeon, Tae Joo;Kim, Joon Mee;Kim, Young Il;Ryu, Keun Won;Kong, Seong-Ho;Kim, Hyoung-Il;Jung, Hwoon-Yong;Kim, Yong Sik;Zang, Dae Young;Cho, Jae Yong;Park, Joon Oh;Lim, Do Hoon;Jung, Eun Sun;Ahn, Hyeong Sik;Kim, Hyun Jung
    • Journal of Gastric Cancer
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    • v.14 no.2
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    • pp.87-104
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    • 2014
  • Although gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to those in western countries. However, there are currently no Korean multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework: the evidence levels were based on a systematic review of the literature, and the recommendation grades were classified as either strong or weak. The applicability of the guidelines was considered to meet patients' view and preferences in the context of Korea. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. An external review of the guidelines was conducted during the finalization phase.

Study on the Sodium Intake Knowledge and Practices for Reducing Sodium Intake in Soldiers (군인의 나트륨 섭취와 나트륨 줄이기 관련 지식 및 실천에 관한 연구)

  • Hwang, Ji Min;Min, Sung Hee;Lee, Min June
    • Journal of the East Asian Society of Dietary Life
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    • v.26 no.6
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    • pp.550-558
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    • 2016
  • This study was conducted to provide guideline data for future instructional materials and practice guidelines on reforming the dietary life of military personnel in terms of lowering sodium intake. A total of 264 persons were surveyed to obtain basic data on sodium intake and understanding of sodium. The study also examined the practice that is carried forward in this endeavor. The subjects liked 'kimchi' and 'rice with topping', and these could be the reason for higher salt intake. Career soldiers scored higher in terms of nutrition knowledge than enlisted soldiers (p<0.01). Nutrition education concerning sodium intake was statistically insignificant between the two, whereas career soldiers showed a higher experience rate at these nutrition educational events. Career soldiers also had with higher sodium intake than enlisted soldiers, and this difference was statistically significant (p<0.01). In terms of practice, officers were more likely to experience difficulty in putting the theory of less sodium into practice than their enlisted soldiers counterparts (p<0.05), and the main reason behind this difficulty was that they did not feel the need to lower their sodium intake. Soldiers should be well educated about sodium and healthy diet during their service. Education should focus on lowering sodium intake and changing their attitudes and awareness of this issue in order to elicit behavioral changes.

Insights into Ergonomics Among Dental Professionals of a Dental Institute and Private Practitioners in Hubli-Dharwad Twin Cities, India

  • Kalghatgi, Shrivardhan;Prasad, Kakarla Veera Venkata;Chhabra, Kumar Gaurav;Deolia, Shravani;Chhabra, Chaya
    • Safety and Health at Work
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    • v.5 no.4
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    • pp.181-185
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    • 2014
  • Background: To assess the knowledge, attitude, and practice of ergonomics among dental professionals of Hubli-Dharwad twin cities, India. Methods: Investigator-developed, self-administered, closed-ended questionnaire assessing knowledge, attitude, and practices regarding ergonomics during dental practice was filled in by undergraduates, house surgeons, postgraduates, and faculty members of dental institutions and private practitioners from Hubli-Dharwad twin cities. Results: Data were collected from a total of 250 participants, 50 belonging to each academic group. Overall mean knowledge, attitude, and practice scores were 52%, 75%, and 55%, respectively. Significant correlation was found for age with attitude (${\chi}^2=10.734$, p=0.030) and behavior (${\chi}^2=12.984$, p=0.011). Marital status was significantly associated with all the three domains; knowledge (${\chi}^2=29.369$, p=0.000), attitude (${\chi}^2=29.023$, p=0.000), and practices (${\chi}^2=13.648$, p=0.009). Conclusion: Participants had considerable awareness and behavior toward ergonomics in dental practice. The high attitude score indicates stronger acceptance of ergonomics principles and guidelines during routine dental procedures. The current study highlights the situation of ergonomics in dental practice in the form of knowledge, attitude, and practices.

COVID-19 vaccine-induced immune thrombotic thrombocytopenia: a review

  • Siti Nur Atikah Aishah Suhaimi;Izzati Abdul Halim Zaki;Zakiah Mohd Noordin;Nur Sabiha Md Hussin;Long Chiau Ming;Hanis Hanum Zulkifly
    • Clinical and Experimental Vaccine Research
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    • v.12 no.4
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    • pp.265-290
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    • 2023
  • Rare but serious thrombotic incidents in relation to thrombocytopenia, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), have been observed since the vaccine rollout, particularly among replication-defective adenoviral vector-based severe acute respiratory syndrome coronavirus 2 vaccine recipients. Herein, we comprehensively reviewed and summarized reported studies of VITT following the coronavirus disease 2019 (COVID-19) vaccination to determine its prevalence, clinical characteristics, as well as its management. A literature search up to October 1, 2021 using PubMed and SCOPUS identified a combined total of 720 articles. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, after screening the titles and abstracts based on the eligibility criteria, the remaining 47 full-text articles were assessed for eligibility and 29 studies were included. Findings revealed that VITT cases are strongly related to viral vector-based vaccines, which are the AstraZeneca COVID-19 vaccine (95%) and the Janssen COVID-19 vaccine (4%), with much rarer reports involving messenger RNA-based vaccines such as the Moderna COVID-19 vaccine (0.2%) and the Pfizer COVID-19 vaccine (0.2%). The most severe manifestation of VITT is cerebral venous sinus thrombosis with 317 cases (70.4%) and the earliest primary symptom in the majority of cases is headache. Intravenous immunoglobulin and non-heparin anticoagulant are the main therapeutic options for managing immune responses and thrombosis, respectively. As there is emerging knowledge on and refinement of the published guidelines regarding VITT, this review may assist the medical communities in early VITT recognition, understanding the clinical presentations, diagnostic criteria as well as its management, offering a window of opportunity to VITT patients. Further larger sample size trials could further elucidate the link and safety profile.