• Title/Summary/Keyword: Practice guidelines

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Use of Web-Based Evidence-based Clinical Practice Guidelines for Patients following Gastrectomy: Effects on Body Temperature, Shivering, Perceived Thermal Comfort, and Satisfaction with Temperature Management (웹기반 체온 관리 근거중심 간호실무 가이드라인이 위절제술 환자의 체온, 전율, 체온 불편감, 체온 관리 만족도에 미치는 효과)

  • Hong, Sung-Jung;Lee, Eunjoo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.2
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    • pp.112-122
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    • 2014
  • Purpose: The purpose of this study was to examine the effects on body temperature, shivering, and perceived thermal comfort of web-based evidence-based practice guideline for patients undergoing gastrectomy. Methods: Eighty patients scheduled for gastrectomy were recruited and assigned to the control or experimental group by sequential order. Before collecting data from the experimental group, a systematic educational program on evidence-based guidelines was provided to the nurses as well anesthesiologists. Data were analyzed using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature from the induction of anesthesia until four hours after surgery compared to the control group. In addition, the levels of thermal comfort as well as satisfaction with thermal management were significantly higher in the experiment group. Conclusion: Use of evidence-based guidelines was effective in maintaining body temperature, lowering sensitivity to shivering, and promoting perceived thermal comfort. Therefore, adoption of evidence-based interventions in nursing practice is recommended.

Emerging Role of Hepatobiliary Magnetic Resonance Contrast Media and Contrast-Enhanced Ultrasound for Noninvasive Diagnosis of Hepatocellular Carcinoma: Emphasis on Recent Updates in Major Guidelines

  • Tae-Hyung Kim;Jeong Hee Yoon;Jeong Min Lee
    • Korean Journal of Radiology
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    • v.20 no.6
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    • pp.863-879
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    • 2019
  • Hepatocellular carcinoma (HCC) can be noninvasively diagnosed on the basis of its characteristic imaging findings of arterial phase enhancement and portal/delayed "washout" on computed tomography (CT) and magnetic resonance imaging (MRI) in cirrhotic patients. However, different specific diagnostic criteria have been proposed by several countries and major academic societies. In 2018, major guideline updates were proposed by the Association for the Study of Liver Diseases, European Association for the Study of the Liver (EASL), Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) of Korea. In addition to dynamic CT and MRI using extracellular contrast media, these new guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as the first-line diagnostic test, while the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound (CEUS) as the second-line diagnostic test. Therefore, hepatobiliary MR contrast media and CEUS will be increasingly used for the noninvasive diagnosis and staging of HCC. In this review, we discuss the emerging role of hepatobiliary phase MRI and CEUS for the diagnosis of HCC and also review the changes in the HCC diagnostic criteria in major guidelines, including the KLCA-NCC practice guidelines version 2018. In addition, we aimed to pay particular attention to some remaining issues in the noninvasive diagnosis of HCC.

The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Development and Implications (전반적 발달장애의 한국형 치료 권고안 : 개발과정과 의의)

  • Ahn, Joung-Sook;Koo, Young-Jin;Son, Jung-Woo;Yoo, Han-Ik K.;Yoo, Hee-Jeong;Chung, Un-Sun;Cho, In-Hee;Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.2
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    • pp.85-87
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    • 2007
  • The new research data and rapid development of psychotropic drugs over the past few years have warranted the development of clinical practice guidelines for managing pervasive developmental disorder(PDD). These guidelines are urgently needed due to the recent changes in social circumstances and clinical situations in Korea. Despite the many limitations and problems surrounding the development of these guidelines, the Korean Academy of Child and Adolescent Psychiatry(KACAP) has decided to develop the Korean Practice Parameters for the Treatment of PDD. The goal, basic principles, organization, and implications of this development project are introduced in this special paper. We expect these practice parameters to be a useful reference not only for child psychiatrists and other healthcare professionals in clinical practice, but also for the autistic patients themselves and their caregivers. The practice parameters shall be revised and improved in the near future.

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Design Implications for Teachers' Tools in Differentiated Instruction through Case Studies

  • CHA, Hyunjin
    • Educational Technology International
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    • v.14 no.1
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    • pp.55-74
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    • 2013
  • The diversity of students is getting increased in the contemporary classroom. To deal with the diversity, differentiated instruction (DI) should be considered as a way of providing alternative approaches to content, process and product according to the students' readiness, interest, and learning needs. Teachers have problems and difficulties in supporting different student's needs. In fact, teachers need proven tools including framework, guidelines or computing systems to help to practice DI in real context. According to the activity theory, tools influence on how people act and think and even their social practice, playing a crucial role in mediating the activities with people. In DI practice, there are also some studies about physical and abstract tools, but they have been not widely utilized by teachers in real schools. It means that more innovative tool to promote DI might be required. Therefore, to design a better tool to mediate the DI activities with teacher, case studies were conducted. In order to elicit the design implications, two physical and two abstract tools for DI practice were analyzed as case studies. Through the analysis of the case studies, eight design implications better to facilitate DI practice were suggested. This study has implications in suggesting design guidelines for teachers' tools to facilitate their DI practice by analyzing case studies in DI practices for an innovative tool in the educational practice.

Evaluation of Applications of Adaptation of the Evidence-Based Nursing Practice Guidelines Patients with Acute Stroke (급성 뇌졸중 환자 대상 근거중심 간호 가이드라인 수용개작의 적용 평가)

  • Song, So-Lee;Cho, Myoung-Sook;Kim, Ji-Hyun;Han, Yun-Kyang;Yan, Hye-Min
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.1
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    • pp.87-97
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    • 2012
  • Purpose: This study was done to evaluate nursing guidelines for patients with acute stroke, developed by adapting the guidelines of Registered Nurses Association of Ontario, Canada to clinical settings on a large scale and evaluating the effectiveness as a research study. Method: The general characteristics of the 319 patients and the effectiveness of guideline application were evaluated in terms of structure, process, and outcome using questionnaires on the guidelines application with reference to the medical records of patients with acute stroke hospitalized on a ward of the stroke center of S General Hospital in Seoul. Results: Structures as a guidance system for assessment were consistent with the recommendations. With respect to the process of the guidelines, for items on nursing assessment, improved performance was found to be statistically significant. For outcomes of the guidelines, complications occurred in 8 patients (5.3%) prior to application of the guidelines and 11 patients (6.5%) after application of the guidelines, but this result was not statistically significant (p=.841). Conclusion: The results of the study indicate that for the effectiveness of the guidelines, accessibility to the guidelines and effectiveness of quality improvement need to be evaluated, in addition to complications of a stroke.

Effect of practice guideline reminder and flow-sheet for improvement of quality in management of hypercholesterolemia (고콜레스테롤혈증 환자 진료의 질 향상을 위한 임상 지침 리마인더(Reminder)와 추적 관리지의 효과)

  • Cho, Han Kyu;Park, Hye Soon;Cho, Hong-Jun
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.230-240
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    • 1997
  • Background : Hypercholesterolemia is a major independent risk factor of coronary heart disease. Practice guidelines for management of hypercholesterolemia had been made in several developed countries. This study was undertaken to assess the effect of practice guideline reminders and flow-sheets to improve the quality of management of hypercholesterolemia. Methods: Practice guideline reminders and flow-sheets based on National Cholesterol Education Program Adult Treatment Panel II guidelines, were placed on the office desks of outpatient department of family medicine at the Asan Medical Center. Before this intervention, we educated the doctors to use these reminders and flow-sheets. The charts of all patients who had cholesterol levels greater than or equal to 240 mg/dl during 4 months before and after introduction of reminders and flow-sheets, were reviewed retrospectively. We compared the performances of physicians about management of hypercholesterolemia between pre-intervention period and post-intervention period. Results: The detection rate of hypercholesterolemia in post-intervention period was increased to 83.2% compared by 71.5% in pre-intervention period. Risk factor analysis for coronary heart disease increased significantly from 16.9% to 68.7%. Adequacy of management was 19.2% in pre-intervention period and 78.0% in post-intervention period. It showed statistically significant improvement in management of hypercholesterolemia. Conclusion : This study suggested that practice guideline reminders and flow-sheets were the effective methods in improving the quality in management of hypercholesterolemia.

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A Survey on the Clinical Practice Patterns of Irritable Bowel Syndrome in Korean Medicine (과민대장증후군(Irritable Bowel Syndrome)의 한의임상 진료현황에 대한 설문조사 연구)

  • Jun, Hyejin;Kim, Keumji;Ko, Seok-Jae;Park, Jae-Woo
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.532-546
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    • 2021
  • Objective: This study investigated the perception, diagnosis, and treatment of irritable bowel syndrome (IBS) in the general population, in patients, and in Korean medicine doctors (KMDs) in order to provide basic information for the development of Korean medicine clinical practice guidelines for IBS. Methods: A questionnaire was developed in two versions, one for the general population/patients and one for KMDs. The questions were about the general perception, diagnosis, and treatment of IBS. Both online and offline surveys were conducted using these questionnaires. Results: In total, 213 general population/patients and 435 KMDs responded to the survey. The results of the analysis were as follows. Most of the KMDs diagnosed IBS based on clinical aspects. Acupuncture was the most common treatment, followed by prescription herbal medicine, moxibustion, and manufactured herbal medicine. 34.3% of KMDs used clinical practice guidelines for IBS patient treatment. 57.8% of patients were diagnosed with IBS by doctors at primary medical institutions, and 53.1% were diagnosed with colonoscopy. More than half of the IBS patients who have been treated with Korean medicine said they experienced improvement of symptoms and prevention of recurrence, but more than 70% of the respondents said future safety and effectiveness studies of Korean medicine were needed. Conclusions: In spite of the positive perception of IBS treatment with Korean medicine, actual utilization was relatively low. The development and promotion of, as well as education about, appropriate and reasonable Korean medicine practice guidelines for IBS is necessary.

An Analysis of Pharmacy Students' Perceptions and Evaluations after Community Pharmacy Practice Experiences (지역약국 실무실습 후 실습에 대한 약학대학 학생들의 인식과 평가에 대한 분석)

  • Yang, Young-Mo;Lee, Jieun;Lee, Ik-Soo;Choi, Eun Joo
    • YAKHAK HOEJI
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    • v.58 no.3
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    • pp.208-222
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    • 2014
  • Pharmacy practice experiences play a central role in improving the professional abilities and roles of student pharmacists in the changed '2+4'-year curricula of Korean pharmacy schools. For the first 3 years, the students usually learn theoretical areas, and for the last year, they apply learned knowledge to actual pharmacy practice environments. Especially, in order for community pharmacy practice experiences to become firmly established, it is important to evaluate students' feedbacks of community pharmacy practice experiences. However, there have been little studies regarding this area in Korea. This study was to analyze pharmacy students' perceptions and evaluations after community pharmacy practice experiences. The self-reported questionnaire using a 5-point Likert scale was utilized to collect data from the pharmacy students completing community pharmacy practice experiences. Total 62 students responded to the survey questionnaires. The average of students' evaluations of preceptors for overall evaluation items was 4.31 whereas that of student evaluations of practice sites for them was 4.03. The self-evaluations of students' expertises were mostly positive except for that of populations care. The evaluation item 'I believe this experience will help me be a better pharmacist' received the highest satisfaction. According to the results regarding open-ended questions, the students learned the needs for academic motivations and self-developments, and they thought that the curriculum should be standardized and systematized in order to improve contents for community pharmacy practice experiences. Furthermore, based on these results, the guidelines of community pharmacy practice experiences should be modified, and researches on the validation and evaluations of the modified guidelines should be implemented.

Integrative Oncology Practice Guidelines (통합 종양학 시술 지침)

  • Liu, Yuan-Sheng;Lee, Jong-Hoon;Lee, Yeon-Weol;Cho, Chong-Kwan;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.12 no.1
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    • pp.37-65
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    • 2007
  • The Society for Integrative Oncology (SIO) is an international organization established to encourage scientific evaluation, dissemination of evidence-based information, and appropriate clinical integration of complementary therapies (http://www.Integrativeonc.org.). Practice Guidelines were developed by the authors listed below and by the Executive Committee of the Society for Integrative Oncology, which approved this document. Guidelines are a work in progress; they will be updated as needed and are available on the SIO Web site as well: www.IntegrativeOnc.org.

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Clinical practice guidelines for intraoperative neurophysiological monitoring: 2020 update

  • Korean Society of Intraoperative Neurophysiological Monitoring;Korean Neurological Association;Korean Academy of Rehabilitation Medicine;Korean Society of Clinical Neurophysiology;Korean Association of EMG Electrodiagnostic Medicine
    • Annals of Clinical Neurophysiology
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    • v.23 no.1
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    • pp.35-45
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    • 2021
  • The utility and accuracy of intraoperative neurophysiological monitoring (IONM) has evolved greatly following the recent development of new devices for neurophysiological testing and advances in anesthesiology. Until recently, the need for IONM services has been limited to large academic hospitals, but the demand for neurophysiologists with expertise in IONM has grown rapidly across diverse types of hospital. The primary goal of the Korean Society of Intraoperative Neurophysiological Monitoring (KSION) is to promote the development of IONM research groups and to contribute to the improvement of fellowship among members and human health through academic projects. These guidelines are based on extensive literature reviews, recruitment of expert opinions, and consensus among KSION board members. This version of the guidelines was fully approved by the KSION, Korean Association of EMG Electrodiagnostic Medicine, the Korean Society of Clinical Neurophysiology, the Korean Academy of Rehabilitation Medicine, and the Korean Neurological Association.