• Korean Journal of Clinical Pharmacy
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• v.6 no.2
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• pp.7-13
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• 1996

The purposes of this study were to define the pharmacokinetic parameters of vancomycin in Korean neonates, to evaluate current neonatal vancomycin dosing guideline being used in a teaching hospital, and to develop the optimal vancomycin dosing guideline. The evaluation of 35 sets of peak and trough concentrations drawn on current dosing regimen showed that $29\%$ of peak concentrations and $46\%$ of though concentrations were within therapeutic range. Otherwise, pharmacokinetic parameters, based on 62 sets of peak and trough serum concentrations obtained from 39 neonates, showed that mean vancomycin clearance (CL), volume of distribution (Vd), and terminal elimination half-life were $0.13\pm0.08\;L/hr,\;0.94\pm0.48\;L,\;and\;5.6\pm2.13$ hours, respectively. Volume of distribution (Vd) normalized for body weight remained constant throughout PCA range, whereas the absolute CL (r=0.74) and normalized CL (r=0.36) showed high correlation with PCA. Also, the normalized CL showed a strong inverse correlation (r=-0.55) with serum creatinine concentrations (SrCr). Based on the high correlation among PCA serum creatinine concentration, CL, and the daily dosage requirements, the following dosing guideline for vancomycin in neonates was suggested: 10 mg/kg $12{\sim}18$ hourly for < 30 weeks PCA and < 0.6 mg/dl SrCr; 10 mg/kg 18 hourly for < 30 weeks PCA and $0.6{\sim}1.2$ mg/dl SrCr; 10 mg/kg 8 hourly for $30\sim44$ weeks PCA and < 0.6 mg/dl SrCr; 10 mg/kg 12 hourly for $30\sim44$ weeks PCA and $0.6{\sim}1.2$ mg/dl SrCr.

• Journal of Korean Clinical Nursing Research
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• v.25 no.1
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• pp.67-79
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• 2019

Purpose: This study was conducted to update the existing evidence-based nursing clinical practice guideline in management of pressure injury in South Korea. Methods: The update process underwent the 22 steps according to the update method based on the international standards. Results: The updated nursing practice guideline for pressure injury consists of 4 domains and 436 recommendations. The numbers of recommendations in each domain were 25 for hospital policies, 51 for assessment, 350 for prevention and management, and 10 for education. There were 2.5% of A, 13.3% of B, 84.2% of C in terms of grading of recommendations. Among these, the major revision was done in 32 recommendations (7.4%). A total of 299 recommendations (68.6%) were added newly. Minor revisions, such as change or addition of some words, were also made in 25 recommendations(5.7%). No change was made in 80 recommendations (18.3%) compared to the previous ones. Conclusion: The nursing practice guideline for pressure injury has been updated. This updated guideline can be used as educational materials for both healthcare workers and patients with pressure injury.

• The Journal of Korean Medicine
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• v.40 no.2
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• pp.1-16
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• 2019

Objectives: The purpose of this study was to increase the utilization of Korean Medicine Clinical Practice Guidelines(KMCGP) for ankle sprain by investigating the recognition of guideline developed in 2015 and evaluating the current status of treatment. Methods: An e - mail questionnaire survey was conducted for Korean medicine doctor(K.M.D) registered in Korean Medicine Association. Survey data were analyzed through Excel. Results: The most common Korean medicine treatments used in clinic were acupuncture(adjacent points)(28.5%), cupping therapy(19.7%) and pharmacopuncture(9.8%). The treatments with high patient satisfaction were acupuncture (adjacent points)(27.9%), moxibustion(22.4%) and herbal medicine(10.4%). Herbal medicine(17.9%), tuina(10.7%) and embedding therapy(9.2%) were difficult to perform during treatment because of cost. In the case of a later revision, respondents most thought it is necessary to update evidence and adjust recommendation ratings. A majority of all respondents said they would like to know about the revised guideline through the Internet. In the expected revision effect, the first order was 'presentation of standardized treatment method', the second was 'establishing the basis of Korean medicine treatment', and the third was 'strengthening the status of Korean medicine as therapeutic medicine'. Many respondents wished to add exercise therapy. In order to increase the utilization rate of the guideline, many respondents thought it should be included in textbooks and 90.6% of respondents answered that they would use more than 50% of the revised guideline. Conclusion: It is necessary to update evidence and adjust recommendation ratings and to promote KMCGP. At the same time treatment methods should be taught to K.M.D

• Journal of Korean Biological Nursing Science
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• v.23 no.1
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• pp.55-63
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• 2021

Purpose: To identify the differences in perception of and adherence to the COVID-19 social distancing behavior guidelines among health care workers, patients, and the general public and to use them to prevent the spread of COVID-19. Methods: From October 16 2020 to November 30, 2020, a survey was conducted among 85 health care workers, 85 patients, and 82 general public regarding the perception of and adherence to the COVID-19 social distancing behavior guidelines. Results: Patients scored significantly higher than the general public in the adherence to the COVID-19 social distancing behavior guideline, and there was no difference between health care workers and general public, and patients and health care workers. In the multivariate analysis, the factors that influence the adherence of the COVID-19 social distancing behavior guide were found in women and the perception of the COVID-19 social distancing behavior guideline. Conclusion: In order to promote the implementation of the COVID-19 social distancing behavior guideline, it is necessary to increase the perception of the COVID-19 social distancing behavior guideline and provide additional education in men. It is necessary to investigate the reason behind why men have low adherence to the COVID-19 social distancing behavior guideline.

• Journal of Korean Society for Quality Management
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• v.42 no.1
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• pp.81-89
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• 2014

Purpose: The purpose of this study is to propose Clinical Practice Guideline(CPG) model and Clinical Index(CI) for implementing CDSS in digital hospitals. Methods: This study uses EMR data at department of family practice in A hospital; 636 patients, 570 diseases (based on ICD 10-CM criteria), and 37,000 data related with labs and treatments. This study focuses on disease J342 which is the most high rate of incidence. Results: Using the suggested model, this study calculates frequency matrix and probability matrix to find out the correlation of diseases and labs. This study indicates the lab sets of Disease (J342) as CI for CPG. Conclusion: This study suggests CPG model including Lab-based, Disease-Based and Case-based modules. Through 6 level cased-based CPG model, especially, this study develops Clinical Index(CI) such as the Incidence Rate, Lab Rate, Disease Lab Rate, Disease confirmed by Lab.

• Korean Journal of Clinical Pharmacy
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• v.34 no.2
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• pp.79-99
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• 2024

Background: There was an important revision of the Korean Clinical Practice Guideline for Stroke (KCPGS) for antithrombotic therapy in patients with acute ischemic stroke in 2022. This review is to provide an updated information in this revision. Methods: The revision history by year after the first announcement was examined for each topic, focusing on antithrombotic therapy during acute phase which was revised in 2022. We compared before and after the revision, and investigated the clinical outcomes presented as evidence. It was also compared with the current U.S. guidelines. Results: The major changes about antiplatelet therapy are a clause stating that dual antiplatelet therapy with clopidogrel and aspirin initiated within 24 hours from the stroke onset and maintained for up to 21-30 days is recommended as an acute treatment, as well as the clause that antithrombotic therapy may be initiated within 24 hours after intravenous thrombolytics and that the use of glycoprotein IIb/IIIa receptor antagonists can be considered in highly selected patients as rescue therapy taking into account of benefit and risk. The change to the use of anticoagulants is that it may be reasonable to start oral anticoagulant between 4 and 14 days after stroke onset for patients with acute ischemic stroke and atrial fibrillation. Conclusions: It will be helpful in improving health outcomes for clinical pharmacists to be aware of the latest information for antithrombotic therapy and to actively use it in pharmaceutical care of stroke patients.

• Journal of Korean Clinical Nursing Research
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• v.22 no.2
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• pp.238-247
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• 2016

Purpose: This study was done to develop an evidence-based practice guideline for catheter dysfunction in hemodialysis patients. Methods: Development of the guideline process was done according to the De Novo development version 1.0 by NECA which consists of 12 steps. Results: The developed guideline consisted of 5 domains and 14 recommendations. The number of recommendations for each domain were: 3 on catheter dysfunction assessment, 1 on conservative management of catheter dysfunction, 7 on drug management of catheter dysfunction, 1 on catheter function test and 2 on maintenance management. Of the recommendations, 7.15% were marked as A grade, 52.85% of B grade, and 50% of C grade. Conclusion: Findings in this study indicate that this guideline can be added to the evidence-based practice guidelines for fundamentals of practice and that this guideline can be disseminated to nurses nationwide in order to improve the care of hemodialysis patients with catheter dysfunction.

• Journal of the Korea Society of Computer and Information
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• v.23 no.4
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• pp.115-120
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• 2018

A Clinical Pathway(CP) is standard process to way of treat diseases or injuries which is adapted to each hospital based on National Clinical Practice Guideline(CPG). Since CP is standard guideline for doctors and nurses working in a hospital, making and modifying CP is one of the most important administrational work for hospital and also rare work because once it is fixed, it's not changed whether there are new kind of disease discovered or new treatment is developed. However, in present, patient's waiting time during hospital residence process, is discussed as service competitive for patients. In this research, we utilize process mining tool to verify patients treatment process follows CP with EMR(Electronic Medical Record) in a sample hospital, and suggest modifcation point of CP through verification.

• Urogenital Tract Infection
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• v.13 no.3
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• pp.45-50
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• 2018

The Institute of Medicine in its report "Clinical Practice Guidelines we can trust" defined standards for clinical practice guidelines. However, many guidelines continue to rely on expert opinion and lack a formal framework for moving from evidence to recommendations. These guidelines may or may not be labeled as "consensus statements" and do not meet contemporary standards for guideline documents we would refer to as "evidence-based". Therefore, the Grading of Recommendations Assessment, Development and Evaluation working group developed a novel, rigorous and transparent approach to grading certainty (quality) of evidence. In addition, it created a system for "moving from evidence to decisions", for example for the development of evidence-based guidelines. In this article, we aim to introduce this approach to appraising the certainty of relevant evidence and estimate the benefits and detriments of health care interventions within the larger context of evidence-based medicine.

• The Journal of Pediatrics of Korean Medicine
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• v.34 no.2
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• pp.75-85
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• 2020

Objectives Although clinical practice guidelines (CPGs) are becoming crucial in medical decision-making worldwide, there are very few development guidelines for children. Therefore, this preliminary study aimed to assess the status of worldwide except east asia-CPGs recommending complementary and alternative medicine interventions (CAM-i) in children worldwide except east asia in order to help developing Korean medicine CPGs (KMCPGs) for children. Methods To identify the current status of CPGs including CAM-i that have been developed so far, the author searched the related databases, and selected CPGs for children. The data related to the status of evidence-based CPGs, the materials related to the characteristics of CAM-i, and the details of recommendations for CAM-i were selected from the obtained findings. Results A total of 106 CPGs were identified based on the searches, of which 11 were finally selected as pediatric CPGs. These pediatric CPGs have been developed since 2007 to target various diseases. The countries developing these CPGs include the United Kingdom, Scotland, Australia, and the United States, with the U.K. having the largest share. The majority of CPGs used MEDLINE, Embase, and Cochrane library as databases. The most frequently recommended topic was acupuncture, followed by herbal medicine. Many CPGs suggested that more research was needed. Conclusions Through this study, the author was able to identify the characteristics of the developed pediatric CPGs that include CAM-i. More preceding studies are needed for the development of pediatric KMCPGs. It is hoped that this report can be used as the foundation for future development of pediatric KMCPGs.