• Title/Summary/Keyword: clinical guideline

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A Study on the Development of a Clinical Pathway of Korean Medicine for the Management of Patients with Ankle Sprain (족관절염좌 환자 관리를 위한 한의표준임상경로 개발 연구)

  • Yoon, Sangdo;Song, Mi-Yeon;Chung, Won-Seok;Kim, Hyungsuk;Shin, Woo-Chul;Kim, Taeoh;Cho, Whi-Sung;Seo, Yeonho;Seo, Sangwoo;Seo, Joonwon;Kang, Junhyuk;Yu, Seung-Ho;Kim, Seyun;Cho, Jae-Heung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.141-151
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    • 2022
  • Objectives The purpose of this study is to improve the accessibility of Korean medicine by standardizing managements, improving quality of medical services, and reducing medical costs in ankle sprain by develop clinical pathway (CP). Methods The development of CP in this study is based on clinical practice guideline (CPG) for ankle sprain, and aims to maximize the quality of treatment, such as reducing treatment time and medical costs, and increasing patient satisfaction through standardized pathway. The CP was revised after consultation and review by the advisory committee. The advisory committee is consisted of a stakeholder group applying the CP. Results In previous research studies, there were no Korean medicine CP studies on ankle sprain. Based on CPG for ankle sprain and analysis of medical records, 6 types of time task matrix type CP (for Korean medicine doctors, medical assistant, patients) and 4 types of algorithm type CP (for Korean medicine clinics, Korean medicine hospitals, and cooperative practicing hospitals, public medical centers) were derived as a result. Conclusions Ankle sprain CP is expected to not only increase patient satisfaction and maximize the quality of treatment, but also reduce the financial burden of health insurance by reducing medical costs.

Current conditions of dental hygiene clinical training in Korea and suggestions for improvement (국내 치위생학 관련 임상실습 교육의 현황과 개선 방안)

  • Won, Bok-Yeon;Jang, Gye-Won;Hwang, Mi-Young;Kim, Seol-Ak;Oh, Sang-Hwan;Lee, Kyeong-Hee;Jang, Jong-Hwa
    • Journal of Korean society of Dental Hygiene
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    • v.19 no.1
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    • pp.19-31
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    • 2019
  • Objectives: The aim of this study was to propose a standardized guideline for clinical training courses among dental hygiene departments of colleges in Korea. This study comparatively evaluated periods and durations of the curricula and specific domains, credits and hours of clinical training classes, and institutions providing practical lessons, and calculated the total credits and hours. Methods: From August 15 to September 15, 2017, a literature review was conducted in dental hygiene departments of 82 schools around the country in order to investigate the current conditions of clinical training in each educational system. Furthermore, 5 colleges were selected from each type of educational system, and their credits and hours for clinical training were analyzed in subjects of practical training for clinical dental hygiene, practical training for dental clinic, practical training for local community dental health, clinical training, and pre-clinical level practical training. The total credits and hours were calculated on the basis of analysis results. Results: The findings revealed that the hours of clinical training classes and hours per credit for practical training in the dental hygiene departments as well as the practical training institutions varied between the colleges. In some cases, the hours of practical training were not indicated. Standardized clinical training in the dental hygiene department was allotted 675 hours, whereas practical training in local community dental health studies was allotted 105 hours, which totaled to 780 allotted hours. Conclusions: There was a significant difference among the colleges in terms of the current conditions of clinical training in the dental hygiene department. The literature review revealed that a total of 780 hours was allotted to clinical training, and this was significantly more than the standard (500 hours) set by the. Moreover, these clinical training hours were lower than in advanced countries or other health and medical treatment occupations. Therefore, efficient improvement is required in order to provide a timely guideline for clinical training.

Updates of Nursing Practice Guideline for Enteral Nutrition (경장영양 간호실무지침 개정)

  • Cho, Yong Ae;Gu, Mee Ok;Eun, Young;Yu, Mi;Kim, Jung Yeon;Lee, Hyun Hee;Min, Ja Kyung;Song, Jung Mi
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.1
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    • pp.10-25
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    • 2020
  • Purpose: The purpose of this study was to update the previously developed nursing practice guideline for enteral nutrition (EN). Methods: The guideline update was done in 22 steps using standardized methodology for nursing practice guidelines. Results: The updated EN guideline consisted of 16 domains and 228 recommendations. The domains and number of recommendations in each domain were for IDSA (Infectious Diseases Society of America): 8 on general instruction, 9 on general instruction for special nutrition, 9 on general instruction for EN, 3 on assessment of EN, 10 on access to EN, 18 on EN device insertion, 16 on selection and preparation of nutritional supplements, 46 on administration and stopping EN, 22 on maintenance and management of EN, 9 on monitoring EN, 16 on prevention and management of complications of EN, 18 on medication administration, 20 on EN in various situations, 20 on prevention of errors, 1 on nursing education, and 3 on nursing documentation. For the levels of evidence, there were 9.7% for level I, 13.1% for level II, 62.5% for level III and 1.1% for GRADE (Grading of Recommendations Assessment, Development and Evaluation): 3.3% for low, 0.8% for moderate, 9.3% for very low. A total of 133 recommendations were newly developed and 10 previous recommendations were modified. Conclusion: This updated EN nursing practice guideline can be used to enhance evidence-based practice in fundamentals of nursing practice and it should be disseminated to nurses nationwide in order to improve the efficiency of EN practice.

Development of Evidence-Based Nursing Practice Guideline for Prevention of Ventilator-Associated Pneumonia (인공호흡기 관련 폐렴의 예방을 위한 근거기반 간호실무지침 개발)

  • Kim, Hwa-Young;Ryu, Seang
    • The Journal of the Korea Contents Association
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    • v.21 no.10
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    • pp.630-644
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    • 2021
  • This study was conducted to develop evidence-based nursing practice guideline for the prevention of VAP. This is a methodological study to develop guideline and verify the effectiveness according to the hybrid method of the NECA. Topics and key questions were derived through literature review and interviews, and recommendations were converged and developed through guidelines review and SR and meta-analysis. This was verified through the RAND and evaluated through AGREEII. The clinical feasibility of the nursing practice guideline, consisting of 44 recommendations in 9 categories, was evaluated by 122 ICU nurses. Conclusively this evidence-based nursing practice guideline for the prevention of VAP was confirmed methodological quality and content validity and was suitable for our nursing practice environment.

Evaluation of NSAID Usage and Appropriateness for Prevention of NSAID-Related Ulcer Complications (비스테로이드소염제로 인한 궤양 합병증 예방을 위한 비스테로이드소염제 사용 현황 및 적절성 평가)

  • Cho, Jungwon;Lee, Eunsook;Shin, Wan Gyoon
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.211-219
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    • 2012
  • Nonsteroidal antiinflammatory drugs (NSAIDs) are used in the treatment of extensive diseases related to various symptoms; inflammation, pain and fever. NSAIDs work by blocking prostaglandin synthesis, but adverse drug events (ADEs) have been increasing dramatically such as gastrointestinal bleeding, perforation and stenosis, a kind of serious ADEs. Therefore, NSAID-related ulcer complication guidelines have been announced containing various risk factors and symptoms. Thus, this study aims to evaluate of NSAID usage and appropriateness for prevention of NSAID-related ulcer complication based on American journal of gastroenterology (AJG) guideline 2009. Further, the study suggests Korean guideline for prevention of NSAID-related ulcer compared to AJG guideline. For this study, data was collected through electronic medical record (EMR) at Seoul national university of Bundang hospital. The primary end point was a composite of NSAID-related ulcer risk factor, types of NSAIDs, co-prescribed NSAID ulcer prevention drugs and NSAID-related ulcer after taking NSAID. The risk factors include over 65 years, high dose NSAID, previous ulcer history and taking drugs (e.g. aspirin, anticoagulant and steroid) causing ulcer. If a patient has 3 or 4 factors, that patient was classified high risk group. And if 1 or 2 factors that patient was classified moderate risk group. The patient who has no risk factor was in low risk group. I studied 8,120 patients who received NSAID from 1 January 2009 to 31 December 2009. High risk group was 16(0.2%), moderate risk group was 4,364(53.7%), and low risk group was 3,740(46.1%). The results show that high risk group should be prescribed COX-2 inhibitors with ulcer prevention drugs, and moderate or low risk group need traditional NSAIDs with ulcer prevention drugs. This may be different with 2009 AJG guideline because AJG guideline suggested taking COX-2 inhibitor alone in moderate group or taking traditional NSAID alone in low risk group could get higher ulcer complication. The results indicated that choosing preventive drug is important in case that how many risk factors the patients have. The proper drugs would be helpful for safe and effective NSAID usage in each patient group.

Strategy for Clinical Progress Note of Physical Therapy (물리치료 임상기록 전략)

  • Bae Sung-Soo;Kim Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.133-148
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    • 1998
  • Documentation of patient care has much emphasis during the past few years. As reviewing the orthopedic, neurosurgery, rehabilitation medicine of progress note, SOAP note, modified SOAP note and have been integrated a model of Korean clinical progress note of physical therapy. Academically, educationally and clinically development of physical therapy depend upon writing clinical progress note. Based on the research results, the following considerations and guideline are presented. 1. Include writing a clinical progress note of physical therapy in the school curriculums. 2. Physical therapist write the clinical progress note their procedure to the patients. 3. Korean Physical Therapy Association can provide a model of clinical progress note of physical therapy.

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Early recognition of high risk factors of acute abdominal pain in children (소아 급성 복통에서 고위험 인자의 조기 발견)

  • Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.117-128
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    • 2006
  • Non-traumatic acute abdominal pain in children presents a diagnostic dilemma. Numerous disorders can cause abdominal pain. Although many etiologies are benign, some require a rapid diagnosis and treatment in order to minimize morbidity. This review concentrates on the clinical office evaluation of acute abdominal pain in infants and children and details the clinical guideline for the diagnostic approach to imaging and the salient clinical features of some of the conditions. The clinical outcomes of children presenting with acute abdominal pain and the risk factors of the high risk underlying diseases would be provided for the diagnostic algorithm.

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.

Electronic Risk Assessment System as an Appropriate Tool for the Prevention of Cancer: a Qualitative Study

  • Amoli, Amir hossein Javan;Maserat, Elham;Safdari, Reza;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8595-8598
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    • 2016
  • Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

A Study on the Space Organization and Facility Equipment of Medical Laboratory - focusing on the USA, UK and Germany - (병원 진단검사의학부의 공간구조와 설비기준에 대한 조사 - 미국, 영국, 독일을 중심으로 -)

  • Kim, Youngaee
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.22 no.3
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    • pp.7-15
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    • 2016
  • Purpose: As medicare services have gotten spreaded, clinical laboratory has been dominant position. So, it has been acted for quality control and clinical pathology accreditation. But there has been quite deficient information to evaluate working space and technical standards of medical laboratory for accreditation. This study goals to figure out accreditation standard and design guideline for clinical laboratory, and to give safe and efficient design information. Methods: This study has been searched by literature for accreditation standards and design guidelines of clinical pathology in USA, UK, and Germany. Results: Three countries have accredited based on working lab space, staff space, storage space, patient space and health and safety equipment. Design guidelines of three countries commonly have focused on worktable layout, worktable distance and module, and specific laboratory biosafety level. And USA guidelines stress on the architectural design such as design process and passage distance for escape, UK stress on the efficiency as functional work flow and construction cost, lastly Germany design guidelines stress on the operator's safety distance and workstation. Three countries have not only accreditation standards but also design guidelines for more specific quality management, separating from accrediting institute. Implications: In korea, it has been needed to make clinical laboratory design guideline for the safe and efficient environment and reliable and competitive medical service.