• Title, Summary, Keyword: Practice guideline

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Development of Evidence Based Clinical Practice Guideline to Improve Quality of Critical Care Nursing (중환자 간호실무 질 향상을 위한 근거중심 임상실무지침서의 개발)

  • Park, Myong-Hwa
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.68-78
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    • 2009
  • Evidence based clinical practice guideline are designed to help healthcare practitioners evaluate and implement the increasing amount of evidence on best practice. Critical care area is one of the clinical sites where evidence based clinical practice guideline is needed most. This paper reviewed the definition of evidence based clinical practice guidelines, the development method of evidence based clinical practice guideline, and the current trends in guideline developing. Traditional method of guideline development is consensus based but it moves into evidence based development. Evidence based guideline is based on best available evidence and uses the strongest method to determine its effect on clinical outcomes. The current trends in guidelines is to develop the guideline at regional/national level and do subsequent modification to suit local circumstances. There is an urgent need of exploring the method of guideline development and adaptation which are appropriate for Korean clinical setting.

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Development of Nursing Practice Guideline for External Ventricular Drainage by Adaptation Process (수용개작을 통한 뇌실외배액 간호 실무지침 개발)

  • Jung, Won Kyung;Yi, Young Hee
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.3
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    • pp.294-304
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    • 2016
  • Purpose: This study was done to develop an evidence-based external ventricular drainage (EVD) nursing practice guideline in order to provide standardized nursing and prevent EVD related complications. Methods: We used the standardized methodology for nursing practice guideline adaptation developed by Korean Hospital Nurses Association for the guideline adaptation process in this study. Results: The newly developed EVD nursing practice guideline was adapted to the American Association of Neuroscience Nurses (AANN)'s clinical practice guideline which is 'Care of the patient undergoing intra-cranial pressure monitoring/external ventricular drainage of lumbar drainage.' There were 61 recommendations documented in the preliminary guideline all evaluated by 9 experts based on acceptability and applicability. The final practice guideline was composed of 3 domains with 57 recommendations. The three domains of nursing were the insertion, maintenance, and removal of the EVD. The number of recommendations in each domain was 8 in EVD insertions, 39 in EVD maintenance, and 10 in EVD removals. Of the 57 recommendations 3.5% were level 1, 31.5% were level 2, and 65% were level 3. Conclusion: The standardized practice guideline can improve nurses' performance and accuracy. It can also be used as the foundation for effective communication between all medical staff.

Email survey in obtaining basic data for the development of clinical practice guideline for infertility in Korean Medicine (불임증 임상진료 지침 개발의 기초 자료 확보를 위한 전자우편 설문 조사)

  • Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.4
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    • pp.80-94
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    • 2010
  • Purpose: This survey was done in order to determine Korean medical doctors (K.M.D)' expertise on clinical practice guideline for infertility and the degree of concordance with the guideline. Methods: The questionnaires were distributed via e-mail to all members of Korean Medical Doctors Society and Korean Gynecology Society from August $30^{th}$ to September $1^{st}$ in 2010. Two hundred sixty nine of completed questionnaires were analyzed through two groups, members of the Gynecology Society and nonmembers of the Gynecology Society. Results: According to the analysis of the outcome of the survey done by 99 members of the Korean Gynecology Society and 170 non-members, two-thirds of the participants had prior information of the clinical practice guideline. 63.6 percent of the participants feel strong necessity of the development of Korean medical infertility clinical practice guideline. Seventy percent of the participants are willing to participate in developing or reviewing a clinical guideline. On the question in active utilization and concordance to the guideline once the Korean medical infertility guideline is developed, 44% answered they would while 34.6% said they would utilize the guideline after some modifications. On the prospect of the impact of the development and application of Korean medical clinical practice guideline for infertility, majority of the participants marked positively that the standardization of clinical practice for infertility will lead to the nation's participation with the Nation's Support Work and that the development will somewhat contribute to the standardization of the clinical practice. Conclusions: The survey confirmed high demand of the clinical practice guidelines for infertility and the degree of concordance for infertility amongst Korean Medical doctors.

Evaluation of the Effect of Clinical Practice Guideline using Systematic Review (체계적 고찰 방법을 이용한 임상진료지침 정책효과 평가)

  • Lee, Sun-Hee;Ha, Gwi-Yeom;Kim, Ju-Hye;Seo, Ju-Hyun;Kim, Hyun-Mi
    • Korea Journal of Hospital Management
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    • v.14 no.1
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    • pp.62-98
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    • 2009
  • A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

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Development of Clinical Practice Guideline for Hwabyung (2) - Tools for Development - (화병 임상진료지침 개발 연구 (2) - 지침 개발에 활용되는 도구 -)

  • Chung, Sun-Yong;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.153-162
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    • 2009
  • Objectives : The approach to Hwabyung from all angles is needed to develop the clinical practice guideline. To achieve this approach, various tools should be used practically and systematically. Methods : We gather the tools based on multi aspects of Hwabyung's characteristics. The tools will be used to each steps of clinical practice guideline development. Results : For the clinical practice guideline, there should be applied many kinds of tools, such as for decision and assesment, survey with oriental medicine property, collecting individual stress information, mental and psychological trait, and related or following disease. Conclusions : Application of many objective tools provides the evidence-based medical approaches for development of clinical practice guideline for Hwabyung.

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Updates of Nursing Practice Guideline for Oral Care (근거기반 구강간호 실무지침 개정)

  • Cho, Yong Ae;Lee, Seon Heui;Kim, Kyeong Sug;Im, Hyo Min;Kim, Tae Hee;Choi, Mi Young;Seo, Hyun Ju;Park, Hyo Sun;Wang, Keum Hyun;Kim, Chan Hee;Choi, Hee Kyung
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.141-153
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    • 2020
  • Purpose: This study aimed to update the previously published nursing practice guideline for oral care. Methods: The guideline were updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 1.0. Results: Updated nursing practice guideline for oral care was consisted of 10 domains and 79 recommendations. The number of recommendations in each domain were: 5 general issues, 2 oral care indications, 9 oral assessment, 16 general oral care, 12 oral care for critically ill patients, 16 oral care for cancer patients, 12 oral care for cancer patients with oral complications, 5 oral care education, 1 oral care referral, and 1 documentation and report. In terms of grades for recommendations, 11.4% was grade A, 17.0% was grade B, and 68.2% was grade C. Twelve new recommendations were developed and 7 previous recommendations were deleted. Conclusion: Updated nursing practice guideline for oral care is expected to serve as an evidence-based practice guideline for oral care in South Korea. It is recommended that this guideline be spread to clinical nursing settings nationwide to improve the effectiveness of oral care practice.

Development of Oral Care Nursing Practice Guideline using the Guideline Adaptation Process (간호분야 실무지침의 수용개작 방법론에 따른 구강간호 실무지침의 개발)

  • Cho, Yong Ae;Eun, Young;Gu, Mee Ock;Kim, Kyung Sook;Kwak, Mi Kyong;Kim, Jeong Hye;Lee, Seon Heui;Park, Dong-Ah;Noh, Hwakyung
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.154-168
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    • 2015
  • Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

Clinical Practice Guidelines of Korean Medicine for Hepatocellular Carcinoma (간세포암종 치료에 대한 한의 임상 가이드라인)

  • Hong, Sang-Hoon;Son, Ho-Young
    • Journal of Korean Traditional Oncology
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    • v.20 no.1
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    • pp.55-79
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    • 2015
  • Hepatocellular carcinoma(HCC) is the fifth most common cancer worldwide (fifth in male, seventh in female) and the third most common cause of cancer mortality. Since 2001, the various research group in the United States, Europe and Asia have published clinical practice guidelines for HCC. In Korea, a clinical practice guideline for HCC have been published by The Korean Liver Cancer Study Group in 2003, revised in 2009 and 2014. In China, oriental medicine clinical practice guideline have been published for the first time in 2014, and in the oriental medical profession of Korea, there is growing need for the guideline. This study will introduce the methods of diagnosis and the medical therapeutics which is commonly utilized for HCC in Korea, and existing korean medicine clinical practice guideline for Disease Analysis and Treatment(辨證論治) and herbal therapy of HCC. Further clinical research about various herbal medicines are needed to develop more advanced guideline of HCC.

Establishment and Application of the Guideline for Hypertension by Delphi Method in the Field of Primary Medical Care (Delphi방법을 이용한 일차의료 고혈압 진료지침 개발 및 적용)

  • Yang, Yun-Jun;Hong, Myung-Ho
    • Quality Improvement in Health Care
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    • v.2 no.1
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    • pp.68-84
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    • 1995
  • Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

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Updates of Nursing Practice Guideline for Intravenous Infusion (정맥주입요법 간호실무지침 개정)

  • Gu, Mee Ock;Cho, Yong Ae;Eun, Young;Jung, Ihn Sook;Kim, Hyun Lim;Yoon, Hee Sook;Kim, Eun Hyun;Yoon, Ji Hyun;Chang, Hee Kyung
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.361-375
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    • 2017
  • Purpose: This study was conducted to update the existing nursing practice guideline for intravenous infusion guidelines according to the evidence-based practice guideline in South Korea. Methods: Guideline update process was performed using 22 steps according to the manuals developed by NICE and SIGN. Results: Updated nursing practice guidelines for the intravenous infusion were consisted of 23 domains and 322 recommendations. The number of recommendations in each domain were 4 for general instruction, 12 for vascular access device selection, 20 for site selection, 9 for insertion, 54 for stabilization, 21 for maintaining patency, 4 for blood sampling, 33 for exchange and removal, 28 for add-on device selection, 28, 72 for infusion related complications, 56 for infusion therapies, 7 for education, and 2 for documentation and report. There were 15.9% of A, 30.2% of B, 53.9% of C in terms of grade recommendations. A total of 178 (51.6%) recommendations were newly developed and 24 previous recommendations have been deleted. Conclusion: Updated nursing practice guideline for intravenous infusion was expected to be an evidence-based practice guideline for intravenous infusion in South Korea. This guideline is suggested to be disseminated to clinical nursing settings nationwide to improve the efficiency of intravenous infusion practice.