Journal of Korean Academy of Nursing

Research Papers

Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients: Kim, Soomi , Kim, Chul-Gyu; J Korean Acad Nurs 2023;53(3):275-294. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.22109

Abstract PDF: Purpose
This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol.
Methods
The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol’s effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses’ outcome variables were evaluated using a questionnaire.
Results
First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001).
Conclusion
This protocol may help prevent infections and pressure injuries in patients, and improve nurses’ satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

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Development and Effectiveness of Practice Application Program of Intravenous Infusion EvidenceBased Nursing Practice Guideline - for Small and Medium Sized Hospitals: Hong, Inhwa , Eun, Young; J Korean Acad Nurs 2020;50(6):863-875. Published online December 31, 2020; DOI: https://doi.org/10.4040/jkan.20196

Purpose
This study was conducted to develop and test the effects of a program for practice application of intravenous infusion evidence based nursing practice (EBP) guidelines in small and medium-sized hospitals.
Methods
A mixed method research design was used, combining non-equivalent control group pre-post test design with qualitative study analysis. The subjects consisted of 55 nurses. The practice application program was developed based on the Advancing Research and Clinical practice through close Collaboration (ARCC) model. Data were collected for analysis in the following areas: nurses’ EBP organizational culture and readiness, EBP beliefs, EBP implementation, importance about intravenous infusion, and performance about intravenous infusion, with data assessed using valid and reliable instruments. Patient outcomes were collected from the hospital’s medical records. Data were analyzed using t-test, χ² -test, and Shapiro-Wilk test, with qualitative content analysis used for interview data.
Results
Following the intervention, nurses’ EBP organizational culture and readiness, EBP beliefs, EBP implementation, and performance of intravenous infusion and perceptions of its importance showed significant improvement in the experimental group. Phlebitis rates decreased in the experimental group compared to the control group.
Conclusion
This program is effective to improve nurse’s perception and practice of evidence based nursing. Therefore we recommend to use this program at same levels of hospitals.

Citations

Citations to this article as recorded by

Developing and evaluating an evidence-based practice research competency enhancement program for clinical nurses in Korea: a pilot study
Suhyun Kim, Hye Won Jeong
BMC Nursing.2024;[Epub] CrossRef
Effects of nurse’s knowledge and self-efficacy on nursing performance in pediatric intravenous fluid management in South Korea: a descriptive study
Se-Won Kim, Mi-Young Choi
Child Health Nursing Research.2024; 30(4): 288. CrossRef
Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients
Soomi Kim, Chul-Gyu Kim
Journal of Korean Academy of Nursing.2023; 53(3): 275. CrossRef

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2 Web of Science
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Original Articles

Adaptation and Evaluation of the Incontinence Care Protocol: Kyung Hee Park, Heejung Choi; J Korean Acad Nurs 2015;45(3):357-366. Published online June 30, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.3.357

Abstract PDF

Purpose

This study was done to develop an evidence-based incontinence care protocol through an adaptation process and to evaluate the effects of the protocol.

Methods

The protocol was developed according to the guideline of adaptation. A non-randomized controlled trial was used for testing the effects of the new Incontinence Care Protocol. A total of 120 patients having bowel incontinence with Bristol stool type 5, 6, and 7 and admitted to intensive care units were recruited to this study. The newly developed incontinence care protocol was used with patients in the experimental group and conventional skin care was given to patients in the control group. Outcome variables were incontinence-associated dermatitis (IAD) severity, pressure ulcer occurrence and severity.

Results

The experimental group had significantly less severe IAD (t=6.69, p<.001), lower occurrence of pressure ulcers (χ²=7.35, p=.007), and less severity of pressure ulcers (Mann-Whitney=86.00, p=.009) than the control group.

Conclusion

Use of this incontinence care protocol has the effects of preventing pressure ulcers and inhibiting worsening of IAD and pressure ulcers. Therefore, this incontinence care protocol is expected to contribute to managing IAD and pressure ulcers.

Citations

Citations to this article as recorded by

Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients
Soomi Kim, Chul-Gyu Kim
Journal of Korean Academy of Nursing.2023; 53(3): 275. CrossRef
The Efficacy of a Viscoelastic Foam Overlay on Prevention of Pressure Injury in Acutely Ill Patients
Kyung Hee Park, Joohee Park
Journal of Wound, Ostomy & Continence Nursing.2017; 44(5): 440. CrossRef

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Adaptation of Evidence-based Surgical Wound Care Algorithm: Jung Yeon Han, Smi Choi-Kwon; J Korean Acad Nurs 2011;41(6):768-779. Published online December 31, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.6.768

Abstract PDF

Purpose

This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit.

Methods

This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75.

Results

A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ≥.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations.

Conclusion

The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

Citations

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Bioactive Dressing: A New Algorithm in Wound Healing
Gianmarco Polverino, Francesca Russo, Francesco D’Andrea
Journal of Clinical Medicine.2024; 13(9): 2488. CrossRef
Knowledge, attitude and practices towards surgical wound care and healing among the public in the Jazan Region, Saudi Arabia
Hassan Mashbari, Sulaiman Hamdi, Hussam Darraj, Mohammed Awaf, Shaden Zaalah, Faisal Hakami, Khalid M. Hakami, Essam Alhazmi, Layla Al khairat, Shatha A. Hakami, Amani Aburasain, Ibrahim Ali I. Hakami, Abdulaziz A. Arishi
Medicine.2023; 102(51): e36776. CrossRef
Surgical wound assessment tool: Construct validity and inter‐rater reliability of a tool designed for nurses
Hien Thi Thu Do, Helen Edwards, Kathleen Finlayson
Journal of Clinical Nursing.2023; 32(1-2): 83. CrossRef
Development of a surgical wound assessment tool to measure healing and risk factors for delayed wound healing in Vietnam: a Delphi process
Hien Thi Thu Do, Helen Edwards, Kathleen Finlayson
Journal of Wound Care.2022; 31(5): 446. CrossRef
Xây dựng và chuẩn hóa bộ công cụ đánh giá vết mổ
Huế Nguyễn Thị
Journal of Clinical Medicine- Hue Central Hospital.2022;[Epub] CrossRef
Exploring guideline adaptation strategy for Turkey: Is “ADAPTE” feasible or does it need adaptation as well?
Duygu Ayhan Baser, Rabia Kahveci, Aylin Baydar Artantas, İlknur Yasar, Hilal Aksoy, Esra Meltem Koc, İsmail Kasim, Ilkka Kunnamo, Adem Özkara
Journal of Evaluation in Clinical Practice.2018; 24(1): 97. CrossRef
Using a Modified ADAPTE Process to Enable Effective Implementation of Electrical Stimulation Therapy for Treating Pressure Ulcers in Persons With Spinal Cord Injury
Deena Lala, Pamela Houghton, Paul Holyoke, Dalton Wolfe
Rehabilitation Process and Outcome.2017;[Epub] CrossRef

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The Effect of Treadmill Exercise on Ischemic Neuronal Injury in the Stroke Animal Model: Potentiation of Cerebral Vascular Integrity: Kyoung Ah Kang, Hohyun Seong, Han-Byeol Jin, Jongmin Park, Jongmin Lee, Jae-Yong Jeon, Youn Jung Kim; J Korean Acad Nurs 2011;41(2):197-203. Published online April 30, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.2.197

Abstract PDF

Purpose

This study was done to identify whether pre-conditioning exercise has neuroprotective effects against cerebral ischemia, through enhance brain microvascular integrity.

Methods

Adult male Sprague-Dawley rats were randomly divided into four groups: 1) Normal (n=10); 2) Exercise (n=10); 3) Middle cerebral artery occlusion (MCAo), n=10); 4) Exercise+MCAo (n=10). Both exercise groups ran on a treadmill at a speed of 15 m/min, 30 min/day for 4 weeks, then, MCAo was performed for 90 min. Brain infarction was measured by Nissl staining. Examination of the remaining neuronal cell after MCAo, and microvascular protein expression on the motor cortex, showed the expression of Neuronal Nuclei (NeuN), Vascular endothelial growth factor (VEGF) & laminin.

Results

After 48 hr of MCAo, the infarct volume was significantly reduced in the Ex+MCAo group (15.6±2.7%) compared to the MCAo group (44.9±3.8%) (p<.05), and many neuronal cells were detected in the Ex+MCAo group (70.8±3.9%) compared to the MCAo group (43.4±5.1%) (p<.05). The immunoreactivity of laminin, as a marker of microvessels and Vascular endothelial growth factor (VEGF) were intensively increased in the Ex+MCAo group compared to the MCAo group.

Conclusion

These findings suggest that the neuroprotective effects of exercise pre-conditioning reduce ischemic brain injury through strengthening the microvascular integrity after cerebral ischemia.

Citations

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Treadmill Exercise and its Effect on Rehabilitation of Patients after Ischemic strok: A Narrative Study
Monireh Motaqi, Ali Ghanjal, Mahsa Afrand
International Journal of Musculoskeletal Pain Prevention.2022; 7(3): 730. CrossRef
Voluntary exercise ameliorates the good limb training effect in a mouse model of stroke
Victoria Nemchek, Emma M. Haan, Rachel Mavros, Amanda Macuiba, Abigail L. Kerr
Experimental Brain Research.2021; 239(2): 687. CrossRef
HIF‑1α in cerebral ischemia (Review)
Peiliang Dong, Qingna Li, Hua Han
Molecular Medicine Reports.2021;[Epub] CrossRef
Modulating effects of preconditioning exercise in the expression of ET-1 and BNP via HIF-1α in ischemically injured brain
Huijie Wang, Feng Niu, Wei Fan, Jimin Shi, Jihong Zhang, Bing Li
Metabolic Brain Disease.2019; 34(5): 1299. CrossRef
A new analytical model for the changes of vascular endothelial growth factor in ischemic diseases
Feng Qiu, Hui Cao, Yue Wu
Medical Hypotheses.2017; 109: 73. CrossRef
Use of Animals for Nursing Research in Korea
Hae Young Yoo
Journal of Korean Biological Nursing Science.2015; 17(4): 324. CrossRef
Physical exercise training and neurovascular unit in ischemic stroke
X. Wang, M. Zhang, R. Feng, W.-B. Li, S.-Q. Ren, J. Zhang, F. Zhang
Neuroscience.2014; 271: 99. CrossRef

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