간호분야 실무지침의 수용개작 방법론에 따른 구강간호 실무지침의 개발
Development of Oral Care Nursing Practice Guideline using the Guideline Adaptation Process
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목적: 본 연구는 국내 근거기반간호의 활성화를 위해 간호실무지침개발 방법론으로 제시한 수용개작 방법론에 따라 구강간호실무지침을 개발하는 연구를 시도하였다. 방법: 본 연구의 방법은 국내 근거기반간호의 활성화를 위해 구미옥 등(Gu, et al. 2012)이 한국보건의료연구원 임상진료지침지원국이 발간한 임상진료지침 수용개작 매뉴얼 version 2.0 (Kim, et al., 2011)에서 제시한 수용개작 방법론을 수정하여 간호실무지침개발 방법론으로 제시한 수용개작 방법론에 따라 구강간호실무지침을 개발하는 연구를 시도하였다. 결과: 수용개작된 구강간호 실무지침은 10개 영역, 85개 권고안으로 구성되었다. 영역별 권고안 수를 보면 영역별 권고안 수는 일반적 지침 4개, 적응증 2개, 구강사정 10개, 일반적 구강간호 16개, 중환자 구강간호 15개, 암환자 구강간호 15개, 암환자 구강합병증 간호 14개, 교육 5개, 의뢰 2개, 기록 2개 모두 85개의 권고안이었다. 이들 권고안에 대해 근거수준을 보면 I 수준이 9개(10.6%), II 수준이 17개(20.0%), III수준이 59개(69.4%)이고, 권고등급은 A 등급이 9개(10.6%), B 등급이 17개(20.0%)이고, C 등급이 59개(69.4%)이었다. 결론: 수용개작된 구강간호 실무지침이 전국의 병원에 확산되면 간호실무가 과학적인 근거를 기반으로 수행되어, 구강간호실무의 효율성이 개선되는데 크게 기여할 수 있을 것으로 생각된다.
Abstract
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.
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