간호분야 실무지침의 수용개작 방법론에 따른 경장영양 실무지침의 개발
Development of Nursing Practice Guidelines on Enteral Tube Feeding using the Guideline Adaptation Process
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초록
본 연구는 기존에 잘 개발된 근거기반경장영양실무지침을 수용개작하여 국내 간호실무지침으로 제공하기 위한 것이다. 연구방법: 수용개작 방법은 한국보건의료연구원에서 개발한 임상진료지침 수용개작 매뉴얼(version 2.0)을 기반으로(Kim. et al., 2011) 구미옥 등(2011)이 표준화한 간호분야 실무지침의 수용개작 방법론에 따라 시행되었다. 결과: 수용개작된 경장영양 간호실무지침은 11개 영역, 95개 권고안으로 구성되었다. 하위영역별 권고안은 일반적 지침 4개, 경장영양의 적응증 및 투여의 중단 2개, 경장영양 접근장치의 선택 6개, 경장영양접근장치 삽입 12개, 경장영양액 종류 및 선택 3개, 경장영양관의 시작과 진행 16개, 경장영양액 유지 관리 20개, 경장영양 주입의 감시 15개, 경장영양시의 오류 예방 10개, 약물주입 5개, 간호기록 2개로 구성된다. 권고안의 등급은 A 12.4%, B 18.6%, C 69.0%이다. 결론: 수용된 경장영양간호실무지침은 경장영양을 위한 근거기반의 실무가 제공되는데 기여할 것이다. 본 지침을 국내에 보급하여 경장영양간호실무의 효율성을 개선할 것을 제언한다.
Abstract
Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines 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 NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.
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