근거기반 임상실무지침: 장루간호
Evidence-Based Nursing Practice Guideline: Ostomy Care
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초록
목적: 본 연구의 목적은 효과적인 장루 간호를 위한 장루 위치 선정을 포함한 수술 전·후 간호, 합병증 관리와 이를 사정하는 방법, 교육, 퇴원 후 관리에 대한 근거기반 장루간호 임상실무지침서를 개발하는 것이다. 방법: 장루간호 실무지침의 수용개작은 병원간호사회에서 개발한 간호 분야 실무지침 수용개작방법론에 근거하여 23단계로 진행하였으며 권고안마다 근거수준과 근거등급을 기재하였다. 결과: 본 연구는 총 8개의 대분류와 8개의 소분류로 구성하여 총 55개의 권고안으로 구성되었으며8개의 대분류는1) 기관의 정책, 2) 수술 전 간호: 교육, 장루 위치 선정, 3) 장루조성술, 4) 수술 후 간호: 수술 후 교육, 수술 후 장루 사정, 고용량 배출 장루, 5) 제품 선택, 6) 장세척, 7) 장루 및 장루주위 피부 합볍증 8) 퇴원 후 관리이다. 결론: 본 실무지침서는 전문가들의 의견과 함께 체계적인 문헌고찰을 기반으로 한 권고안을 제시하고 있다, 또한 대상자에 대한 중재를 제공함에 있어서 위해와 위험에 대한 충분한 고려를 반영하여 체계적인 합의 과정을 거쳐서 개발되었기 때문에 생성된 근거기반의 지식이 적극적으로 실무 현장에 적용된다면, 의료의 질과 대상자의 삶의 질 향상에 이바지 할 것으로 여겨진다.
Abstract
Purpose: The aim of this study was to develop an evidence-based guideline for stoma management providing institutional policy, assessment, complications and follow-up care. Methods: The guideline adaptation manual consisting of 23 steps developed by the National Evidence-Based Healthcare Collaborating Agency was used for this study. It presents an overview of the process used to develop the guideline and lists specific recommendations from the guideline. Results: It provides 55 recommendations that include the following 8 topics: 1) Organization and policy recommendations, 2) Preoperative nursing; Ostomy education, stoma site marking, 3) Ostomy formation, 4) Postpoperative nursing; education, assessment, high output stoma management, 5) Selection of ostomy products, 6) Colostomy irrigation, 7) Stomal and peristomal complications, 8) Follow-up care after discharge. Conclusion: The guideline can be used to address stoma management in hospital settings. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patients’ outcomes.
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