간호분야 실무지침의 수용개작 방법론에 따른 정맥혈전색전증예방 간호실무지침의 개발
Nursing Practice Guideline for Prevention of Venous Thromboembolism According to the Guideline Adaptation Process
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목적: 국내에서 사용할 수 있는 근거기반의 “정맥혈전색전 예방간호” 실무지침을 개발하기 위한 것이다. 방법: 2012년 병원간호사회에서 개발한 “간호분야 실무지침 수용개작”방법론에 따라 24단계의 수용개작 과정을 진행하였다. 결과: 정맥혈전색전 예방간호 실무지침 권고안은 16개 영역, 163개 권고안으로 구성되었다. 영역별 권고안 수는 일반적 지침 4개, VTE 위험요인 사정 4개, VTE 발생의 중재 2개, VTE 예방을 위한 기계적 중재 14개, VTE 예방을 위한 약물적 중재 30개, 내과환자의 VTE 예방 19개, 뇌졸중환자의 VTE 예방 10개, 암환자의 VTE 예방 16개, 임산부의 VTE 예방 14개, 원거리여행자의 VTE 예방 6개, 외과환자-복부수술환자 VTE 예방 5개, 흉부수술환자 VTE 예방 10개, 정형외과 환자 VTE 예방 10개, 신경외과 환자 VTE 예방 5개, 기타 외과환자 VTE 예방 4개, 비뇨기과 수술환자 VTE 예방 2개, 이비인후과 수술환자 VTE 예방 1개, 성형과 재건수술 환자 VTE 예방 1개, 통원수술환자 VTE 예방 3개, 환자를 위한 VTE 예방 교육 3개로 총 163개의 권고안이다. 권고등급은 각 권고안별로 제시되었으며, 권고등급은 총 173개이고, 권고등급은 A 등급이 24개(13.8%), B 등급이 106개(61.3%)이고, C 등급이 43개(24.9%)였다. 결론: 정맥혈전색전 예방간호 실무지침의 확산은 보다 과학적인 근거를 기반으로 수행되고, 표준화되며, 간호업무의 효율성이 개선되는데 기여할 것이다. 이에 정맥혈전색전 예방간호 실무지침을 병원간호사회를 통하여 전국의 병원에 확산하여 실무에서 활용할 것을 제언한다.
Abstract
Purpose: This study was conducted to develop a useful evidence-based guideline for preventing venous thromboembolism(VTE) in Korea adapting previously developed VTE guidelines. Methods: The guideline adaptation process was performed using 24 steps according to the nursing practice guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed VTE prevention guideline was consisted of 16 domains and 163 recommendations. The number of recommendations in each domain were: 4 general issues, 4 risk factors, 2 intervention at occurrence of VTE, 14 mechanical interventions, 30 pharmacological interventions, 19 VTE prevention for medical patient, 10 stroke patient, 16 cancer patient, 14 pregnancy, 6 for long distance traveller, 5 for abdominal surgery, 10 thoractic surgery, 10 orthopedic surgery, 5 neurosurgery, 4 other surgical patient, 2 urological surgery, 1 ENT surgery, 1 plastic surgery, 3 day surgery, 3 education of VTE prevention. Fourteen point three percent, 61.1%, and 24.6% of the recommendations were graded A, B, and C, respectively. Conclusion: The findings suggest that the new VTE prevention guideline can be more efficiently used to prevent VTE in hospital settings.
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