성인 환자를 위한 근거기반 냉 요법 간호실무지침 개발

Purpose: The aim of this study was to develop evidence-based nursing practice guidelines for cold application in adult care. Methods: The study procedure was based on the Scottish Intercollegiate Guidelines Network and Korean Hospital Nurses Association"s guideline development methods. The evidence review procedures included targeted searches from databases including the Cochrane Library, PubMed, CINAHL, Embase, KoreaMed, KERIS and NDSL. The initial search yielded 6,426 articles published from 2006 to 2016. Based on the screening process, 147 articles were selected and systematically reviewed. From evidence summaries of 20 clinical questions, recommendations were formulated and graded. Draft recommendation were evaluated through external review. Results: The guidelines consisted of 10 domains and 27 recommendations. The content validity index of the recommendations was above .80. Major recommendations include 1) applying external cooling to reduce acute pain, edema, and hemorrhage, 2) selecting cooling instruments based on the purpose, patient’s condition, and preference, 3) preparing and maintaining cooling instruments at an adequate temperature, and 4) intermittent cold application for appropriate durations with sufficient recovery time. Conclusion: These guidelines can be utilized in both clinical and community settings to help narrow the gaps between nursing practices.