Show Menu
Cheatography
  1. Home >
  2. Home and Health >

PBL CLASS READINGS Cheat Sheet (DRAFT) by

2I04 PBL class readings for Tests

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Fine-t­uning the 5S Model into a 6S Model

Evidence is called pre-ap­praised b/c they have undergone a filtering process to include only those studies that are higher quality and are regularly updated
6S Model: systems, summaries, Synopses of Syntheses, syntheses, synopses of Studies, studies
5S model created by Haynes: original single studies, syntheses, synopses, summaries, systems
SYSTEMS: eviden­ce-­based clinical inform­ation system that concisely summarizes all relevant research evidence about clinical problem and is always updated + automa­tically links circum­stances related to your patient -- results in patein­t-s­pecific assess­men­ts/­rec­omm­end­ations
SUMMARIES: clinical pathwa­ys/­tex­tbook summaries that inegrate eviden­ce-­based inform­ation about specific clinical problems + regularly updated -- CPG = clinical practice guidelines are developed statements to aid in patient decision for specific clinical circum­sta­nces; high quality CPG produced by RNAO and Canadian Diabetes Associ­ation
SYNOPSES OF SYNTHESES: synthesis or systematic review with a compre­hensive summary of all the search evidence relates to a focused clinical question. Involves a multi-step where the question will get formulated and the relevant studies will be identified and appraised for quality. Relevant findings will be synthe­sized either quanti­tat­ively or non where conclu­sions will be drawn. Clinicians don't have time to review a detailed systematic review, synopsis of summaries way to go
DARE or Health­-ev­ide­nce.ca - Synopses can be found in the eviden­ce-­based abstra­ction of journals. Advantage: synopsis provides a convenient summary of the corres­ponding synthesis and it is often accomp­anied by a commentary that addresses the method­olo­gical quality of synthesis
DATABASES OF SYNTHESIS - SYSTEMATIC REVIEW: Cochrane Library houses syntheses about effect­iveness of healthcare invent­ions, includes DARE database of systematic reviews
SYNOPSES OF SINGLE STUDIES: provides a brief but detailed summary of a high-q­uality study. Can be found in eviden­ce-­based abstra­ction journals
Advantages: the assurance of the study being suffic­iently high quality and clinical relevance to abstra­ction. The brevity of the summary. The added value of the commentary
SINGLE ORIGINAL STUDY: if there are no synopses of single studies available. Studies that have met critical appraoch criteria appear in ACPJC PLUS, Eviden­ceU­pdates, Nursing+, these are the original articles published in journals

The View From Bed 10 Summary

Sue with a rare condition called Gullian- Barre Syndrome paralyzed everything from the neck down and spoke about her time in the ICU
"many of the discom­forts that ICU patients routinely experience are entirely avoida­ble­"
doctors would do their rounds on her and essent­ially ignore her as the patient because she couldn't speak and directly spoke to the nurse; "did the patient get a good sleep?­" Nurse said yes, but in reality, she did not have a good sleep and no one asked her
she mentioend that management would see the issues that are predom­inant in the ICU if they had just spent a night or so in the unit to see for themselves
one time the nurse was changing her diaper and while changing, another nurse called her and left her on the bed naked for 45 minutes; "I felt stripped of my dignit­y"
realized that hospitals are organized with the conven­ience of their staff and not of the interest of patients
first person to consider her feelings was a RT who realized her light was on at night while she was trying to sleep and people obviously want to be in the dark so he tried to turn off the light for her - the first time anyone had her interests in mind
one nurse who was clearly incomp­etent at her job did not like Sue becasue she was paralyzed and just annoying to take care of; the management knew of this, and literally said to her "I'm going to apologize for giving you nurse A but we cannot risk giving her to somebody who is really sick"
a doctor read this article, the doctor had no idea that was how patients were treated and that little things by health care workers could be so important
the surrou­ndings are really important b/c some patients may lack support and effort of their loved ones or may not even have any and health care workers are all they have
she learned that caregivers can learn to be more compas­sio­nate, more caring etc... also management can change this and implement change onto such a discussion
people can listen without even needing to use their ears, but mainly just by paying attnetion to the little things and signs that a patient may show
Look Up, Look Down, Stretch Out, Look Around, Listen, Look Out the Window, Sit Down, Now Take Note
 

Gullian - Barre Syndrome

Caused by infection from underc­ooked poultry
where cells in your nervous system attacks your nerves
it will make a person paralyzed and affect the CNS that causes you to become weak everywhere
paralysis of the entire body, unable to speak
no true but treatment to ease compli­cations

Asking Answerable Questions - EBN

Nurses are expected to keep their practice up to date and read public­ations to maintain continuing education which will place pressure and expeca­tations of nurses. How do you relieve this pressure? EBN, eviden­ce-­based nursing which is to include current best evidence from research in clinical and healthcare decisions. It is a 5 Stage Process
STAGE 1: Inform­ation needs to be from practice and converted into focused, structured questions
STAGE 2: the focused questions are used as a basis for literature searching in order to identify relevant external evidence from research
STAGE 3: the research evidence is critically appraised for validity and genera­liz­ability
STAGE 4: the best available evidence is used alongside clinical expertise and the patient's perspe­ctive to plan care
STAGE 5: perfor­mance is evaluated through a process of self-r­efl­ection, audit or peer assessment
EXAMPLE: you would initially find an issue, usually gained from a clinical and managerial situat­ions, then formulate your questions. There are 3 elements to questions: the situation, the interv­ention and the outcome.
The situation can be: a single patient or group of patients with a similar healthcare issue, or indivi­duals with similar demogr­aphic charac­ter­istics
the interv­ention is the dimension of health care of interest. For example putting wound dressings to make a wound therap­eut­ically better
It can be difficult to find and focus on a question so you will have to read research papers. Background reading and quick and dirty searching can really help you start and initaite the question making process.