P24S03: Pneumonia (hospitalisation)
Bottom line: Information on pneumonia was used to justify the management of a
patient (justify the hospitalization of the patient). There were no information-related patient
health outcomes.
Level 1 outcome (situational relevance): On October 10,
2008, P24 did a search at work, by themselves, and during an encounter with a
patient. P24 retrieved two information hits about pneumonia outside the examination room, discussed with the supervisor, and came back in the room.The reported
search objectives were: to address a clinical question, to fulfill an
educational or research objective, to share information with a patient or a
caregiver, and to exchange information with another health professional. The patient [a
man in his seventies] came [to the emergency
room] short of breath and needing oxygen. [
] I examined the
patient, and then ordered an x-ray. I thought that there was a pneumonia, and
so I tried to calculate [with table 2] along with all the
patients diseases. [
] If we have more
than 90 points it makes a good indicator to keep them admitted in the hospital.
If it was less than 90 per cent then we can usually send them back home and
treat them as outpatients. [
] My question was should we keep
the patient in the hospital or not. [
] All these criteria
and tables and calculations, [
] the whole chart [table 2], [
] is educational [for me]. [
] I discussed with my staff and we looked up the
chart and we calculated together. [
] Once we get the
treatment, [and we decide
if] we keep [the patient in
or not], we have to discuss with the patient and the caregivers also. According to P24,
the information from e-Therapeutics+ was in agreement and equally relevant as
the information from two other resources: an electronic resource (Google) and another health professional (supervisor).
Level 2 outcome (cognitive impact): The first hit
was associated with a report of
positive cognitive impact (see table). Regarding practice improvement, P24 stated: Im not an
emergency doctor, but in the emergency its important to follow up. [
] It [the table 2] tells me what to do
next. The second hit
was associated with a report of a positive cognitive impact (learning). I didnt know how
quick the treatment had to be started. [
] Some people come
in after a few days of being sick.
Retrieved information hits:
1) e-Therapeutics+ (CIRT): Therapeutics
Tab Keyword: Pneumonia Community acquired pneumonia Table 2 (P24S03H01)
2) e-Therapeutics+ (CIRT): Therapeutics
Tab Keyword: Pneumonia Community acquired pneumonia Highlight (P24S03H02)
Level 3 outcome
(information use): Information on pneumonia was retrieved, and used to justify the management of a patient
(information used as presented in e-Therapeutics+). I had to decide if they [the patient] need to stay in the
hospital or not. So, I decided that they did [based
on the calculation of points with table 2]. I didnt tell the patient about the table but I
told him that they will have to stay in hospital for the question of the
treatment.
Level 4 outcome (patient health): Patient health
outcomes were unknown (no follow-up).
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Fulfill educational objective Share information Exchange information |
Practice improved Learned something Reminded something Motivated to learn Confirmed Reassured |
Justify choice |
No outcome |