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Lecture 10

INST 352 Lecture 10: INST352 Lecture 10: Helping a PatientExam


Department
Information Studies
Course Code
INST 352
Professor
Gigigan
Lecture
10

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INST352 Lecture 10: Helping a Patient
Although our usual focus in information behavior research is the individual, it is important to
recognize that much information seeking takes place in groups, and that sharing of information with
others is very common. In this scenario, we consider the many exchanges that might take place
among members of a health care team in a hospital. Because the information seeking plays out over
several days and involves many individuals, it is possible only to sketch out some of the dozens of
actions and interactions that are likely to occur. Also for simplicity’s sake, we will consider only a
single patient, while recognizing that a team would certainly be caring for multiple patients at any
one time, each at different stages of crisis or healing. To further condense the description, we focus
on only four key team members: physician (Dan), day nurse (Marta), night nurse (Gary), pharmacist
(Ming).
The story begins without the team, in the emergency entrance to a rural hospital, where a 22-year-
old male has been brought in by an ambulance shortly after midnight. The man was in a car accident
and is semi-conscious but shows no injuries other than contusions. Unfortunately, the man carries
no identification and the car was registered in a female name in another state. Thus, he must be
admitted without access to a medical history.
The patient is first examined by a nurse, and then by an attending physician. Both of these
administer the Glasgow Coma Scale (GCS), a 15-point neurological measurement of
consciousness. A score of eight is recorded each time, which could indicate severe brain injury.
Then he is taken for a CT scan of the head and upper body, and a blood test for presence of alcohol
and drugs. Afterward, the patient is taken to the intensive care unit (ICU). Here the night nurse,
Gary, supervises the movement of the patient to one of the ICUs 15 beds. The patient is soon fitted
with an IV to deliver fluids and medications, and devices to monitor blood pressure, heart rate, and
oxygen levels of the blood. His temperature is taken, and he is given periodic ice packs to reduce
swelling. Gary also gives the patient the coma test again, consulting a flashcard” he keeps for this
purpose, as he has trouble recalling the individual indicators. He records a score of 10 on the chart
using the conventional breakdown for the Eye, Verbal, and Motor components of the scale: GCS 10
= E2 V4 M4 at 01:17. The patient is given no medications at this point, as they might interfere with
indicators for the scale.
The patients hospital room contains a number of potential sources of information, the ultimate origin
of which, in some cases, is the patient himself. Among these sources are: the monitors attached to
the patient (including blood pressure, heart rate, and oxygen level of blood); the CT scan results,
viewable at a nearby workstation; electronic and paper versions of the patient records, including
orders for medications administered; and, a bedside white board for nurses to record any facts that
need to be called to the immediate attention of anyone who enters. On this board, Gary has noted
the latest coma scale score and the words Patient Name Unknown. In a nearby alcove outside the
room is a nursing station, where a number of medical reference works (e.g., the AACN Procedure
Manual for Critical Care, Quick Reference to Critical Care , and Micromedex ) are available online,
along with medical databases like MedLine, PubMed , and Drug Interaction Checker .
The fact that the patients name is not yet known is a serious problem, as nothing is understood
about medical problems that might have predated the accident. This situation is resolved early in the
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