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Samenvatting multidisciplinaire benadering
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Samenvatting multidisciplinaire benadering
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By: kristelverbuyst • 3 year ago
By: bostyl • 3 year ago
By: valentinedesousa • 3 year ago
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Multidisciplinairebenadering van klinische
besluitvorming
Schakelprogramma Master in de Verpleegkunde en de Vroedkunde
2019 – 2020
,Inhoud
INTRODUCTIE .....................................................................................................................10
1. SITUERING ...............................................................................................................10
2. DOELSTELLINGEN...................................................................................................11
3. INHOUD ....................................................................................................................11
4. EINDCOMPETENTIES ..............................................................................................12
5. LESPLANNING EN LOKALEN ..................................................................................12
HOOFDSTUK 1. KLINISCH REDENEREN EN BESLUITVORMING ....................................13
1. INLEIDING .................................................................................................................13
2. SITUERING ...............................................................................................................15
3. BENADERINGEN ......................................................................................................18
3.1 Medische besliskunde.........................................................................................19
3.2 Clinical reasoning ...............................................................................................19
3.3 Scripts ................................................................................................................24
3.4 Pluis vs. niet pluis / intuïtie / gutfeeling ................................................................26
3.5 Patroonherkenning (short cuts) ...........................................................................26
3.6 BIAS ...................................................................................................................26
4. Clinical reasoning web ...............................................................................................27
HOOFDSTUK 2. MULTIDISCIPLINAIR SAMENWERKEN EN COMMUNICATIE .................29
1. INLEIDING .................................................................................................................29
2. DEFINITIE .................................................................................................................30
3. VOORBEELDEN .......................................................................................................30
3.1 Interdisciplinary rounds .......................................................................................30
3.2 Multidisciplinair Oncologisch Consult (MOC) ......................................................30
3.3 Bedside shift report .............................................................................................32
4. BARRIÈRES ..............................................................................................................32
4.1 Organisatie .........................................................................................................33
4.2 Team ..................................................................................................................33
4.3 Individueel teamlid ..............................................................................................33
4.4 Advantages of Interdiciplinary Team Care ..........................................................34
5. OPDRACHT 1............................................................................................................34
6. OPDRACHT 2............................................................................................................35
6.1 Deel 1 .................................................................................................................35
6.2 Deel 2 .................................................................................................................36
HOOFDSTUK 3. MEDISCHE BEELDVORMING ..................................................................37
1. INLEIDING .................................................................................................................37
2. TECHNIEKEN AFWEGEN .........................................................................................39
2.1 Röntgenstralen ...................................................................................................40
2
, 2.2 Ultrageluid (echografie).......................................................................................42
2.3 Magnetisme ........................................................................................................43
2.4 Radio-activiteit ....................................................................................................48
3. SOORTEN BEELDEN ...............................................................................................51
3.1 Morfologische info...............................................................................................51
3.2 Functionele info ..................................................................................................52
3.3 Chronologische info ............................................................................................53
3.4 Info: kwalitatief en kwantitatief ............................................................................53
3.5 Pathognomonische tekens ..................................................................................53
3.6 Specifiek beelden of tekens ................................................................................54
3.7 Niet specifiek beeld .............................................................................................56
3.8 Soorten informatie: overzicht ..............................................................................62
3.9 Besluit.................................................................................................................62
4. HOE KIJKT DE RADIOLOOG? ..................................................................................63
5. HOE VRAAGT MEN MBV AAN? ...............................................................................66
5.1 Standpunt van de aanvrager ...............................................................................66
5.2 Het kader: de geneeskunde ................................................................................66
5.3 Waarom beeldvorming? ......................................................................................67
5.4 Strategie achter de guidelines.............................................................................68
5.4.1 Strategie: rule in..................................................................................................... 69
5.4.2 Strategie: rule out .................................................................................................. 69
5.4.3 Slechte strategie .................................................................................................... 69
6. DE BEELD-TEST.......................................................................................................70
6.1 Kenmerken van een test .....................................................................................70
6.2 Normaal – Pathologisch ......................................................................................70
6.3 Onthouden ..........................................................................................................72
7. DE AANVRAAG .........................................................................................................73
7.1 Richtlijnen MBV ..................................................................................................75
7.2 Belangrijke opmerking ........................................................................................76
7.3 Wat brengt de toekomst? ....................................................................................78
7.4 Verantwoordelijkheden .......................................................................................78
8. HET VERSLAG..........................................................................................................79
8.1 Het verslag: sjabloon. .........................................................................................79
8.2 Beschrijving ........................................................................................................79
8.3 Besluit.................................................................................................................80
8.4 Classificaties .......................................................................................................80
8.4.1 Morfologische classificatie ..................................................................................... 80
8.4.2 Oncologische classificatie ....................................................................................... 81
3
, 8.4.3 Classificatie van evolutie van tumoren ................................................................... 81
8.5 Inschattingscategorie ..........................................................................................81
8.6 Hoe wordt het resultaat meegedeeld? ................................................................82
9. DE BEELDVORMER IN HET MULTIDISCIPLINAIR TEAM .......................................83
9.1 Connexisten........................................................................................................83
9.2 De radioloog als collega......................................................................................83
9.3 De radioloog en de chirurg ..................................................................................83
9.4 De radioloog en de internist ................................................................................83
9.5 Urgente en onverwachte bevindingen .................................................................84
9.6 Radioloog en MOC .............................................................................................84
9.7 De radioloog en de huisarts ................................................................................84
10. WAT DOET MEN MET HET VERSLAG? ...............................................................85
11. STANDPUNT VAN DE PATIËNT ...........................................................................85
11.1 Algemeen ...........................................................................................................85
11.2 Communicatie met de patiënt .............................................................................87
12. KLINISCHE VOORBEELDEN ................................................................................88
12.1 Beeldvorming van pezen ....................................................................................88
12.1.1 Pijn in de schouder: DD .......................................................................................... 88
12.1.2 Schouderpijn: 4 graden van tendinose op MRI ....................................................... 90
12.1.3 Drempels bij schouderpijn...................................................................................... 92
12.2 Casus: acuut abdomen .......................................................................................92
HOOFDSTUK 4. GENETICA ................................................................................................96
1. ALGEMEEN...............................................................................................................96
2. VAN MENDEL TOT HET HUMAAN GENOOM PROJECT.........................................96
3. HET HUMAAN GENOOM PROJECT ........................................................................97
3.1 Algemeen ...........................................................................................................97
3.2 Dimensies ...........................................................................................................97
3.3 Ter vergelijking ...................................................................................................98
4. DE CELKERN............................................................................................................98
5. BIJZONDERE STRUCTUUR ...................................................................................101
6. DE GENETISCHE CODE ........................................................................................ 102
7. CHROMOSOMEN ...................................................................................................105
8. ERFELIJK <> GENETISCH ..................................................................................... 108
9. DE GENETISCHE BASIS VAN ZIEKTE...................................................................108
10. BELANG VAN GENETISCHE DIAGNOSTIEK ..................................................... 109
11. WEEFSELS VOOR GENETISCH ONDERZOEK .................................................110
12. CONVENTIONELE CYTOGENETICA - KARYOTYPERING ................................ 111
13. KARYOTYPERING: PROCEDURE ......................................................................112
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