BCPS cheat sheet

Vancomycin for MRSA: target AUC24/MIC 400-600 mg·h/L; AUC-guided dosing is preferred over trough-only monitoring because it is equally effective and less nephrotoxic.

CHA2DS2-VASc: 2 points each for age >=75 and prior stroke/TIA; 1 point each for CHF, hypertension, diabetes, vascular disease, age 65-74, and female sex. Anticoagulate men at >=2 and women at >=3.

HAS-BLED >=3 indicates high bleeding risk; it flags modifiable factors (labile INR, NSAIDs, alcohol) for correction but is not by itself a contraindication to anticoagulation.

Cockcroft-Gault: CrCl = [(140 - age) x weight] / (72 x SCr), multiplied by 0.85 if female.

Adjusted body weight = IBW + 0.4 x (TBW - IBW); used for aminoglycoside dosing when total body weight exceeds roughly 120-130% of ideal body weight.

Corrected calcium = measured calcium + 0.8 x (4.0 - serum albumin in g/dL).

Anion gap = Na - (Cl + HCO3), normal about 8-12 mEq/L; a high gap with metabolic acidosis suggests lactate, ketones, uremia, or toxins.

Discontinue a QT-prolonging drug when QTc exceeds 500 ms or rises more than 60 ms from baseline, especially with hypokalemia, bradycardia, or syncope.

NNT = 1 / ARR, where ARR = control event rate - treatment event rate; NNH = 1 / absolute risk increase.

Odds ratio approximates relative risk only when the outcome is rare (<10%); for common outcomes the OR exaggerates the treatment effect.

A 95% confidence interval crossing the null value (1 for ratios, 0 for differences) corresponds to p > 0.05; narrower intervals indicate greater precision.

Intention-to-treat analysis preserves randomization and is conservative; per-protocol and as-treated analyses can bias toward efficacy.

Power = 1 - beta; required sample size increases with smaller expected effect size, greater variance, higher power, and lower alpha.

I-squared >=50% indicates at least moderate heterogeneity across pooled studies; explore subgroup and sensitivity analyses before drawing conclusions.

Evidence hierarchy: systematic review/meta-analysis of RCTs > RCT > cohort > case-control > case series > expert opinion; GRADE rates overall certainty and may downgrade RCTs for risk of bias or imprecision.

Trial phases: I for safety and dosing, II for efficacy signal, III for comparative efficacy against a control, IV for post-marketing surveillance.

PDSA (Plan-Do-Study-Act) cyclically tests small changes; scale an intervention only after documented improvement in the study step.

Failure mode and effects analysis is prospective risk assessment before harm; root cause analysis is retrospective review after a sentinel event.

NCC MERP index categories run A through I: A = circumstances that could cause an error, I = an error that contributed to patient death.

Just culture: human error is consoled, at-risk behavior is coached, and reckless behavior is sanctioned.

High-alert medications (insulin, heparin, opioids, concentrated potassium, neuromuscular blockers) require independent double checks and standardized concentrations.

Medication reconciliation is performed at admission, transfer, and discharge; unresolved discrepancies are a leading source of transition-of-care harm.

ICER = change in cost / change in health effect, reported as dollars per QALY and compared against a willingness-to-pay threshold.

Six Sigma DMAIC sequence: Define, Measure, Analyze, Improve, Control; Lean methodology targets waste reduction through value-stream mapping.

Kirkpatrick levels in order: reaction, learning, behavior, results; only the results level captures patient or organizational outcomes.

Bloom's revised taxonomy order: remember, understand, apply, analyze, evaluate, create; objectives should state observable, measurable verbs.

SMART objectives are specific, measurable, achievable, relevant, and time-bound.

One-minute preceptor sequence: get a commitment, probe for supporting evidence, teach a general rule, reinforce what went well, correct errors.

Miller's pyramid: knows, knows how, shows how, does; entrustable professional activities assess performance at the 'does' level.

Thomas-Kilmann modes by assertiveness and cooperativeness: competing, collaborating, compromising, avoiding, accommodating.

Kotter's eight-step change model begins with creating urgency and forming a guiding coalition, and ends with anchoring changes in culture.

Andragogy (Knowles): adult learners are self-directed, problem-centered, internally motivated, and need to know why content is relevant.