NURS 6512 A 38yr old pregnant Native American woman Building a Health History

NURS 6512 A 38yr old pregnant Native American woman Building a Health History

Week One Discussion

     The purpose of this discussion is to understand effective patient communication. To build a health history, obtaining accurate information may depend on a health care provider’s ability to communicate with a patient. I’ll also pick out a tool to assess risks and explain why it’s useful for this particular patient. Lastly, I’ll come up with five specific questions to ask this patient.

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Summary of interview

A 38-year-old pregnant Native American woman from a reservation comes to the health care facility for a checkup. As an APRN (Advanced Practice Registered Nurse), I’ll think about her gender, age, ethnicity, and where she lives while getting information about her health (Ball et al., 2019). Even though I’m a male practitioner and might not completely understand her experience, I’ll approach her with compassion. I’ll ask about her medical history, any procedures she had, if she uses any drugs or alcohol, her prenatal care, the medicines she took or is taking, her home life, nutrition, and any extra support she might need for her health. I’ll also make sure there’s enough quiet time for her to share her worries, ask questions, and tell me what I need to know.

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Description of Communication Techniques

Effective communication involves understanding the information shared between two or more parties (Bramhall, 2014). The techniques used in communication can significantly influence a patient’s treatment. To ensure clear communication, I will be mindful of any barriers that may exist between the patient and me. Assessments can be uncomfortable for patients, and the information gathered may not always be straightforward. Some patients may feel frustrated and seek understanding and empathy from me. During assessments, I will adopt a patient-friendly approach by sitting at eye level, speaking softly, actively listening, and being attentive while taking notes. I have observed instances where others use electronic devices or take notes during assessments, which may create a sense of detachment. Such detachment can hinder the opportunity to gather crucial patient information. According to a report by the Joint Commission, 80% of serious medical errors occur when there is a foundation of poor communication during patient transfers (Commission, 2019). To enhance communication, I will consistently employ the teach-back method throughout the examination to ensure that the patient accurately understands the information conveyed.

The reasoning for Utilizing these Specific Techniques

I plan to apply these particular techniques to establish a connection with the patient. I firmly believe that every patient wishes and deserves to be acknowledged and listened to. In my past experiences, I’ve noticed that when a patient feels acknowledged, heard, and safe, they are more willing to engage in open communication. This connection and positive dynamic can pave the way for successful treatment plans, enhance patient safety, and ensure continuity of care.

Risk Assessment Instrument and why it is Applicable for Patient

    I will employ the PRAMS (Pregnancy Risk Assessment Monitoring System) tool to assess risks for both the patient and the baby. This tool is valuable as it not only identifies potential risks but also functions as a survey, allowing for adjustments in universal healthcare practices and promoting optimal patient outcomes. PRAMS addresses crucial considerations for pregnant women, encompassing topics such as preconception health, folic acid awareness, HIV testing, work-related aspects, leave, childcare, infections, chronic conditions, stressful life events, and physical activity (Shulman, 2006). Given the patient’s pregnancy, this tool is highly relevant, covering essential questions that can benefit pregnant patients universally. Early intervention based on the insights gained from this tool can significantly impact achieving the best possible outcomes for the patient.

Five Targeted Questions for the Patient:

1. Can you share with me the reasons for your visit today? I want you to feel comfortable expressing any concerns, and I’m here to listen and address all possibilities.

2. Do you have a history of medical conditions or diagnoses? Additionally, is there a family history of any diseases?

3. Could you provide information about the medications you are currently taking? I would like to know if there have been recent changes, and I will cross-verify using reliable pharmaceutical databases.

4. Are you allergic to any foods, medications, or substances? If you are, please describe what happens during an allergic reaction. For instance, some individuals may consider stomach aches as part of their reaction, and I want to understand your specific experiences.

5. Before we conclude this assessment, is there anything else you would like to share or ask me? I believe an open-ended question can yield valuable information that may not have been covered yet.

ConclusionIn conclusion, I will assess with compassion, understand the patient’s abilities to communicate, use tools when unsure, and lastly, ask the patient questions to retrieve information vital in providing the best patient outcomes.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B.S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO

Bramhall, Elaine. Nursing Standard (2014+); London Vol. 29, Iss. 14, (Dec 3, 2014): 53. DOI:10.7748/ns.29.14.53. e9355

The Joint Commission, Joint Commission Center for Transforming Healthcare Releases Targeted Solutions Tool for Hand-Off Communications, August 2012, Volume 32, Issue 8, 2019.

Shulman HB, Gilbert BC, Lansky A. The Pregnancy Risk Assessment Monitoring System (PRAMS): Current Methods and Evaluation of 2001 Response Rates. Public Health Reports. 2006;121(1):74-83.

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Discussion: Building a Health History

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

  • By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
  • How would your communication and interview techniques for building a health history differ with each patient?
  • How might you target your questions for building a health history based on the patient’s social determinants of health?
  • What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
  • Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
  • Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
  • Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:

  • Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
  • Suggest additional health-related risks that might be considered.
  • Validate an idea with your own experience and additional research.

sample response 1

xxx,

You’re welcome! I appreciate your positive feedback. I completely agree that approaching patient care with compassion and cultural sensitivity is crucial for building trust and ensuring effective communication.

Your recommendation to inquire about holistic or herbal medicinal approaches is excellent, especially considering the cultural background of the Native American pregnant woman. Understanding and respecting her potential use of herbal remedies aligns with the holistic perspective that many individuals value. It’s essential to recognize and appreciate diverse cultural practices, such as the use of herbal medicine, which can play a significant role in an individual’s health and well-being.

Moreover, being open to discussing these approaches can foster a more collaborative and patient-centered relationship, allowing the healthcare provider to integrate these insights into the overall care plan. This aligns with the patient-centered care model, promoting mutual respect and shared decision-making between the healthcare provider and the patient.

If you have any more aspects you’d like to discuss or explore further, feel free to let me know!

References

Goodkind, J. R., Ross-Toledo, K., John, S., Hall, J., Ross, L., Freeland, L., Coletta, E., Becenti-Fundark, T., Poola, C., Roanhorse, R., & Lee, C. (2011). Rebuilding trust: A community, multiagency, state, and university partnership to improve behavioral health care for american indian youth, their families, and communities. Journal of Community Psychology39(4), 452–477. https://doi.org/10.1002/jcop.20446

Illamola, S. M., Amaeze, O. U., Krepkova, L. V., Birnbaum, A. K., Karanam, A., Job, K. M., Bortnikova, V. V., Sherwin, C. M., & Enioutina, E. Y. (2020). Use of herbal medicine by pregnant women: What physicians need to know. Frontiers in Pharmacology10https://doi.org/10.3389/fphar.2019.01483

sample response 2

Hello xxx, great post and very informative, I enjoyed reading it.

Absolutely, your insights align well with the principles of effective communication in healthcare. Clear and accurate information is fundamental to providing quality care, and poor communication can indeed lead to adverse events and medical errors. The importance of well-designed discharge orders and evaluating patient understanding through demonstrations or verbalizations highlights the need for comprehensive and patient-centered communication strategies.

Establishing rapport during patient interviews is a key component of patient-centered care. When patients feel comfortable and supported, they are more likely to share relevant information, which is crucial for accurate assessments and treatment plans. Accepting emotional responses without criticism is particularly important, as it fosters a trusting relationship between the healthcare provider and the patient.

Moreover, your mention of refraining from interrupting the interviewee is crucial. Allowing patients to express themselves without interruption not only respects their autonomy but also ensures that they can convey their concerns, symptoms, or thoughts effectively. Structuring questions in an easily understood manner is another essential aspect, as it promotes clarity and helps patients articulate their responses.

If you have any specific aspects or questions you’d like to explore further, feel free to let me know!

References

Stewart, J., & Snowden, V. (2021). Promoting Communication and Safety Through Clear and Concise Discharge Orders. Journal for Nurse Practitioners17(7), 874–878. https://doi-org.ezp.waldenulibrary.org/10.1016/j.nurpra.2021.02.023

Luizzo, A. (2019). Effective interview techniques. Journal of Healthcare Protection Management35(2), 110–117.

sample response 3

Thank you for emphasizing the use of effective communication skills during your interview process to obtain accurate patient information and history such as active listening, maintaining good eye contact, and use of open- ended questions (Arsith, 2017). As practitioners, the use of effective communication help to build a good patient relationship that helps to develop great plan of care (Ball et al., 2019).

Reference

Arsith, M., & Popa, D. (2017). General aspects on the communication between healthcare provider and patient. Acta Universitatis Danubius. Communicatio11(1), 83–90.

 https://doi.org/https://ezp.waldenulibrary.org/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fgeneral-aspects-on-communication-between%2Fdocview%2F2118381535%2Fse-2%3Faccountid%3D14872

Ball, J., Dains, J., Flynn, J., Solomon, B., & Stewart, R. (2019). Seidel’s guide to physical examination: An interprofessional approach (mosby’s guide to physical examination) (9th ed.). Mosby.

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