Walden University Communication Techniques Discussion
Description
BY DAY 3
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. Identify and discuss at least one online, national, or local resource available to your at-risk client.
Margaret is a 46-year-old female patient who presents to the office today to discuss changes in her mood, increased fatigue, and new shoulder pain.
Each patient who presents in the office is unique. Each comes from different backgrounds, cultures, and living conditions and has individual social determinants to their health including, social isolation, interpersonal violence, access to housing, transportation, or access to food that changes the way a practitioner may target their questions in the health history. (Gruß et al., 2021). Knowing patient living arrangements or housing status will focus on questions that may revolve around abuse or social isolation problems and or access to running water or healthy food. Although each patient will come in with varied SDH and risk factors the nurse practitioner will need to choose a comprehensive risk assessment instrument to assess these factors. This topic has come into light since 2012 when the Affordable Care Act directed the Centers for Medicare & Medicaid Services (CMS) to require that a health risk assessment (HRA) be completed as part of the Medicare annual wellness visits. Since its inception debate on whether this program was effective in preventative screenings has been studied. In a 2017 study by Camacho et al., 2017 it was concluded that one of the main benefits of its implementation was its reduction of disparities in preventive services, such as cancer screenings and vaccinations, especially in disadvantaged groups which tend to lack prior preventive services.
One risk assessment instrument that I am familiar with is the Hurt Insult Threat Scream HITS tool. This is a simple tool with a Likert scale (1= “Never”; 5=“Frequently”). Scores 11–20 are considered “positive” for safety concerns. In my interview, I will review the use of this tool in the below interview summary (Rabin et al., 2009)
K: Hi Margert can you tell me what brings you into my office?
Open-ended questions allow for the patient to freely communicate their concerns.
M: I am here because I am tired, and my mood has been low lately.
K: Can you tell me why you think you are tired and feeling low?
Repeating the answer back to the patient allows them to know you heard what they said and also asking for clarification can elicit more details.
M: I haven’t slept well lately. I am worried about so many things going on.
K: That sound like it can be rough. What are some things that are concerning you?
Empathizing with the patient’s feelings begins to build a trusted rapport and could lead to more honest answers.
M: My husband drinks a lot and when he drinks, he gets angry.
At this point in the interview, I would ask the HITS questions which include the following, How often does your partner, Physically hurt you? Insult you or talk down to you? Threaten you with harm? Scream or curse at you? These are rated 1-5 from never to frequently. If the score adds up to 11-20 the practitioner should be aware that this indicates a positive risk questionnaire. Additional questions that the NP could ask include if the patient has any help or family they talk to for help. Do you feel safe at home? Since this issue is widespread national effort has gone into offering hotlines that can be found online for assistance. The National Domestic Violence Hotline run through the US department of human health services is one such website that offers hotline numbers for crisis intervention, educational materials, and offers referrals to counselors.
Whether you are assessing for violence, or other SDH the practitioner has to start with a thorough and detailed history. This should aid in building a trusting relationship and offering a safe space for your patient to share their concerns and medical issues.
References
Camacho, F., Yao, N., & Anderson, R. (2017). The effectiveness of medicare wellness visits in accessing preventive screening. Journal of Primary Care & Community Health, 8(4), 247–255. https://doi.org/10.1177/2150131917736613
Gruß, I., Bunce, A., Davis, J., Dambrun, K., Cottrell, E., & Gold, R. (2021). Initiating and implementing social determinants of health data collection in community health centers. Population Health Management, 24(1), 52–58. https://doi.org/10.1089/pop.2019.0205
Rabin, R. F., Jennings, J. M., Campbell, J. C., & Bair-Merritt, M. H. (2009). Intimate partner violence screening tools. American Journal of Preventive Medicine, 36(5), 439–445.e4. https://doi.org/10.1016/j.amepre.2009.01.024
| Excellent | Good | Fair | Poor | ||
| Main Posting | 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors. |
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style. |
|
| Main Post: Timeliness | 10 (10%) – 10 (10%)
Posts main post by day 3. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not post by day 3. |
|
| First Response | 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
|
| Second Response | 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
|
| Participation | 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days. |
|
| Total Points: 100 | |||||