46 y/o African American male who recently was seen in the Emergency Department for alcoholic withdrawal seizures and released. Referred to clinic for follow up on his hypertension history. He ran out of the Norvasc prescription given by the Emergency Department. He is living in a homeless shelter now. He states not drinking anymore but needs to smoke cigarettes to calm down and function.
For this first Assignment, you will take on the role of an APRN who is building a health history for a particular patient assigned by your Instructor. You will consider how social determinants of health and specific cultural considerations will influence your interview and communication techniques as you work in partnership with the patient to gather data for an accurate health history.
To prepare:
· Reflect on your experience as an advanced practice nurse and on the information provided in the Week 1 Learning Resources on building a health history and the Week 2 Learning Resources on diversity issues in health assessments.
· By Day 1 of this week, your Instructor will assign a case study for this Assignment. Note: Please see the Course Announcements section of the classroom for your Case Study Assignment.
· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of your assigned patient.
· Consider how you would build a health history for the patient. What questions would you ask? How might you target your questions based on the patient’s social determinants of health? How would you frame the questions to be sensitive to the patient’s background, lifestyle, and culture?
· Identify any potential health-related risks, based on the patient’s age, gender, ethnicity, or environmental setting, which should be taken into consideration.
· What risk assessment instruments would be appropriate to use with this patient?
· What questions would you ask to assess the patient’s health risks?
· Select one (1) risk assessment instrument discussed in the Learning Resources, or another tool with which you are familiar, related to your selected patient.
· Develop five (5) targeted questions you would ask the patient to build their health history and to assess their health risks.
· Think about the challenges associated with communicating with patients from a variety of specific populations. What communication techniques would be most appropriate to use with this patient? What strategies can you as an APRN employ to be sensitive to different cultural factors while gathering the pertinent information?
Assignment: Building a Health History With Cultural and Diversity Awareness
Include the following:
· Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Be specific.
· Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
· Describe the communication techniques you would use with this patient. Include strategies to demonstrate sensitivity with this patient. Be specific and explain why you would use these techniques.
· Summarize the health history interview you would conduct with this patient. Provide at least five (5) targeted questions you would ask the patient to build their health history and to assess their health risks. Explain your reasoning for each question and how you frame each for this specific patient.
· Identify the risk assessment instrument you selected, and then justify why it would be applicable to your assigned patient. Be specific.
· Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). Elsevier Mosby.
· Chapter 2, “The History and Interviewing Process” This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.
· Chapter 5, “Recording Information” This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.
· Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). F. A. Davis Company.
· Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–29)
· National Prevention Information Network. (2021, September 10). Cultural competence in health and human services Links to an external site. . Centers for Disease Control and Prevention. https://npin.cdc.gov/pages/cultural-competence This website discusses cultural competence as defined by the National Prevention Information Network at the Centers for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website.
· U.S. Department of Human & Health Services Office of Minority Health. (n.d.). A physician’s practical guide to culturally competent care Links to an external site. . https://cccm.thinkculturalhealth.hhs.gov/ From the Office of Minority Health, this website offers CME and CEU credit and equips healthcare professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.
· Coleman, D. E. (2019). Evidence based nursing practice: The challenges of health care and cultural diversityLinks to an external site. . Journal of Hospital Librarianship, 19(4), 330–338. https://doi.org/10.1080/15323269.2019.1661734
· Pirhofer, J., Bükki, J., Vaismoradi, M., Glarcher, M., & Paal, P. (2022). A qualitative exploration of cultural safely in nursing from the perspectives of advanced practice nurses: Meaning, barriers, and prospectsLinks to an external site. . BMC Nursing, 21, 178. https://doi.org/10.1186/s12912-022-00960-9
