HLTAMB012: Communicate in Complex Situations – Support Health Care – Psychological Impairment – Health Case Study Assessment Answer

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HLTAMB012: Health Assessment Answer
Task: 1
Questions and Answers

What are the four (4) common themes (emotions) a health professional may be faced with when communicating in the patient space and discuss what the health professional needs to be aware of and consider when communicating in the patient space?

Define what ‘vulnerability’ means with regards to people that are ill or injured and what this may  look like in the professional health space, that is how the patient may  communicate the vulnerability? (40-80 Words)

Discuss how you can gain trust and promote professionalism and a care factor with clients, even
before you verbally communicate with them? (30-70 Words)

Discuss how in your communication, you can actively demonstrate or show empathy toward a
patient and their relatives or carer’s. How can you actively validate their feelings and/or
experience? (Dot point responses acceptable)
*Conduct some additional research to support your response, remember to reference your sources.

Discuss in your own words your understanding of allied health and allied health roles and
referrals. Conduct additional research to clarify your understanding, remember to reference any
sources used. (60-120 Words)

Identify six (6) guidelines when using a radio and mobile communication systems.

Communicating with the people who have a hearing, visual and/or speech impairment can be
challenging. For the following impairments identify 3 key points to remember when
communicating.a. Discuss in your own words your understanding of the term ‘Challenging Behaviours’ and identify
considerations that you may need to make related to the ‘triggers’ or behaviours of client(s)
exhibiting challenging behaviour. (60-120 Words)Hearing Impairments

b. Visual Impairment

c. Speech Impairment

d. Psychological Impairment

Discuss in your own words your understanding of the term ‘Challenging Behaviours’ and identify
considerations that you may need to make related to the ‘triggers’ or behaviours of client(s)
exhibiting challenging behaviour. (60-120 Words)

In your own words, discuss your understanding of ‘de-escalation’ and identify the communication
approaches by health care professionals related to the same.

Identify the terms Critical Incident and Critical Response. Inclusive of your understanding of
referral services for both the patient and the health care worker. (50-100 Words)

11. Identify six (6) behavioural cues that may indicate heightened emotional states and could alert
you to potential aggressive situations with a client/patient?

Part B | Engaging, Questioning and Gathering Information
A Situational Example
You and your work colleague have been called from your workplace to an incident involving a young boy (14 years) who has fallen from his bike near the local skate park.
On arrival, the primary assessment determines no immediate ‘Danger’ to patient or others and the patient is ‘Responsive’. His ‘Airway’ is clear, however, his breathing is rapid and irregular, he is pale in colour and in obvious pain. You cannot locate/see a bike helmet at the scene. It appears he has sustained a displaced fracture to his lower right arm and the right side of his body has fresh abrasions.
You also identify there are no obvious open wounds and you can only see capillary bleeding from the abrasions. There are several bystanders around him. The bystanders identify they saw him riding his BMX bike on the gravel side of a road, he was riding against traffic and about to turn into the skate park when he lost control and skidded falling and sliding sideways off his bike. He was not wearing a helmet, and the bystanders said he was ‘knocked out’ and sat up about 5 minutes before you arrived. He then lied down in a lot of pain and was complaining that his head hurt.
Your initial (primary) assessment on arrival has identified there is no apparent open wounds or obvious bleeding among other observations required.
For the following, based on the situational example above and the ‘Standardised History
Framework’, consider what you need to know and what is relevant to support assessment of the patient and the incident.
You need to respond to each questioning technique and answer the following (relevant to the situational example provided.

Who will you ask each question to (for each technique)?

Why are they the best person to ask the question? (5-15 Words)

What is the actual question you will ask? (write the question)

What is the outcome, how will it help, how will it be of benefit? (10-30 words)

Open Question

Who:

Why:

What:

Outcome:

b. Closed Question

Who:

Why:

What:

Outcome:

c. Limiting Question

Who:

Why:

What:

Outcome:

d. Leading Question

Who:

Why:

What:

Outcome:

e. Comparative Questioning

Who:

Why:

What:

Outcome:

f. Clarifying or Paraphrasing.

Who:

Why:

What:

Outcome:

13. Is the use of more than one questioning technique better in this situational example? Explain why. (40-60 Words)

14. Discuss what other communication actions are valuable when asking any questions to build rapport with a client/patient and to promote effective responses? (50-100 Words)

15. Identify several key requirements for maintaining patient confidentiality and privacy, include the relevant act that governs this requirement (dot points acceptable, 40/70 words)

16. Discuss any debriefing communication activity with staff post incident and identify phases of a debriefing techniques and /or referral systems available for colleagues post incident. (80 -150 Words)

17. Identify three 3 factors you would consider when determining the urgency of client/patient’s referral. (3 dot points)

18. Consider the 14-year-old boy that fell from his bike in the situational example above, consider that whilst attending the scene you identified the boy had the following conditions and discuss how you would amend your communication and receive and convey information to the patient whilst continuing to maintain respect and sensitivity regarding the patient.

a. The boy was identified as having a mental health condition, how would you amend your communication?

b. The 14-year-old boy was under the influence of alcohol and aggressive, how would you amend your communication and how will you respond to the complex situation?

c. The boy in the situational example is identified as hearing impaired, what or how would you amend your communication, and who or what could be of assistance?

19. Identify any organisational Standards, Policies and/or Processes that would be relevant to the area of communication in your health care role and responsibilities. (Dot Point Responses acceptable)

20. Conduct some research and discuss in your own words your understanding of Acute Behavioural Disturbances (ABD) additionally respond to the following: (40-80 Words)

21. Using the 1CPG QAS Acute Behavioural Disturbances as a reference guide, respond to the
following questions.
a. Identify the four ABD classification categories (dot points acceptable)

b. Identify the mnemonic relevant to the Main Principles to Apply (where possible) when managing ABD patients, and (Mnemonic & meaning)

c. Identify and explain the five (5) Strategies for de-escalation related to managing ABD incidents21 (in your own words). (40-80 Words)

22. From your learning and researched information, discuss your understanding of the application of Patient Privacy and Confidentiality in the Health Care environment
*Note: you must reference any researched information (see APC Academic Integrity Policy) See next page for the Assessment Task Checklist (criteria)

Task: 2
The Case Study 1 – Part A
Edward Turner is a 78-year-old gentleman who has lived alone for many years following the death of his wife. He has one child, a daughter of 32 years who lives in another town (a 5- hour drive away). ‘Ted’ is supported by good friends and neighbours who have taken on many responsibilities to help him safe, healthy, and in his home.
Ted is fiercely independent and has learned a lot on new skills since the passing of his wife, but in the past year his health has deteriorated; with his arthritis and mobility starting to make home life difficult. Some of his hardship has been reduced by several appliances being installed in his home to help him mobilise around the house and be safe in the toilet. Although this has meant that Ted has had to make compromises in his life, the supports systems have worked well for some months.
In the past month he has had three falls in and outside of his house causing him only superficial bruises; but, one fall necessitated a trip to his GP for a sizable skin tear to his shin. Sadly, this afternoon, Ted’s neighbour arrived to find him on the patio floor with a laceration to the forehead, a swollen left wrist, and chilled to the bone. Ted’s friend immediately called the ambulance.
On arrival at the scene, you find Ted on the patio floor covered with a blanket and his neighbour by his side. He is agitated, and with a firm voice telling his neighbour to: “leave me alone…I’ll wait for my daughter to come! More of his neighbours come to see if they can help and begin to talk about what has happened and Ted appears to become more annoyed and agitated. You say hello to Ted, but he seems to ignore you. His neighbour says: “his hearing aid is not in…I’ll go look for it”
Case Study 1 – Part A
Response Questions (Part A)

Considering the information in the Case study notes above, discuss why might this patient, Ted, might be reluctant to call ‘000’? (dot points or 10-20 words)

Identify and discuss three (3) communication strategies you could use to introduce yourself and begin to develop rapport with Ted, specifically considering he does not have his hearing aid in? *You must identify a minimum of three (3) communication strategies/techniques you could use (e.g. use a slow pace in speech, do not use this as a response) (5-15 Words each)

How ‘could’ you reduce the external interference (noise) in the immediate environment?* You must identify two (2) strategies/actions you might use. (dot points acceptable)

At this moment, would touching Ted seem appropriate? You must provide a justification for your answer of either yes or no (20 -50 Words).

What other non-verbal communication techniques can be used to reduce Teds distress? List a minimum of 3 the non-verbal communication techniques you could use and discuss how they would likely support reducing ‘stress for the patient. (10-40 Words per technique)

Proximity – Personal Space and your interaction with Ted?
Identify and discuss the four (4) common zones of proximity with regard to the personal space and your interaction with the patient, Ted. *Note-all 4 common zones must be identified and the purpose or use of the same identified. (10-40 words per zone)

Discuss the privacy and confidentiality issues or concerns you need to be aware of specifically related to interactions by and with Ted’s neighbours (60-100 words)

The Case Study 1 – Part B
Ted acknowledges your presence and his neighbour arrives with his hearing aid and Ted places it in his left ear. He allows you to examine him. Your assessment uncovers:
Pulse = 110, Reg GSC= 15 Orientated to time, place, and person
BP = 98/75 PEARL Swollen left wrist with a “dinner fork’ deformity
Resp Rate = 24 BGL= 5.1mmol 3cm laceration to left temple – minimal bleeding
SaO2= 93% Diaphoretic ECG Rhythm strip = ‘sinus tachycardia’
Ted complains of pain to his wrist left which is a ‘throbbing’ pain that he rates as 6/10. During your assessment Ted appears angry and only gives you short terse answers to your questions. However, you further ascertain that he has an allergy to iodine, and has not had major surgery. He is prescribed Non-Steroidal Anti-inflammatory drugs (NSAIDs) for his arthritis.
You apply oxygen at 4 L/min by nasal cannula, dress the wound to his head, and immobilize his left wrist and arm. You then tell Ted of your intention to take him to hospital to be treated by the doctors and he becomes quite agitated and angry. He tries to stand and says: “I’m fine! I am not going anywhere until my daughter gets here! Has anyone rang my daughter?” He kicks the patio chair and then shouts, “I know my rights! I’m not leaving my house”
Case Study 1 – Response Questions Part B
8. Describe and explain the use of three (3) de-escalation measures in this situation that may assist in reducing Ted’s distress relevant to the case study part 2 of 3 (10-40 Words per method)
9. Read and analyse the following statements and describe (identify) why they would be considered judgemental and the impact to the patient comprehension or understanding? That is may it make the patient feel or would it impact on the emotional response/assumption from the patient.

a. “Living here is too unsafe. We need to take you to the hospital to get you fixed and then you will need to find somewhere else to live.” (min 3 dot points with explanation and/or 20-50 words minimum)

“Your impaired mobility, secondary to your arthritis, will prohibit normal living. You need immediate medical interventions and then professional assessment prior to placement.” (min 3 dot points with explanation and/or 20-50 words minimum)

“I know you’re angry about all of this, but it’s no-one else’s fault. We would just like you to get you into hospital to be treated and have you assessed.” (min 3 dot points with explanation and/or 20-50 words minimum)

10. For this task you are required to re-construct one of the statements above (a-c) to ensure you reflect communication that encompasses and shows empathy and will support Ted’s understanding and validate his emotions/feelings. (20-50 Words)
11. Discuss Ted’s rights related to not wanting go to hospital, the issues related to contacting  his daughter and discussing Ted’s personal information with her, additionally discuss the privacy and confidentiality issues related to this scenario. (60-100 words)
The Case Study 1 – Part C
Ted now sits on the chair and you discern/establish that Ted has attained the mental capacity and physical stability to wait for his daughter to call back.
In the meantime, you take the opportunity to document some patient notes on the patient events.
Case Study 1 – Response Questions (Part C)

Using the S O A P method of reflective writing, describe your findings.

Discuss your role and responsibilities as an allied health professional from the case scenario and identify the role and responsibilities of one (1) other allied health professional or stakeholder that you could seek advice, support or information from relevant to the scenario. (e.g. Medical support/paramedics/client case workers) (40-80 Words)

Case Study 2 – Part A
Edward Turner is a 78-year-old gentleman who has lived alone for many years following the death of his wife. He has one child, a daughter of 32 years who lives in another town (a 5- hour drive away). ‘Ted’ is supported by good friends and neighbours who have taken on many responsibilities to help him stay safe, healthy, and in his home.
Ted is fiercely independent and has learned a lot of new skills since the passing of his wife, but in the past year his health has deteriorated; with his arthritis and mobility starting to make home life difficult. Some of his hardship has been reduced by several appliances being installed in his home to help him mobilise around the house and be safe in the toilet. Although this has meant that Ted has had to make compromises in his life, the supports systems have worked well for some months.
In the past month he has had three falls in and outside of his house causing him only superficial bruises; but, one fall necessitated a trip to his GP for a sizable skin tear to his shin. Sadly, this afternoon, Ted’s neighbour arrived to find him on the patio floor with a laceration to the forehead, a swollen left wrist, and chilled to the bone. Ted’s friend immediately called the ambulance.
On arrival at the scene, you find Ted on the patio floor covered with a blanket and his neighbour by his side. He is agitated, and with a firm voice telling his neighbour to: “leave me alone…I’ll wait for my daughter to come! “
More of his neighbours come to see if they can help and begin to talk about what has happened and Ted appears to become more annoyed and agitated. You say hello to Ted, but he seems to ignore you. His neighbour says: “his hearing aid is not in…I’ll go look for it”
Ted’s neighbour arrives back and has found his hearing aid and Ted places it in his left ear. He allows you to examine him. Your assessment findings are as follows:
Pulse = 110, Reg GSC= 15 Orientated to time, place and person BP = 98/75 PEARL Swollen left wrist with a “dinner fork’ deformity Resp. Rate = 24 BGL= 5.1mmol 3cm laceration to left temple – minimal bleeding SaO2= 93% Diaphoretic ECG Rhythm strip = ‘sinus tachycardia’
Ted complains of pain to his wrist left which is a ‘throbbing’ pain that he rates as 6/10. During your assessment Ted appears angry and only gives you short terse answers to your questions. However, you further ascertain that he has an allergy to iodine, and has not had major
surgery. He is prescribed Non-Steroidal Anti-inflammatory drugs (NSAIDs) for his arthritis.
You administer oxygen for Ted at 4 L/min by nasal cannula, you clean and dress the wound to his head, and immobilise his left wrist and arm. You offer Ted pain relief, however Ted fervently refuses, saying: “I’m okay…I can look after myself you know!”
You tell Ted of your intention to take him to hospital to be treated by the doctors and he becomes quite agitated and angry. He tries to stand and says: “I’m fine! I am not going anywhere until my daughter gets here! Has anyone rang my daughter?” He kicks the patio chair and then shouts, “I know my rights! I’m not leaving my house” you encourage Ted to sit on a chair and take some breaths.
Ted sits on the chair and breathes, you perceive that Ted in a calmer state and has the mental capacity and physical stability to wait for his daughter to call back.
It is at this time you take the opportunity to document some patient history notes.
Case Study 2 – Part A – Response Questions

The standardised history framework provides elements that are important for an accurate and detailed patient history (patient interview). Using Ted’s circumstances, identified in the case study notes above, create two (2) open ended questions for each element identified below (a – f) , that will expand on Teds case history:

*Note: Your 2 response questions for the sub headings (a – f) below need to specifically reflect ‘open end’ questions to support the gathering of information.

Present complaint

Medication history

Allergies

Social history

e. Mental health

Further information from 3rd party (e.g. neighbour, daughter)

Case Study 2 – Part B
You have documented some information on the patient’s history and treatment and Ted is in a calm state. Ted’s mobile phone rings and his neighbour answers it: “Ted, it’s your daughter Emily “he says and hands the phone to Ted. Ted talks to his daughter and tells her that he has broken his arm, however you hear her voice over the phone and it appears to be loud, high pitched and fast. Ted gives you the phone and says: “…here you tell her!”
You introduce yourself, but before you can say another word she demands: “Why is my father not at the hospital? What’s happening to my him?”.
You can hear in her voice and her phone manner and from this you determine that she is very anxious and concerned about her father’s situation.
Case Study 2 – Part B – Response Questions

Describe three (3) verbal communication skills that allow you to introduce yourself and build some rapport with Emily inclusive of supporting the reduction of her anxiety. You must ensure that your response includes an explanation of why you are using the specific communication skills and how it’s likely going to impact on reducing the anxiety of Emily. (15 – 40 words minimum for each skill response)

Discuss how you could show empathy and build rapport with Emily over the phone? Create a statement that reflects empathy and on you could you in this situation. Include in your response how the statement will assist with regard to empathy and building rapport with Emily (20-50 Words including your statement)

How might Emily help to encourage her father to go to hospital? Recommend below three (3) ways in which you could encourage Emily to help her father. (5-15 words per recommendation)

Use the NATO alphabet communication System to spell out ‘Chrystal St’.

Use IMIST-AMBO mnemonic identifying what the letters represent and provide relevant Assume the situation escalates and you identify from the emotions of the father and daughter the situation may become quite complex. What can do to deescalate the situation and respond in the immediate timeframe effectively to both the father (patient) and the daughter that reflects a caring, firm and confident manner. Provide for both the daughter and father (patient) a minimum of two (2) communication/action responses you could apply and discuss how it will likely assist in the de-escalation of the situation.

Patient (Father)

Daughter (Emily)

Case Study 2 – Part C Emily asks for the address to the hospital that her father Ted will be transported to.

You state that the hospital is on ‘Crystal’ St, but she has trouble hearing you over the phone and she asks you to spell the street name.

Finally, Ted agrees to go to the hospital. At the emergency ramp you ‘hand over’ Ted to the Nurse.

Case Study 2 – Part C Response Questions of information related to the case scenario to support a clinical nurse handover.

Discuss how you will clarify Ted’s understanding of the situation relevant to the Case study information you have been provided [e.g. age, emotional state] (30-60 Words)

Assume Ted does not have a clear understanding of his current health situation; what communication changes (minimum 2) could you make to assist and support Ted to understand his situation and identify why your changes will assist? (identify the change and 20-40 words explanation of why it would help)

Case Study 2 – Part D – The Incident Report
Later in the day you receive a notification that reveals Emily has made a complaint to the operations manager on the way the situation was managed. The operations manager asks you to write up a report of what had happened.

Before writing up an incident report for the Operations Manager responding to Emily’s complaint, who might you seek help from and why would they be of assistance (20-40 Words)

What resources could you use to support the development of the report and respond to the complaint made by Emily? You must identify at a minimum two organisational documents relevant to your role and how they will assist in your report response. (50- 100 Words)

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