Split into six phases in a logical manner, the aim is to complete each phase. 0000002642 00000 n To give their account, the patient must speak. Clinical decision-making: Patients' preferences and experiences. Unauthorized use of these marks is strictly prohibited. This article will discuss some of the more common consultation models in use today and their relative advantages and disadvantages. Epub 2006 Sep 7. If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! (2001) has shown that compared to a biomedical consultation, patient satisfaction is greater when using a patient-centred approach and their is the preferred method when attending a primary care practitioner. In 2019, the patient should have online access to, at least, referral letters, clinic letters, discharge summaries and test results. Behavioral Consultation Model Behavioral consultation is a problem-solving process that includes four stages, problem Share. . ) 72 0 obj<>stream The other person is also a second set of ears. If healthcare providers want good patient outcomes and patient experience, they have to ensure and insist that staff take full refreshment breaks not 10 minutes carrying a coffee, answering emails, making referral calls and chasing tests results a proper gossipy break doing nothing else but eat, drink and chat. For more information on how to submit, please see our instructions for authors. However, an incorrect diagnosis usually results in delayed and prolonged care, iatrogenic harm or even an avoidable death. Our nursing and healthcare experts are ready and waiting to assist with any writing project you may have, from simple essay plans, through to full nursing dissertations. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date. The issue of communication in relation to prescribing has received much less prominence. Department Health (2003) advocate empowering patients to take more ownership of their health condition. The site is secure. I have not experienced well-organised electronic charts. One of the six blueprint areas tested in the CSA is a person-centred approach using recognised communication techniques that enhance understanding of a patient's illness and promote a shared approach to managing problems. Thomson et al. I am sure there are many other quality indicators that could be applied. We need a lot of information readily available to make the correct diagnosis in the patient's context. It provides a definition and conceptualization of critical thinking and critical analysis, and highlights the differences, similarities and interrelationships between them. Roger Neighbour explained how a consultation is really about a patient who has a story to tell. In my previous hospital, I had to have 10 software applications open for an outpatient (office) consultation and the paper notes too! MeSH Stripping the consultation back like this is a refreshing thought and might remove some of the threat of communication skills for doctors who have struggled to find a model that works for them. Pendletons consultation model: assessing a patient. 1).In the paternalistic model, practiced over centuries, the doctor chooses the . The Me First tool encourages discussion with both parent and child to empower them to make informed choices. In this paper, a PC based computer mine ventilation consultation software model developed by the authors is introduced. HHS Vulnerability Disclosure, Help Even when drug therapy is considered essential (such as insulin and thyroxin) many patients will experiment with dosages and drug-free periods. HHS Vulnerability Disclosure, Help Add to Mendeley. This model sees the consultation entirely from the patient's perspective using a series of questions such as: 'what has happened?' Epub 2019 Apr 18. The more you practice, the more your model will become automatic so you can concentrate on what the patient is saying. 0000003543 00000 n FOIA To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the NursingAnswers.net website then please: Our academic writing and marking services can help you! Attentive listening and clinical reasoning require simultaneously doing two high-level mental activities. Disclaimer: This essay has been written by a student and not our expert nursing writers. Hand in hand with this success goes the realisation that nurse prescribing carries with it a responsibility to fully understand the issues that relate the act of prescribing to the eventual treatment outcome, together with the factors that tend to confound such linkage. The clinician has decided on a likely or definite diagnosis and recommended a treatment plan. References and further information The voice for today's GP. 0000008925 00000 n Grounded theory qualitative approach from Foucault's ethical perspective: Deconstruction of patient self-determination in the clinical setting. This paper highlights some of the limitations of models of patient involvement in decision-making and explores the reasons for, and implications of, these limitations. (1984), patient-centred care and joint decision making is incorporated into consultation. The hostile and the heart-sink patient can be a particular headache to the prescriber and inappropriate decision can be made unless great care is taken to specifically tackle these issues. Most clinicians will be laughing by now. NHS Plan (2010) encourages shared decision making with the patient and family to aid concordance. ) e'xix|>| Furthermore, models now involve more patient participation rather than the use of biomedical models aimed at patients with physical symptoms which the medical practitioner would identify and treat, requiring minimal input from the patient and the assumption that the diagnosis can be made by variances of normal (Perry 2011). Costs would also come down. (Elwyn et al.2000), The paper by Cox (et al.2000) found that it was common practice for prescribers to initiate the discussions about just what medication there were going to prescribe, rarely refer to the medicine by name and equally rarely refer to how a newly prescribed medication is perceived to differ in either action or purpose, to those previously prescribed. In those precious 10 minutes, time spent listening might seem time wasted, but early investment in the patients agenda can be time saving in the long run. If the patient has fallen away from the expected trajectory then the diagnosis must be reviewed as well as determining whether the treatment plan has been executed. If an incorrect diagnosis is made, a good outcome can only arise by good luck eg if the clinician believes that the diagnosis is a urine infection but is actually pneumonia, by good luck the antibiotic might treat the pneumonia. It also means you have a range of different techniques to use in difficult consultations. (Elwyn et al. Dignity is often fairly minimal with patients expected to accept physical examination in front of several strangers. I am sure that I can discharge more patients from clinic after one attendance because I try to make the consultation unhurried. However, yesterday Roger Neighbour reminded us that rigid use of these models in practice can lead to consultations that are prescriptive and formulaic at the expense of individual style and flare. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 19 April 2018. It is even easy to overlook checking the chest X-ray. It is therefore essential that the consultation is documented and good record keeping adhered to, to ensure safe and effective continuation of care (NMC 2009). Consultations are a vital part of assessment and diagnosis during the patients journey, it is imperative for the practitioner to carry this out in a holistic and systematic manner in order to promote wellbeing and therefore creating a safe and evidence based management plan tailored to each patient (Nutall and Rutt-Howard 2015). Most people cannot even do attentive listening to someone else, let alone high-level thinking at the same time! Patient-doctor decision-making about treatment within the consultationA critical analysis of models. Expert clinicians know that the majority of the information directing towards the correct diagnosis comes from attentive listening to the patient's history of the presenting complaint, set in the context of the patient's life and known medical conditions. Internally, the clinician has to find ways to try to block out the external factors and any internal or personal issues so that their mind is able to hear itself think. No plagiarism guarantee. A framework guiding critical thinking through reflective journal documentation: a Middle Eastern experience. This site needs JavaScript to work properly. 8600 Rockville Pike Although we have briefly examined the overall issues of nurse prescribing, the consultation is obviously the core skill required to establish the diagnosis and therefore the appropriate treatment and prescription. Sophie Cook is clinical reviews editor, BMJ. CONSULTATION MODELS Consultation models are established lists of questions or areas to be explored, and provide a framework for a consultation. 2002), At this point in time, there is little published evidence that this process actually leads to improved clinical outcome measures, but consideration of ethical principles would allow us to conclude that the involvement of patients will inevitably result in safer and better patient care. Home / Essay Samples / Life / Communication Skills. This site needs JavaScript to work properly. (Editor BMJ 2000)Critical Analysis Of A Consultation Model Essay, This essay is particularly directed to the issue of consultation skills in relation to nurse prescribing. This area used to be termed compliance which was a reflection of the now outmoded concept of implicit power and authority invested in the prescriber. Another person is almost essential if the patient is suffering from dementia or delirium. As in any new project there were inevitable protagonists and detractors and the initial results of the first eight studies were extremely positive. Info: 1861 words (7 pages) Nursing Essay This particular study was extensive in its analysis and many of the results are not particularly relevant to the subject of this essay, but the significant outcomes showed that there was no significant difference in health outcome, prescribing patterns or prescribing cost. He was an absolute wonderful writer and had a great amount of patience with me as well as following all directions very accordingly. This article was first published in March 2010 and reviewed in April 2018 by Dr Ravi Ramanathan. Based on these principles, Roger Neighbour says there are four simple rules to get through a consultation; pay attention, give receipts, summarise, and think aloud. Game theorya theory based on assumptions of rational choice and focusing on interactive decision makinghas the potential to provide models of the consultation that can be used to generate empirically testable predictions about the factors that promote quality of care. Sprague (2005) identifies that consultation models should be straightforward, practical and. 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