Journal Article Review Deveane Atkinson Chamberlain College of Nursing NR 305 Professor Joni Knapp 2013 Journal Article Review Introduction The article by Lloyd, H. , & Craig, S. (2007). A guide to taking a patient’s history, appearing in volume 22, issue 13 of the journal Nursing Standard in 2007 explains certain process, approach and procedure in obtaining patients history, emphasizing on the importance of information order collection. This article also expounding on the triage process uses general and non-specific gender, race, or population criteria to obtain the assessment information to treat patients.
I plan on summarizing the pros and cons of this article while explaining the author’s process of taking a patients history. In conclusion, incorporating the history taking process using viewpoints of others, while showing key factors that have been excluded. Summary of Article The authors focused on assessment, communication and gathering information on history while providing an adequate environment to facilitating appropriate care. Preparing the environment is also another key aspect covered in the article noting that the practitioner may practice in many different areas and or may encounter the patient in not so desired places.
With all the environmental challenges the authors imply that it is still the practitioner’s duty in the “maintenance of privacy and dignity; the environment should be private, quiet and ideally there should be no interruptions” (Lloyd, H. , & Craig. S. 2007). The authors placed increased importance and awareness on the environment that they cited “when interruptions is not possible the nurse should do everything possible to ensure that patient confidentiality is maintained” (Crouch & Meurier, 2005).
The possibility of interruptions and being overheard can discourage or prevent patients from telling their story (Clark, 1999). Also, Lloyd & Craig (2007) noted from (Rogers, 1951) respecting the patient as an individual and this includes considering beliefs, values and the ability to remain non-judgmental and professional. Lloyd & Craig (2007), noted the importance of the nurse possessing good communication skills in order to gather information in a systematic, sensitive and professional manner is essential.
Also other authors who support the theory “To underpin a structured systematic history-taking approach in consultations, specific clinical skills are fundamental, including comprehensive clinical knowledge relating to a wide variety of clinical conditions, pharmacological aspects and diagnostic skills” (Young, K. , Duggan, L. , & Franklin, P. , 2009). After introduction of self to the patient the authors believe letting the patient tell their story in their own words while using active listening skills while not appearing rushed, or using technical terms or jargon and paraphrasing the patients when possible.
The authors uses example of non-verbal and verbal communication. The author’s support “the most important aspect of patient assessment is in the taking of patient history” Lloyd & Craig (2007). This allows the patient the opportunity to give the practitioner information and insight on what the patient is having a problem with from the patient own view point. Obtaining the history on patient’s envelopes a trifold approach many different theorists explain their belief.
As noted “a consultation is a private and intimate interaction between clinician and patient. It assists in the diagnosis of health problems in clinical settings and has traditionally been the domain of medical practitioners” (Kaufman, G. , 2008). “This article provides the reader with a framework in which to take a full and comprehensive history from patients” Lloyd & Craig (2007). The authors pointed out the importance of collecting informed consent in various different methods before any intervention, including history taking is done.
When collecting and obtaining history the authors geared towards using open ended strategy questions while interviewing the patient this tool will enable the nurse to obtain more information. Closed ended questions can enable the nurse to gather more information along with the patient story. At the end of the interview it is advised that the nurse clarify the information with the patient before proceeding. Lloyd & Craig (2007) discussed the use of the Calgary Cambridge framework for obtaining patient history.
The Calgary Cambridge framework uses five stages of explanation, planning, aiding accurate recall achieving, and shared understanding, planning, and closed consultation. This health assessment tool guides the nurse in asking specific questions pertaining to specific symptoms in each body system. Evaluation of the Article This article covered a broad scope being very general, non-specific in patient race, religion, and or sex. The approach used in this article was exceptional and can be used by any facility for dialoging and training.
The authors incorporating mental health history, medication history, family, social, sexual and occupational health history when obtaining a complete patient’s history to ensure all areas of the interviewing process will be covered. The examples of unhelpful interview techniques used in this article will definitely help me because I currently work in an emergency department and participate in training new graduate nurses along with participate in triaging patients as they enter the facility and or at the bedside via an EMS system.
In addition, all hospital that has an Emergency intake facility attached should include a triage certification class that is separate from general orientation. Consultation skills development involves a variety of teaching and learning approaches. “In addition to theory-based sessions the following strategies have been successful in consultation skills development: role- play, recording of real clinical cases, receiving clinical tutor feedback and peer-review processes” (McManus et al, 1993; Macguire & Pitceathly, 2002; Kramer et al, 2004).
All nurses that participate in the triage process should partake in a class that includes but not limited to the systemic approach process presented in this article. I have worked in to many facilities that do not have specific training on the triage process of patient and simply knowing the ethics of approaching certain situation. Some disadvantage with this article were not covering specific population, group, gender or age, sex, also no information was given on how to approach or handle language barriers along with different cultures. Conclusion
Since this article did not expound on different groups it is very general in information being conveyed and can be used as a platform or foundational start to a good triage history taking tool. The article placed information on obtaining patient history in a uniformed format that can be easily read and it is very user friendly with information non polluted with references. The information presented can enable any novice or advance nurse clinician a foundational start to the process of history taking. References Lloyd, H. , & Craig, S. (2007). A guide to taking a patient’s history…
Clinical skills: 28. Nursing Standard, 22(13), 42-48. Crouch, A. , & Meurier, C. (2005). Vital Notes for Nurses: Health Assessment Blackwell Publishing, Oxford. Clark, C. (1999). Taking a history. In Walsh M, Crumbie A, Reveley, S. (n. d. ) Nurse Practitioners: Clinical Skills and Professional Issues. Butterworth-Heinemann, Oxford, 12-23. Rogers, C. , (1951). Client Centered Therapy: Its Current Practice, Implications and Theory. Houghton Mifflin, Boston MA. Young, K. , Duggan, L. , & Franklin, P. , (2009). Effective consulting and history-taking skills for prescribing practice.
British Journal Of Nursing, 18(17), 1056-1061. Kaufman, G. (2008). Patient assessment: effective consultation and history taking. Nursing Standard, 23(4), 50-56. McManus, IC. , Vincent, CA. , Thom, S. , & Kidd, J. , (1993). Teaching communication skills to clinical students. BMJ 306: 1322–7. Macguire, P. , & Pitceathly, C. (2002). Key communication skills and how to acquire them. BMJ 325: 697–700. Kramer, AWM. , Dusman, H. , Tan, LHC. , Grol, RPTM. , van der Vleuten, CPM. , (2004). Acquisition of communication skills in postgraduate training for general practice. Med Educ 38: 158–67