mpp2 consultation frameworks studynet (1)
TRANSCRIPT
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MPP2 – Practice lectures 6 & 7Kelly Lefteri
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At the end of this session you should be; Able to describe structured consultation
frameworks Aware of professional responsibility to
safety net the patient Able to identify the professional roles and
responsibilities associated with symptom assessment.
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In pairs, discuss what your expectations are when you visit a pharmacy?
What are the 3 key activities that must happen?
Where would you like the discussion to take place?
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What are your responsibilities?
How are you going to ensure that these are going to be delivered?
Why is it important to do so?
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Over the Counter advice Instructions on medicines Health Promotion Ward Rounds Telephone queries
◦ Patients◦ Healthcare Professionals
5
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Structured framework for questioning Asks basic information Originally developed for counter assistants
W – Who is the medicine for?W – What is the medicine for?H – How long have they had the symptoms?A – Action already takenM – Medicines taken for other reasons
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“Why trusting your pharmacist could put your health at risk”
http://www.dailymail.co.uk/health/article-1077346/Why-trusting-pharmacist-health-risk.html
Which? report
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Moving forward need to be more in depth; Symptom analysis
◦ PQRST framework (ordinary or extended)◦ SIT DOWN SIR (Minor illness or Major disease? Ch1)
BUT Not just about questions Listen to needs and concerns Observe for signs of health related issues Ask questions in a non-threatening manner Assess the persons responses
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P - Person being treated, are they on any other medicines? (Create a background picture)
P - Provocation or Palliation◦ What caused first occurrence ( onset)◦ What makes it worse?◦ What makes it better, have they tried anything
already? Q - Quality or Quantity
◦ How does the symptom look/feel/sound?◦ How much are you experiencing it now?◦ Have you had it before?◦ Have they tried any medicines?
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R - Region or Radiation◦ Where is the symptom located?◦ Does it spread?
S - Severity Scale◦ Severity - How does the symptom rate on a
severity scale from 1-10◦ Course - Is the symptom better/worse staying the
same? T – Timing
◦ Type/Onset - Did it start suddenly or gradually?◦ Frequency - when and how often does it occur?
(hourly, daily, weekly, associated with meals?)◦ Duration how long does it last?
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U - Underpin concordant relationship◦ Identify treatment priorities◦ Establish what medicines they are going to take
(consider current medication for long term conditions)
V - Is a visit needed to other
healthcare professional (signposting)?
W - What public health interventions?
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Kurtz SM, Silverman JD, Benson J and Draper J (2003) Marrying Content and Process in Clinical Method Teaching: Enhancing the Calgary-Cambridge Guides, Academic Medicine In Press
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Processing Skills patient’s narrative question style: open to closed cone attentive listening facilitative response picking up cues clarification time-framing internal summary appropriate use of language understanding patient’s perspective
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The bio-medical perspective (disease)◦ sequence of events ◦ symptom analysis e.g. PQRST◦ relevant systems review
The patient’s perspective (illness)◦ ideas and beliefs ◦ concerns◦ expectations◦ effects on life ◦ feelings
Background information - context◦ past medical history◦ drug and allergy history◦ family history◦ personal and social history◦ review of systems
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Frameworks for; Handing in a prescription Giving out a prescription Symptoms analysis
Check Studynet Site (MPP2 OSCPE folder)
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At the end of this session you should be; Able to describe structured consultation
frameworks Aware of professional responsibility to
safety net the patient Able to identify the professional roles and
responsibilities associated with symptom assessment.