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Collaborative Questions to Discuss for Farhan Fahez
Q1: When visiting Farhan to change his dressing you notice over granulating tissue. What action do you take?
- Carry on using the prescribed dressing.
- Reassess the wound.
- Call the GP immediately.
Q2: Farhan does not always understand what is happening to him during a consultation. How do you approach this?
- Continue to talk to him like you would any other patient.
- Adapt your communication to explain to Farhan carefully and appropriately what is happening.
- Talk to a relative instead.
Q3: People who live in assisted living can be discharged home at any time?
- Correct, there are always people there to look after them.
- Wrong, each patient needs to be treated as an individual. Needs change and you need to establish the cause for admission in the first place.
- Yes, it is crucial to empty hospital beds to keep the flow of patients. They can always be readmitted.
Q1 – In the case that Farhan’s pilonidal sinus is no longer healing with the dressing (over granulating tissue) I would take action of option 2. I would not keep using th dressing as it is clearly no longer appropriate and it could further his issues with it. I would therefore reassess the wound and see which dressing is now going to be more appropriate for this kind of wound care – every wound is different!
Q2 – I would choose option 2. It is important to communicate to your patients in a way that they will understand and feel comfortable. If adapting my communication means speaking slower, using physical body language, or cue cards with pictures then that is what I would do. However, speaking to a relative (option 3) isn’t a bad idea as relatives know best! They could advise me on how Farhan understands things better, what he likes and dislikes in terms of communication and this therefore would enable me to tailor my communication to him in a way we can converse.
Q3 – Wrong, each patient needs to be treated as an individual. Needs change and you need to establish the cause for admission in the first place.
Conversations need to be had with Farhan’s assisted living accomodation – why has his sore gotten so bad to begin with? are they sufficiently managing his diabetes as they should be? The diabetes specialist team, ?tissue viability, nursing staff and potentially safeguarding could investigate this and hopefully there is no cause for concern and Farhan can be discharged safely and accordingly, hopefully reducing any future hospitalisation!Q1 is Option 2 as the wound state is changing, the best approach will be to reassess it
Q2-option2 because effective communication reassure and allows the patient to understand better most situations
Q3-is option2-ach patient needs to be treated as an individual and an holistic approach should be use when offering a package of careQuestion 1 option. The presence of granulated tissue will need a reassesment of the wound to see which dressing is now appropriate for the wound as wrong dressing to the wound could cause more harm like infection.
Question 2 i will choose option 2 and consider option 3 if it is stated in his care plan. it is important to adapt communication in a way that our patient could understand considering use of communication tools availabe to help Farhan understand what is going on or what the plan is regarding his care . But because he is sometimes help by relative and mentioned above i might have to explain this to the relative named in his care plan if there is one.
Question 3 option 2 Needs change therefore it is important to establish what package of care is required for Frahan . Each patient actually need to be treated as individual.
Q1. I would choose option 2 because it is best to reassess the wound to know the type of dressing to be used to dress the wound and help in the healing process of the wound.
Q2. I would choose option 2 Adapt your communication to explain to Farhan carefully and appropriately what is happening. It is important to adapt one’s communication as effective communication is key in patient consultation/assessment. Farhan would have better understanding of the situation when the communication is clear.
Q3. I would choose option 2 Farhan would need to have his care package reviewed upon admission to the hospital to highlight any changes in his care after his admission to the hospital to suite his daily lifestyle.
Q1- I would choose 2 because before taking any action, an assessment must be done first, and I would reassess the wound. If granulating tissues improve, I may use a different non-adherent dressing to cover and keep it moist. If exudates are still present, I will use an absorbent foam dressing to cover the wound and keep it moist.
Q2- I would choose 2 because Fahad has down syndrome; I will use a communication technique using simple words or tools such as pictures/drawings to explain the consultation and procedure and ask to confirm his understanding.
Q3- I would choose 2. because each patient needs to be treated as an individual; make sure before discharge that everything is communicated well and the assisted home is informed. I will ensure that the patient is safe when he gets back home and that there be someone with him when he arrives.
Q 1> Option 2; Reassess the wound. Will reassess the wound, it is possible that less oxygen is getting to the wound, which is slowing down the healing process.
Q 2. Option 2; Adapt your communication to explain to Farhan carefully and appropriately what is happening. Recognizing patients’ way of communication is crucial for Healthcare providers. However, the third alternative will also be taken into account because it might be in Farhan’s best interest or be part of his care plan.
Q 3. Option 2; Wrong, each patient needs to be treated as an individual. Needs change and you need to establish the cause for admission in the first place.
Prior to discharge from the hospital, assistance and support should be organized for the individual. A discharge assessment is done once the hospital notifies social services. In order for them to learn what assistance might be required when a person gets home.Q1 – I would go with option 2. Considering that the wound is not healing (visible granulated tissue) I will need to reassess the wound to decide which dressing will be suitable presently to avoid infection.
Q2 – I would go with option 2. Effective communication is like a gate to a house because it will make the patient to feel relaxed and communicate their needs. Clear communication is a requirement if I must Practice Effectively as stated in the NMC Code. I will try as much as possible to adopt a language that will meet the communication need of Frahan (verbal and non-verbal).
Q3 – I would choose option 2 because for Frahan to be discharged safely he will need to be reassessed to identify the level of his needs and the support he might require. Remember one cap does not fit all, patients are to be treated as individual (patient centred care).
Q1 – I would choose option 2 reassess the wound to check the correct dressing is being used. Also check to see if Farhan has been getting the wound wet, keeping it dry or been touching the wound to make sure he is clear how he should be looking after it as well
Q2 – I would choose option 2 as Farhan needs to be involved in his care and if he understands what is happening he would be able to make his own choices and feel reassured. A different approach may be needed such as more visual aids to help explain things
Q3 – I would choose option 2 to make sure that Farhan has support if needed, if the relevant support is not there then his health may suffer again. An assessment to check what support he will be receiving and if any additional support is needed
Q1:Option two: I would reassess the wound. Granulating tissue could be indicating a problem with the healing process and might mean Farhan is not keeping the area clean and dry or that an unsuitable dressing is being used, preventing healing.
Q2: option two, I would adapt my communication to make sure he is understanding what is being said. Different forms of communication could be used for example visual aids to help Farhan to understand what is being communicated with him.
Q3: option two: People who live in assisted living need to be treated in the same manner as every other patient. Farhan’s needs should be assessed to make sure he has the correct support in place where he lives to help him to thrive.Q1 – option 2 – I would reassess the dressing and keep monitoring as the granulating tissue means that the dressing is not healing the wound approprietly
Q2 – option 2 – I would adapt how i am speaking to Farhan as he deserves to understand what is happening with his body to make sure his healing goes smoothly
Q3 – option – his needs need to be assessed individually and he need sot be treated as any ither patient and we should not just ‘pass him on’ to the care staff at his homeQ1 option 2&3: I would reassess the wound and check if the right dressing is being used. i would also ask how Farhan has been looking after the wound. i will also contact the
GP to report the state of the wound and obtain further recommendations.
Q2 option 2: I would choose to take the time to explain to Farhan the outcome of his assessment. It is important that he understand and makes informed choices. I will use simple language as well as breaking the information down. i would ask questions as well as listening to him. It might be helpful to get his consent to discuss the information with relatives.
Q3 option 2: My choice is option two. It is bad practice to assume what would happen to Farhan when he leaves the hospital. Healthcare professional must make sure that he receives the care he requires in order for him to make a good recovery and every patient should be assessed individual and receive person-centred care plan.Q1. Option 2 because overgranulation prevents the wound from healing, hence reassessing and choosing an appropriate wound dressing.
Q2. Adapting communication in healthcare is a major factor to ensure better outcomes for patients. Carefully explaining the situation to Farhan enables better health outcomes.
Q3. People who live in assisted living can NOT be discharged home at anytime because this can be detrimental to such people in terms of their welfare and general wellbeing.
Q1: Option 2 I would not continue to use the dressing because it is simply not sustainable suitable and could aggravate his issues with that as well. As a result, I might well continue to assess the wound and determine which dressing would be suitable for this type of wound management given that each wound is unique.
Q2: Option 2 Since Fahad has Down syndrome, I would then illustrate the consultation and treatment plan using tools such as drawings, pictures and simple language and ask him to clarify his knowledge base.
Q3: Option 2 Wrong, each patient needs to be treated as an individual. Needs change and you need to establish the cause for admission in the first place. It would be a terrible idea to speculate on what will happen to Farhan after he leaves the hospital. Healthcare professionals must ensure that he gets the care he needs to help him recover fully, and all patient must be assessed in a manner of preserving their dignity and person-cantered.
Question 1: Option 2: The wound should be reassessed to enable the team recommend the right dressing to be used; and the patient should be made aware of any further treatment.
Question 2: I will choose option 3: Going by the patient’s care plan and effective communication skills be put in place to enable patient Farhan understand and picture out what’s going on!
Question 3: I will recommend option 2: To enable Farhan care plan reviewed in an event of admission into hospital.
Q1 – I would choose option 2, if a wound was overgranulating it is advisable to reassess the wound.
Q2 – I would choose option 2, involving Farhan and communicating with him at a level that he would understand reflects person centred care or a person centred approach.
Q3 – I would choose option 2 as each individual’s care needs established during the admission should be met prior to discharge.
Q1 – I would choose option 2 and reassess the wound because reapplying a dressing to an over granulating wound is not appropriate.
Q2 – I would choose option 2 and adapt the communication to carefully and appropriately explain what is happening to Farhan. It is important to adapt the communication style to one that will be effective to Farhan as it is essential in patient consultation/assessment allowing him to have a clearer understanding of the situation.
Q3 – Option 2: Wrong, each patient needs to be treated as an individual. Needs change and you need to establish the cause for admission in the first place. We cannot predict or speculate on what will happen to Farhan once he is discharged. Before Farhans can be discharged, his needs must be assessed individually.
Q1. Option 2 I would reassess the wound because applying a dressing over a granulating wound might cause an infection.
Q2. Option 2 I would adapt to a more effective way of communication to explain to Farhan carefully and appropriately what is happening. or find some different ways to communicate with him.
Q3. Option 2 because each patient needs to be treated as an individual. Needs change and you need to establish the cause for admission in the first place.
Q1. Option 1, I will reassess the wound to avoid the possible chance of an infection then I will follow up with an immediate call to the GP to make the declaration on his medical record to avoid possible reassurance in the future
Q2. Option 2, I will adapt my ways of communicating with Farhan by simplifying my words and not using jargons, I will be slow with my words and maintain eye contact so I can assess if he is understanding what I am saying.
Q3. Option 2, People circumstance differ and the main reason of why they are in a supported living needs to be considered couple with their initial admission needs.
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