Patients that are infants, children, elderly, developmentally disabled, sedated or speak a language we do not know will require certain tools, strategies or modifications when performing a health history. Barriers in communication can be overcome when they are addressed properly. Avoiding miscommunication will lead to safe care and a better patient outcome. As medical professionals, we should be aware of the availability and effectiveness of these methods. 

What strategies would you employ to obtain a complete health history?

Infants and children are unable to provide a complete health history. The parent or legal guardian must be interviewed. The electronic health record should also be utilized for pertinent information. Sedated, confused or intubated patients will require a family member as a first reference and then a review of the electronic health record will be necessary (Bickley et al., 2021, p. 107). A patient with hearing loss may not have a functional hearing aid. The provider must be sure it is functional and turned on. The provider should speak clearly in normal tones without covering their mouth. A patient that speaks a different language will require a translator. This tool is costly to the facility and should be utilized whenever necessary. Elderly patients with dementia, inability to speak or write due to a stroke or the developmentally disabled will require a family member, legal guardian or communication with the facility they are a resident at. The interview must begin with the patient if at all possible. 

Provide a rationale for why you think these strategies would be effective.

The strategies mentioned above for hearing impaired patients can be assessed by doing teach back. There is evidence of effectiveness of strategy if the patient is able to read, repeat back or write out information to the provider (Bickley et al., 2021, p. 66). A translator that is utilized for health history allows back and forth communication which increases communication and patient satisfaction (Al Shamsi et al., 2020). Teach back can also be performed to assess for learning and message delivery. The elderly or developmentally disabled strategy of utilizing a family member, guardian or another facility health care provider for the purpose of a health history would be effective. The person speaking for these patients is often familiar with the patient’s history as a family member or has access to accurate medical records as a residency provider (Zietlow et al., 2022). 

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