ASSIGNMENT: MODULE 1 TAKING A HEALTH HISTORY: BUILDING A HEALTH HISTORY: ASKING DIFFICULT QUESTIONS

ASSIGNMENT: MODULE 1 TAKING A HEALTH HISTORY: BUILDING A HEALTH HISTORY: ASKING DIFFICULT QUESTIONS

ASSIGNMENT: MODULE 1 TAKING A HEALTH HISTORY: BUILDING A HEALTH HISTORY: ASKING DIFFICULT QUESTIONS

Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.

Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations.

More importantly in today’s society, the possible Social Determinants of Health for each of our patient’s also needs to be taken into consideration

For this Assignment, you will develop a make-believe script to be used when you first encounter a patient for a well woman appointment.

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RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

LEARNING RESOURCES
Required Readings
Schuiling, K. D., & Likis, F. E. (2022). Gynecologic health care (4th ed.). Jones and Bartlett Learning.

Chapter 6, “Gynecologic Anatomy and Physiology” (pp. 87–98)
Chapter 7, “Gynecologic History and Physical Examination” (pp. 99–124) (Previously read in Week 1)
Chapter 9, “Periodic Screening and Health Maintenance” (pp. 149–164)
Chapter 12, “Sexuality and Sexual Health” (pp. 211–228)
Chapter 13, “Contraception” (pp. 236–266)
Chapter 14, “Menopause” (pp. 267–291)
Chapter 15, “Intimate Partner Violence” (pp. 295–307)
Chapter 16, “Sexual Assault” (pp. 313–329)

SCREENING GUIDELINES
American Academy of Family Physicians. (2021, August). Adult preventive health care schedule: recommendations from the USPSTF.Links to an external site. American Family Physician. https://www.aafp.org/dam/AAFP/documents/journals/afp/USPSTFHealthCareSchedule2021.pdf
American College of Obstetricians and Gynecologists (ACOG). (n.d.). Well-Woman Health CareLinks to an external site.. https://www.acog.org/topics/well-woman-health-care?utm_source=redirect&utm_medium=web&utm_campaign=otn
Agency for Healthcare Research and Quality (2014). Guide to Clinical Preventive Services, 2014.Links to an external site. https://www.ahrq.gov/prevention/guidelines/guide/index.html
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (n.d.). A guide to taking a sexual history.Links to an external site. https://www.cdc.gov/std/treatment/SexualHistory.pdf

ADULT GERONTOLOGY RESOURCES
Shifren, J. L., & Gass, M. L. S. (2014). The North American Menopause Society Recommendations for Clinical Care of Midlife Women.Links to an external site. The Journal of The North American Menopause Society, 21(10), pp. 1-25. http://www.menopause.org/docs/default-source/2014/nams-recomm-for-clinical-care.pdf

RESOURCES FOR LGBTQ+
Aisner, A. J., Zappas, M., & Marks, A. (2020). Primary Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ) PatientsLinks to an external site.. The Journal for Nurse Practitioners, 16(4), 281–285. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1016/j.nurpra.2019.12.011
Office of Disease Prevention and Health Promotion (ODPHP). (2020, April 18). Lesbian, gay, bisexual, and transgender health.Links to an external site. https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health
Wingo, E., Ingraham, N., & Roberts, S. C. M. (2018). Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: A Qualitative StudyLinks to an external site.. Women’s Health Issues, 28(4), 350–357. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1016/j.whi.2018.03.002

APPS FOR COMMON SCREENINGS
The following common screening apps will require a download or install into your personal device for you to access. Note: Should you have any technical issues, you will need to contact the rightsholder of the app itself and not Walden Student Support for any assistance.

Alvar-Gonzalez, J. (2020). iContraception.Links to an external site. https://play.google.com/store/apps/details?id=com.itiox.icontraception&hl=en_US

Note: This download is available for Android devices only.

ITIOX Technologica S.L. (2020). iContraception.Links to an external site. https://apps.apple.com/us/app/icontraception/id668520861

Note: This download is available for iOS devices only.

Agency for Healthcare Research and Quality (AHRQ). (n.d.). ePSS Electronic Preventive Services Selector.Links to an external site. https://epss.ahrq.gov/PDA/index.jsp
Centers for Disease Control and Prevention (2020). CDC Vaccine Schedules.Links to an external site. https://www.cdc.gov/vaccines/schedules/hcp/schedule-app.html#download

Note: This webpage will provide you with downloads for both iOS and Android Devices.

Nurse Practitioners in Women’s Health. (n.d.). Well Woman Visit Mobile AppLinks to an external site.. https://npwh.org/page/mobile-app

CLINICAL GUIDELINE RESOURCES
American College of Obstetricians and Gynecologists (ACOG).Links to an external site. (2020).  https://www.acog.org/
American Cancer Society, Inc. (ACS). (2020). Information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin.Links to an external site. https://www.cancer.org/
Centers for Disease Control and Prevention. (CDC).Links to an external site. (n.d.). https://www.cdc.gov/
American Nurses Association (ANA).Links to an external site. (n.d.). https://www.nursingworld.org/
The American Association of Nurse Practitioners (AANP).Links to an external site. (2020). https://www.aanp.org/
HealthyPeople 2030. (2020). Healthy People 2030 Framework.Links to an external site.  https://www.healthypeople.gov/2020/About-Healthy-People/Development-Healthy-People-2030/Framework

Required Media
Taking a Health History

Dr. Marianne Shaughnessy discusses one of the most critical components of the nurse/patient relationship—the health interview with the patient. She further discusses how to conduct a health history interview with demonstration (16 mins).
Women’s Issues and Tough ConversationsLinks to an external site.

In this interactive media program, Dr. Rebecca Lee and Cindy Nypaver describe their experiences related to women’s issues and tough conversations (5 mins).

Optional Resources
Note: In Weeks 1-10, these resources are optional for your review. In Week 11, you will be required to review each of the PowerPoint slides from the text Gynecologic Health Care (4th ed.).

Chapter 6, “Gynecologic Anatomy and Physiology” Download “Gynecologic Anatomy and Physiology”
Chapter 7, “Gynecologic History and Physical Examination”Download “Gynecologic History and Physical Examination”
Chapter 9, “Periodic Screening and Health Maintenance” Download “Periodic Screening and Health Maintenance”
Chapter 12, “Sexuality and Sexual Health” Download “Sexuality and Sexual Health”
Chapter 13, “Contraception” Download “Contraception”
Chapter 14, “Menopause”Download “Menopause”
Chapter 15, “Intimate Partner Violence”Download “Intimate Partner Violence”
Chapter 16, “Sexual Assault”Download “Sexual Assault”

To prepare:

Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.
Review the media programs related to a vaginal exam, pap test, and breast exam.
Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a complete health history. (Note: You will also find the Health History Form in Chapter 7)
Provide all the components of a complete gynecologic health history. Include considerations for special populations such as LGBTQ+ individuals.
What health maintenance guidelines should be included for initial and follow up might be needed for follow-up assessments?  (i.e., bone density test, Gardasil vaccine, pap smear, Mammorgram, etc.)?
Using the 5 areas of the Social Determinants of Health:

(Examples of SDOH include but not limited to)

Safe housing, transportation, and neighborhoods
Racism, discrimination, and violence
Education, job opportunities, and income
Access to nutritious foods and physical activity opportunities
Polluted air and water
Language and literacy skills
SDOH also contribute to wide health disparities and inequities.
What questions would you consider in your patient’s complete health history?

Develop your own script for building a complete health history and as you create your script, consider the difficult questions you want to include in your script. There is no sample template to provide to you. (Utilize chapter 7 of your Schuiling textbook to provide guidance). You are the one to develop the script. Think of it as you are writing a movie and you need to write the script for the movie. What lines would you provide for the actor to utilize when sitting down with a patient to perform a COMPLETE Medical History which also entails those DIFFICULT GYN questions. You do not need to provide the answers to the questions however, if you find that beneficial, you may do so.

Assignment: (1- to 2-page reflection)

In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:A brief summary of your experiences in developing and implementing your script during your health history.
Explanations of what you might find difficult when asking these questions. What you found insightful and what would you say or do differently.
As a NP, what could you implement in your community to provide resources/assistance of the Social Determinants of Health.

ReminderLinks to an external site.: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

BY DAY 7 OF WEEK 2
Submit your Module 1 Assignment by Day 7 of Week 2.

SUBMISSION INFORMATION
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To submit your completed assignment, save your Assignment as M1Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.

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Rubric
NRNP_6552_Module1_Assignment_Rubric

NRNP_6552_Module1_Assignment_Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeDescribe the components of a comprehensive gynecologic complete health history. Include considerations for special populations such as LGBTQ+ individuals,,. What health maintenance guidelines should be included during the initial and follow up assessments. (i.e., bone density test, Gardasil vaccine, shingles, etc.)?..What questions would you consider in your patient’s assessment?
30 to >26.7 pts Excellent

The response provides clear, complete, and appropriate descriptions of a comprehensive gynecologic complete health history. Health maintenance guidelines are clear and complete.
26.7 to >23.7 pts Good

The response provides clear, complete, and most of the components of a comprehensive gynecologic complete health history. Most health maintenance guidelines are included and appropriate.
23.7 to >20.7 pts Fair

The response provides components of the gynecologic health history but they are incomplete, vague or inaccurate. Health maintenance guidelines are somewhat complete or inappropriate applied.
20.7 to >0 pts Poor

The response provides unclear, incomplete, or inappropriate components of the gynecologic health history. Health maintenance guidelines are missing, incorrect, or inappropriate applied.

30 pts
This criterion is linked to a Learning OutcomeBuilding a Health History: Asking Difficult Questions… Create your own script for building a health history. Consider the type of language you would use to help your patient be more comfortable). Ensure you include the difficult questions required to complete a thorough health history.
25 to >22.3 pts Excellent

The script contains a complete set of questions, including difficult questions, necessary to build a health history. Questions are phrased in a manner that supports the patients comfort.
22.3 to >19.75 pts Good

The script contains a mostly complete set of questions, including difficult questions, necessary to build a health history. Most questions are phrased in a manner that supports the patients comfort.
19.75 to >17.25 pts Fair

The script containing some relevant questions, including a few difficult questions. Information collected provides a cursory health history. Questions are not phrased in a supportive tone.
17.25 to >0 pts Poor

The script contains few or no relevant questions, including few or no difficult questions. Information collected is not sufficient to provide an adequate health history. Questions are not phrased in a supportive tone.

25 pts
This criterion is linked to a Learning OutcomeIn addition to your script for building a health history for this assignment, include a separate section called “Reflection”… Briefly reflect and provide a summary of your experiences in developing your script during your health history.
30 to >26.7 pts Excellent

The response provides an accurate, clear, and complete summary of experiences in developing the script during the health history
26.7 to >23.7 pts Good

The response provides an accurate summary of experiences in developing the script during the health history
23.7 to >20.7 pts Fair

The response provides a vague, inaccurate, or incomplete summary of the experiences in developing the script during the health history
20.7 to >0 pts Poor

The response provides a vague, inaccurate, or incomplete summary of the experiences in developing the script during the health history, or the summary is missing.

30 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
5 to >4.45 pts Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity… A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
4.45 to >3.95 pts Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time… Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.
3.95 to >3.45 pts Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time… Purpose, introduction, and conclusion of the assignment is vague or off topic.
3.45 to >0 pts Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time… No purpose statement, introduction, or conclusion was provided.

5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuation
5 to >4.45 pts Excellent

Uses correct grammar, spelling, and punctuation with no errors.
4.45 to >3.95 pts Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.
3.95 to >3.45 pts Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.
3.45 to >0 pts Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 to >4.45 pts Excellent

Uses correct APA format with no errors.
4.45 to >3.95 pts Good

Contains a few (1 or 2) APA format errors.
3.95 to >3.45 pts Fair

Contains several (3 or 4) APA format errors.
3.45 to >0 pts Poor

Contains many (≥ 5) APA format errors.

5 pts
Total Points: 100