Clinical Decision Making

Question 1

What are the main types of information we should be aiming to gather as apart of our patient interview?

Answer 1

Two main:

1. Symptom based information - problem & its presentation
2. Psychosocial information - impacts of dysphagia on patient & family

Question 2

List the general considerations one should take when interviewing

Answer 2

• Have a clear objective around what info you want from this
  
  • symptom based info – problem & presentation
  • psychosocial info - impact on patient & family
• interview with empathy
  
  • consider patient & their context
  • your body language: eye contact, engaging in what they’re saying, notetaking, manner, etc.
• Consider questions & their language
  
  • if client has issues with communication - how will you faciliate this?
  • use other people in patient’s life to gather info from –> nurses, family (other persepective on issue)
  • questions –> mix of open & closed, start with open/broad and then get more specific/closed as it progresses

Question 3

Describe the steps of interviewig a dysphagia patient

Answer 3

1. Collecting info
   
   • current swallow, past swallow, impact
2. Decision making
   
   • formulate hypothesis –> severity, cause, if more info or assessments are needed, other professionals, urgency

Question 4

What is the process for transitioning from non oral intake to oral intake?

Answer 4

• commence small oral trials with non oral sup still in place
• increase size & amounts of trials – discuss with dietician to start to change bolus feeds to increase appetite
• monitor oral intake – once sufficient, dietician, SP and medical determine if non oral can be removed