Module 11 Discussion: Patient Compliance

Module 11 Discussion Patient Compliance

Edith Dawson came to Rasmussen Clinic because she was experiencing sight disturbances, constant thirst, and fainting spells. After examining Edith, Dr. Sobiech ordered a glucose tolerance test. Certified Medical Assistant Wanda Lawry gave Edith a special diet that she was to follow for the 3 days preceding the test and instructions regarding fasting before the test. Edith has returned to the clinic to have test. "Did you follow the diet I have you Mrs. Dawson?" Wanda asks. "Yes I did." "Did you have anything to eat this morning?" "No, but I did have a cup of coffee. I thought it would be all right because I drank it black. I can't start the day without my coffee." Should Wanda perform the test? Explain your answer. How can Wanda emphasize the importance of following the diet, fasting, and test instructions? What can Wanda do to try to ensure Edith's cooperation?

Paper For Above instruction

In this scenario, Wanda Lawry needs to carefully consider whether to proceed with the glucose tolerance test given Edith Dawson's non-compliance with fasting instructions. The primary concern is that ingestion of even black coffee can significantly affect the accuracy of the test results. The glucose tolerance test relies on fasting blood glucose levels, and any intake of calories or caffeinated beverages can interfere with the body's glucose metabolism, leading to unreliable or misleading results (Kumar & Clark, 2013). Therefore, Wanda should ideally postpone the test until Edith fully complies with fasting protocols to ensure the validity of the diagnostic outcome.

Performing the test under these circumstances would compromise its accuracy. Coffee, even without milk or sugar, contains compounds that can stimulate insulin secretion and influence blood glucose levels. Caffeine, a stimulant present in coffee, has been shown to affect glucose metabolism by impairing insulin sensitivity (Hill et al., 2013). Therefore, testing Edith while she has consumed coffee could result in an inaccurate assessment of her glucose tolerance, potentially leading to misdiagnosis or suboptimal treatment planning.

To emphasize the importance of following the diet and fasting instructions, Wanda can use clear, empathetic communication strategies. Explaining the purpose and significance of the fasting protocol helps patients understand why compliance is critical for accurate diagnosis (Bickmore et al., 2018). Wanda could also provide written instructions, highlighting the potential consequences of non-compliance, and reinforce these at each encounter to ensure understanding. Visual aids or diagrams explaining how the test works and why fasting is necessary may further enhance comprehension (Turner et al., 2017).

Moreover, Wanda can take practical steps to increase Edith’s cooperation. These include confirming the patient’s understanding by asking her to repeat instructions, offering reassurance about the temporary discomfort of fasting, and addressing any concerns or misconceptions she might have. Scheduling the test at a convenient time or providing flexible appointment options can reduce anxiety and improve compliance. Additionally, Wanda can remind Edith about the importance of adhering strictly to the fasting guidelines through follow-up calls or messages before the test date. Building rapport and trust through respectful and patient-centered communication fosters cooperation and improves adherence (Fiscella & Zou, 2017).

In conclusion, it is advisable for Wanda to postpone the glucose tolerance test until Edith can fully adhere to the fasting and dietary instructions. The integrity of the test results depends on strict compliance, and effective communication, patient education, and personalized care strategies are essential in ensuring cooperation. Enhancing understanding and addressing barriers to compliance ultimately lead to more accurate diagnosis and better patient outcomes.

References

• Bickmore, T., Schulman, D., & Nussbaum, J. (2018). Patient-centered communication and health outcomes: A review. Journal of Healthcare Communication, 3(2), 45-53.
• Fiscella, K., & Zou, B. (2017). The impact of trust and communication on patient adherence. Patient Education and Counseling, 100(12), 2159-2163.
• Hill, M., de Valk, H. W., & Cohen, N. (2013). The impact of caffeine on glucose metabolism: Implications for testing. Diabetes Research and Clinical Practice, 99(2), 181-185.
• Kumar, P., & Clark, M. (2013). Kumar & Clark's Clinical Medicine (8th ed.). Elsevier Saunders.
• Turner, B., Foy, R., & Greenfield, S. (2017). Visual aids and patient understanding: A systematic review. Family Practice, 34(1), 16-22.