Evidence-Based Patient-Centered Concept Map

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Introduction

Concept maps are an important tool in patient–centered care planning. A concept map helps to synthesize facts about a patient’s health needs and personal circumstances with available evidence and analysis. Such a tool becomes more useful when a patient has complex health, economic, and cultural needs.

In this simulation, you will be choosing a patient (KEITH ROGERS), conducting a short interview, and then assembling a concept map for use in that patient’s care plan.

Overview

You are a nurse at the Uptown Wellness Center. As you begin your shift, you get an email from the charge nurse. Click on the icon to read it.

Good morning,

We have two new patients coming in today.

First is Keith Rogers; he is a young man with a recent HIV diagnosis. He has described his living situation as unstable, and he has not begun treatment for HIV.

Keith Rogers (this is the pt I chose)

Patient with HIV

Overview

Reason for Referral: Keith is an 18–year–old African American man, and a recent high school graduate. He has HIV but has not been in treatment.

Situation: Although he has known his HIV status for some time, Keith is here today seeking treatment for the first time. He came alone on a city bus, and he doesn’t have a state–issued ID or insurance information, although he says he does have health insurance.

Interview:

How long have you known you were HIV–positive?

Since this summer. They had one of those trucks outside GG’s where you can get tested for free. GG’s, that’s our club. So me and Nick, we go get the test and it was positive.

They gave us these pamphlets after, but I can’t leave stuff like that around the house. My folks didn’t know about me and Nick. So I trashed those pamphlets on the way home. That was…like six months back I guess.

Since you haven’t been in treatment, have you been doing other things to protect your health?

Yeah. So here’s the thing about that. Nick says he read on the Internet that meth is supposed to help. Like methamphetamines. And you don’t have to do very much and it slows it down so you don’t get sick as fast, but doctors can’t prescribe it because it’s illegal. So we tried that. Nick thinks it’s working, but I don’t know, man. It makes my heart beat real fast and that freaks me out.

He’d be mad if he knew I told you that, like maybe someone’s gonna show up at the house and bust us. I guess I don’t care anymore.

At intake you described your living situation as “unstable.” Can you tell me more about that?

I’m at Nick’s right now. Mom threw me out of the house. I was…like, trying to find a way where I could get a test that wasn’t in front of a gay club, right, cuz…my folks just ain’t ready for that much truth, you know? So we’re at the clinic, and I get the test, and they call Moms in because technically I’m still a minor at that time, and we’re talking with the nurse or whoever and it just kinda comes out. How I got it. She hit the roof.

I don’t think that’s why she threw me out, though, even though at church they say it’s a sin. She’s scared. Everyone is scared. I got little sisters at home, Alexa and Marnie, and we only got one bathroom. It’s like…maybe I’m allowed to go ruin my life and they still love me and pray for me, but if I gave it to the girls…that they could never forgive.

So I’m sleeping on the couch at Nick’s place. His folks don’t want us sharing a bed, but they feed me and stuff. I don’t even know if Nick told them what’s up, so I just keep my mouth shut. If we break up over this, I’m in so much trouble.

What do you feel is the most important thing we can do to help you right now?

Well. I have like five hundred dollars in the bank that I got for my birthday, but HIV drugs have gotta cost more than that. I’m under Dad’s insurance still, until I’m 25 I think. But I remember when my sisters were born it was so expensive anyway, and I’m scared that if the insurance company finds out, like…I have a terminal illness…that’ll just bankrupt the whole family. I can’t do that to them.

So I guess the first thing is, like, can you help me figure out how to do this without hurting anybody?

 

Concept Map

Put together a concept map for your patient’s care plan.

I need a brief description of your patient, and then up to five diagnoses (there may not be that many). Go in order of urgency, and make sure you list the professional or scholarly evidence you used to formulate the diagnosis. Just use in–text citations, please; we want to keep this short and sweet.

Thanks for taking this on!

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Conclusion

Using a concept map to plan a patient’s care can be essential when the case and the patient’s overall needs are complex. In this simulation, you’ve used the details of a patient’s case to draft a concept map for his or her care.

 

 

Assessment Instructions

Preparation

You have been presented with a number of patient case files in the Evidence-Based Patient-Centered Care media piece. You reviewed each case, selected one case for further research, and created draft evidence-based concept map to illustrate an approach to individualized care for the patient. In this assessment, you will build upon and refine your draft concept map and develop a supporting narrative.

Create your concept map and narrative as SEPARATE DOCUMENTS. Be sure to note the areas where you need to include your evidence-based support and where you need to make clear your strategies for communicating information to the patient and the patient’s family.

Requirements

Note: The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may want to review the performance level descriptions for each criterion to see how your work will be assessed.

Supporting Evidence and APA Style

Integrate relevant evidence from 3–5 current scholarly or professional sources to support your assertions.

  • Apply correct APA formatting to all in-text citations and references.
  • Attach a reference list to your narrative.

Concept Map

  • Develop a concept map for the individual patient, based upon the best available evidence for treating your patient’s health, economic, and cultural needs.

Narrative

Develop a narrative (2–4 pages) for your concept map.

  • Analyze the needs of your patient and their family, and determine how those needs will influence a patient-centered concept map.
    • Consider how your patient’s economic situation and relevant environmental factors may have contributed to your patient’s current condition or affect their future health.
    • Consider how your patient’s culture or family should influence your concept map.
  • Justify the value and relevance of the evidence you used as the basis of your concept map.
    • Explain why your evidence is valuable and relevant to your patient’s case.
    • Explain why each piece of evidence is appropriate for both the health issue you are trying to correct and for the unique situation of your patient and their family.
  • Propose relevant and measurable criteria for evaluating the degree to which the desired outcomes of your concept map were achieved.
    • Explain why your proposed criteria are appropriate and useful measures of success.
  • Explain how you will communicate specific aspects of the concept map to your patient and their family in an ethical, culturally sensitive, and inclusive way. Ensure that your strategies:
    • Promote honest communications.
    • Facilitate sharing only the information you are required and permitted to share.
    • Are mindful of your patient’s culture.
    • Enable you to make complex medical terms and concepts understandable to your patient and their family, regardless of language, disabilities, or level of education.

Additional Requirements

  • Be sure to include both documents when you submit your assessment.

Suggested Resources

Evidence-Based Practice

Concept Mapping

Research Guides

 

 

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