Aboriginal Health Case Study: Patient Journey Mapping Activity

This activity involves exploring and critically analysing one of the following three Aboriginal health case studies, which are included in your weekly readings. Get a complete patient-centered nursing and patient-centered care with Desklib's patient journey mapping activity.

This is a 2000-word patient journey mapping activity, worth 50% of your overall
course grade. This activity will be done in pairs. You have been allocated a partner.
Working in collaboration and teamwork is 10% of this grade. No Introduction or
conclusion is required for this activity. This activity introduces a tool for use in future
clinical practice.
This activity involves exploring and critically analysing one of the following three
Aboriginal health case studies, which are included in your weekly readings:
rtrtTieandra – a young woman with rheumatic heart disease who is initially
misdiagnosed, then travels to the city for surgery.
○ a video + additional background information is provided
Assignment description
The assignment has two parts:
Part A - MTWT Patient Journey Mapping Tools
● Narrative (10%)
Tell the story of what happened for the patient and their family, from the perspective
of a nurse who has gotten to know them and their story. (Approximately 1 page).
● Visual (10%)
Visually map their health care journey. Include the health care sites involved and
approximate distances between home and these health care locations. Your map
may be computer generated or hand drawn and scanned in. The emphasis is on
what the visual mapping shows, not technical expertise. Refer to examples of maps
in the MTWT readings.
● Tables 1, 2, 3, 4 (40%)
Fill in these tables using information from the case study video or article and
additional background information provided.
Table 1: Dimension s of health
Use dot points to identify how accessing care locally versus further away or in a
hospital, impacts on this person.

Dimensions of health Health care near home Hospital care
Social & emotional
wellbeing
. Feels unsure and very
worried about the local
doctor’s diagnosis due to
previous experience.
. Feel more trust about
the doctors but would feel
unfamiliar with medical
staffs
Family & community
commitments
. Feel safer and more
secure because family
members are close and
can involve easier.
. The rest of the family is
away and only mum is
with her.
. Her mum would be
worrying about the other
kids and her husband at
home.
Personal, spiritual &
cultural considerations
. Feel comfortable staying
at Cenduna where she
lives in
.
. Doesn’t feel comfortable
in a town like Port
Augusta or a city like
Adelaide, which have
different social structure
to her home community.
. Experiencing difficulty in
transport.
. The family would be
stressed out due to
financial difficulty.
Physical and biological
considerations
. A 16-year-old girl who
requires regular doctor
appointments and further
surgery for her heart.
.
Table 2: Underlying factors impacting on access and quality of care
Use dot points to identify how accessing care locally versus further away or in a
hospital, impacts on this person.
Underlying factors Health care near home Hospital care
Location ● The care facility was
not proper
● The facility was
● The care was proper.
● They helped the
patient with rheumatic

ignorant. heart disease with
surgery.
Impact of illness or
condition
● The patient was
getting paler.
● She was also feeling
pain and could not
walk properly.
● The doctor stated that
there is no
abnormality in the X-
ray of the patient (SA
Health, 2017).
● The doctors took
initiative for the
treatment of the
patient.
● The hospital facility
worked on the
diagnosis and also the
operation procedure
for the patient.
Language and
communication
● Two doctors of the
facility were not
communicating
properly.
● The hospital facility
was helping the patient
family and also
communicated the
proper information
about the patient’s
condition.
Financial resources
Aspects of cultural
safety
● This factor was not
considered properly in
the local healthcare
facility and the doctors
of this facility as well
as they neglected the
health factors and
also did not
communicate properly
(Foronda, MacWilliam
and McArthur 2016).
● The facility focused on
the care process and
the health outcome of
the patient. The
hospital in the city also
provided the proper
support to the patient
and the family properly
Table 3: Multiple perspectives
With reference to table 1 and 2, consider how these factors impact across the entire
journey for this person, their family and health services. What strategies were put in
place to help overcome any gaps?
Perspective Patient Diagnosis/ In Discharge / Follo

history referral/transfer hospit
al
transfer w up
Patient’s
journey
Patient
had a pain
at night
and her
mother
thought
that she
was giving
an excuse
for not
going to
school.
She was
bought to
the
hospital
where the
first doctor
performed
an x – ray
and said
that
nothing
was
wrong.
Then
again after
2 weeks
she was
bought to
hospital
due to
pain and
because
she was
getting
paler.
The local doctors
could not diagnose
the disease and she
had a bad
experience with
them.
They should have
transferred her to a
hospital care if they
were not sure of the
disease or the
diagnosis.
In the beginning, the
first doctor found
nothing in the x-ray
and the patient was
sent back home with
her parent.
Then in the hospital,
after two weeks, she
was diagnosed with
rheumatic heart
disease.
In the
hospital
, she
was
diagno
sed
with
rheuma
tic
heart
disease
.
She
was
again
bought
to the
hospital
The
care
was
proper
and
she
was
given
the
right
antibioti
cs. The
medica
tion
manag
ement
was
appropr
iate.
The
nursing
and ,m
The patient
was
successfully
discharged
with a
discharge plan
– a proper
post-surgical
physical
activity and
dietary regime
was given. A
physical
therapy plan
was
prescribed and
community
based nursing
was extended
for the follow
up.
 Patient
receive
d a
complet
e
patient
centred
nursing.
The
patient
was
asked
to
follow
up
with
the
home
care
proced
ure
and
return
to the
hospit
al after
few
month
s for a
compl
ete
check
-up.

edical
team
were
proficie
nt with
their
care.
A
surgery
was
planned
and
perform
ed by a
speciali
st team
of
surgeon
s and
was
treat for
rheumat
ic
disease.
Family/carer’s
journey The
patient’s
mother
was very
worried
with the
patient
and took
her to the
health
care in the
nearby
and then
to the
hospital,
many a
times.
In the beginning, she
was unsure of the
symptoms produced
by her daughter and
thought she is
making excuses for
not going to the
school.
Then, she took her
doctor who thought it
was nothing, given
the x-ray. The
mother bought the
patient back home
and after about two
weeks almost –
when the patient
She
was
extrem
ely
agitate
d,
confus
ed as
to why
her
daught
er was
not
diagno
sed
properl
y in the
She was
finally
comforted and
content that
her daughter
was fine and
out of the
danger.
She listened to
the discharge
plan properly
and with
attention from
the attending
nurse.
She
was
finally
comfor
ted
and
conten
t that
her
daught
er was
fine
and
out of
the
danger
. She
followe

was presented with
further symptoms –
she turned up with
her daughter back to
the hospital where
she was diagnosed
with rheumatic heart
disease.
first
time
and
was
distrau
ght
about
the
behavi
our and
ignoran
ce of
the
doctors
about
the
proper
diagno
sis
which
could
have
cost
her
daught
er, her
life.
d the
discha
rge
plan
very
closely
, all
the
instruc
tions
and
contin
ued
the
care
for her
daught
er.
She
was
helped
by a
comm
unity
health
worker
, a
comm
unity
nurse
and a
cardio
pulmo
nary
physic
al
therapi
st on
the
same.
Patient’s Giving the
proper
The patient priorities
are proper
She
must
She must be
reporting any
The
patient

priorities,
concerns,
commitments
informatio
n and
exact
explanatio
n of what
she has
been
feeling.
diagnosis, correct
interpretation of the
her signs and
symptoms.
She must be
reporting any
discomfort such as
pain or other
symptoms she has
been feeling.
be
reportin
g any
discomf
ort
such as
pain or
other
sympto
ms she
has
been
feeling.
She
must
adhere
to the
proper
medica
tions
before
and
after
the
surgery
proced
ure.
The
patient
must
build
an
effectiv
e
commu
nication
with the
health
care
worker
s.
discomfort
such as pain
or other
symptoms she
has been
feeling.
The patient
must show
obedience and
compliance
with
medication
administration
the planned
discharge and
post- surgical
care.
must
show
obedie
nce
and
compli
ance
with
the
planne
d
discha
rge
and
post-
surgic
al
care.
The
patient
must
follow
up
approp
riately
as per
the
hospit
al
plan.

Health care
priorities Is to take
the patient
history
properly.
List all the
history of
symptoms
and
incidents
the patient
and her
family is
reporting.
Doing the proper
assessments and by
correlating the same
findings with the
history – the
diagnosis has to be
made (Ploutz et al.
2016).
Communicating the
diagnosis with family
of the patient is
critical (Worrall-
Carter et al. 2016). .
A
patient
centred
care
with
comple
te
patient
autono
my and
integrit
y and
totality
along
with
commit
ment to
the
patient
prioritie
s has
to be
deliver
ed.
Monitor
ing the
health
status
of
patient
before
and
after
surgical
proced
ure is
very
importa
nt.
A patient
centred
discharge plan
has to be
formulated.
All the
instructions
have to be
clearly
communicated
to the patient
and patient’s
family
(Goldman and
Trimmer
2019).
A clear
follow
up
plan
has to
comm
unicat
ed to
the
patient
and
her
family.
What
strategies An
effective
An effective
communication with
An
effectiv
e
An effective
communicatio
n with the
An
effecti
ve

were put in
place to
overcome
any gaps?
clinical
reasoning
and
critical
thinking
strategy.
the patient and her
family.
Patient counselling
Patient family
counselling.
commu
nication
with the
patient
and her
family.
Eviden
ce
based
practic
e.
patient and
her family
A multi-
disciplinary
care
approach.
comm
unicati
on
with
the
patient
and
her
family
Table 4: Action plan
What further actions could be taken to respond to the gaps identified in Table 3
What worked
well?
What didn't
work well?
Nursing actions The patient
was
responsive,
easy to care
for and the
patient’s
mother was
open to
nurse’s
communication
regarding her
daughter.
A culturally
competent
communication
worked well
(Delaney
2018)
At the
patient’s
mother was
too agitated
and confused,
she was
guarded.
Communicatio
n was a
problem
initially but
later on
sorted.
Service actions
– within a local
They
deteriorated
the patient

hospital or clinic. condition with
wrong
diagnosis.
System actions
– across wider
health system
They provided
a complete,
profession
patient centred
and family
centred care
(svhm 2019)
Diagnosed and
treated the
rheumatic
heart case
rightly.
PART B: Discussion (20%)
Use Table 3 and 4 to guide your critical discussion with regards to providing
culturally safe and quality care for this person and their family and community.
A more culturally competent nursing care was critically important and the essential
part of the communication was a providing confidence to patient and her mother regarding
the right diagnosis and the proper care was important as well. As for caring for the patient –
the right medication administration and preparing the patient for surgery was very vital. The
mother of the patient, was counselled from time to time and her concerns were handled with
care and compassion. A complete patient care with nursing principles of totality,
beneficence, integrity and autonomy was practiced. The language of the patient was used.
More than that, the overall condition of the patient has to be assessed for a safe discharge.
A right set of differential diagnosis has to be made and from that – a provisional diagnosis
has to be confirmed. As for the patient herself, she must have complete faith on the health
care workers and help them with the right information. She must talk to her mother and give
her confidence as well. The nurse must listen to the patient problems and discomfort
carefully. Document keeping and planning the alternate strategies. Finally, the patient
received a complete patient centred nursing and patient centred care.
References :-
Delaney, L.J., 2018. Patient-centred care as an approach to improving health care in
Australia. Collegian, 25(1), pp.119-123.

Goldman, N., and Trimmer, K. 2019. Towards a Culturally Inclusive Model of Care: Quality
Practice and Care Through the Lens of a Practising Nurse. In Ensuring Quality in
Professional Education Volume I (pp. 123-149). Palgrave Macmillan, Cham.
Ploutz, M., Lu, J.C., Scheel, J., Webb, C., Ensing, G.J., Aliku, T., Lwabi, P., Sable, C. and
Beaton, A., 2016. Handheld echocardiographic screening for rheumatic heart disease by
non-experts. Heart, 102(1), pp.35-39.
Svhm.Org.Au, 2019. https://www.svhm.org.au/ArticleDocuments/1572/Aboriginal-Quality-
Improvement-Framework-and-Toolkit-for-Hospital-Staff-January-2015-For-Web.pdf.aspx?
embed=y
Worrall-Carter, L., Daws, K., Rahman, M.A., MacLean, S., Rowley, K., Andrews, S.,
MacIsaac, A., Lau, P.M., McEvedy, S., Willis, J. and Arabena, K., 2016. Exploring Aboriginal
patients’ experiences of cardiac care at a major metropolitan hospital in
Melbourne. Australian Health Review, 40(6), pp.696-704.