Appendix H

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In appendix H:
Brief Intervention Case Studies for Community Nurses

Brief Intervention Case Studies for Community Nurses

Activity.

The following three case studies are scenarios that can be role-played for brief intervention skill practice. In the course of your role-plays you may add in additional information or elaborate on the scenarios for the purposes of the exercise. You will certainly have to do this if you complete an AUDIT.

Amy is 74 and lives alone in her own house in a metropolitan area with her three cats. She has been referred from discharge planning at the local hospital and requires daily wound care following a fall. She is lonely and isolated. Her only relatives live interstate.

She has been using analgesics for back pain and has also had scripts for Serepax and anti-depressants. She often uses Temazapam to help her sleep, but says that a glass or two of sherry sometimes works just as well.

As part of your initial Community Nursing assessment conduct an AS+BI. Introduce the AUDIT and then presume an AUDIT score of 10 for Amy.
Do a risk analysis for Amy considering her age, drinking level, medication and presenting problems.
Provide feedback for Amy re. AUDIT and risk factors.
Give Amy some clear information and advice about low risk drinking.
Can you assist Amy to establish a goal?
Finalise the intervention: provide printed info; suggest follow up; referral; or notification etc.

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Jack is 85 and lives in a caravan in a coastal area. He has been referred from the LMO for personal care and medication supervision. The LMO notes "alcohol abuse and smoking" and considers that there may be some degree of dementia. Jack has chronic airway disease, arthritis and has been on medication for chronic back pain. He is taking MS Contin, Zoloft and Zantac.

Jack used to be fairly active but doesn’t venture far from his caravan these days and often calls a taxi for his food and supplies. He says he usually has a few drinks every day. Often on paydays some of the other people in the caravan park come round to his van and they have a ‘bit of a night’, playing cards and drinking.

As part of your initial Community Nursing assessment conduct an AS+BI. Introduce the AUDIT and then presume an AUDIT score of 15 for Jack.
Do a risk analysis for Jack considering his age, drinking level, medications, accommodation and presenting problems.
Provide feedback for Jack re. AUDIT and risk factors.
Give Jack some clear information and advice about low risk drinking.
Can you assist Jack to establish a goal?
Finalise the intervention: provide printed info; suggest follow up; referral; or notification etc.

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Lenny is a 71-year-old Korean War veteran who lives with his wife Grace in a rural town. He has been diagnosed as having PTSD and partly completed a rural outreach program. He has been referred by the LMO for showering. He has chronic angina and has recently had a stroke. He is a big man and his mobility is significantly decreased.

Lenny says he used to be a big drinker, but has slowed down a lot in recent years. On his doctor’s recommendation he gave up smoking when he had the stroke. Now and again, when he has a drink, he lapses and has a cigarette. Lenny says that the doctor said that it wouldn’t be bad for his heart if he had a few drinks.

As part of your initial Community Nursing assessment conduct an AS+BI. Introduce the AUDIT and then presume an AUDIT score of 13 for Lenny.
Do a risk analysis for Lenny considering his age, drinking level, medications, current medical problems.
Provide feedback for Lenny re. AUDIT and risk factors.
Give Lenny some clear information and advice about low risk drinking.
Can you assist Lenny to establish a goal?
Finalise the intervention: provide printed info; suggest follow up; referral; or notification etc.

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