MODULE SEVEN:

1. MODULE SEVEN: Health Observation and Data Collection The information in this section has been adapted from The Standards of Practice Manual for Community Health Workers and Community Health Occupations, Community Health Works of San Francisco and the Centers for Disease Control Handbook for Enhancing CHW Programs.

2. Objectives: Students will: • Conduct an interview using good observation and communication skills. • Practice good listening and communication skills. • Properly measure and record vital signs. • Accurately communicate observations and data to their supervisor.

3. We can learn a lot about the health of a person by observation: • Watch their body language. • Watch how they interact with others. • Do they look happy? • Do they appear healthy? • How are they dressed?

4. Look for things that are keys to health and safety, not just reflections of the current culture: • Ripped jeans may be the current fashion, or they may be a sign that someone is in need of new clothing. • Dirty clothing or clothing that is not appropriate for the weather is more likely a sign of need. • Messy hair may be the style, or it may be a sign of poor hygiene.

5. You can tell quite a bit from observations… But interviews are also important in collecting health data.

6. When you interview someone: • Find a comfortable place. • Find a private place. • Sit at the same level and face the client. • Avoid distractions; turn off cell phones, for example. • If talking to a child, kneel or sit on the floor. • Establish a level of comfort by asking a few general questions.

7. First, introduce yourself: • Tell the person your name. • Explain that you are a Youth Health Service Corps Volunteer. • Allow the person to ask you some questions. • Ask the person to introduce herself/himself.

8. Explain the purpose of the interview: • Tell the person what type of information you will be collecting. • Tell the person why you are collecting the information. • Tell the person what you will be doing with the information.

9. For example, you can say: • “I am going to be collecting some information about your health.” • “I will be asking about your health, medications, illnesses and some family history.” • “Collecting this information will help me determine your needs.” • “After I collect this information, I will share it with the shelter’s medical case manager.”

10. Use body language to make the person comfortable: • Smile • Nod • Do not cross your arms • Sit close, but not too close • Avoid looking around the room • Maintain eye contact with the client

11. Use an icebreaker: • If the person you are interviewing seems nervous, make him/her comfortable by • Bringing up a pleasant, unrelated topic or sharing something about yourself. • Giving a compliment. • Sharing a funny story. • Talking about something current that is positive such as a team winning a game or nice weather.

12. Document the interview: • If you need to take notes or fill out a form, let the person know you will be writing some things down. • Continue to maintain eye contact and positive body language while taking notes.

13. Make sure the person understands you: • Do not use slang terms. • Do not use technical terms. • Do not use acronyms; for example, SARS is an acronym. • Check with the client to make sure he/she understands you. • Define words if necessary. • Use an interpreter if needed.

14. Assess the person’s comfort and comprehension level: • Observe the client’s body language. • Does he/she look confused? • Ask “Do you have any questions?” • Ask “Am I being clear?” • Maintain eye contact. • Review as you go along.

15. Intake forms: • Complete all information • Write legibly • Answer all questions • Take notes on another sheet if necessary • Make a copy for the client

16. Listening: • Active listening • Verbal active listening • Non-verbal active listening

17. Active listening: When you listen actively you will: • Help the person feel as though his/her ideas are important. • Gain a better understanding of the person’s concerns or experiences. • Provide more effective and appropriate services.

18. Verbal active listening: • Repeat what the person has said. • Rephrase what was said. • Connect points to something said earlier. • Ask for clarification if you are not sure of what was meant. • Thank the person for feedback and participation.

19. Non-verbal listening: • Maintain open and receptive body language • Maintain eye contact • Nod when appropriate • Smile

20. Time management: • Make sure to let the client know start time, end time, and if/when there will be breaks. • Refocus when client wanders off the topic. • Stick to start and end times as much as possible.

21. Ending the interview: • Thank the client. • Address any concerns. • Let the person know what to expect for a next meeting or step. • Ask if there are any questions.

22. Vital signs: Vital signs tell a lot about your health status. They include: • Temperature • Pulse • Respiratory rate • Blood pressure

23. Temperature: • Can be taken by a manual or digital thermometer. • The thermometer must be accurately read and recorded.

24. Pulse: • The pulse is the number of heartbeats per minute your heart pumps blood through your arteries. • The pulse is counted for one minute (60 seconds). • However, you can take the pulse for 30 seconds and MULTIPLY the number of beats by 2 to get the beats per minute. • Use a watch with a second hand as a timer. • Normal adult pulse is between 60-100 beats per minute.

25. Respiratory rate: • One inspiration (breath in) and one expiration (breath out) equals one full respiration. • To count respirations, observe the person’s chest rise and fall. • The person should be sitting and should not be talking. • As with taking a pulse, the respiratory rate is usually counted for 30 seconds and then multiplied by 2 to obtain the number of respirations per minute. • Normal adult respiratory rate is 10-20 respirations per minute.

26. Blood pressure: • Blood pressure is the pressure that is exerted by the blood against the blood vessels and arteries. It is an indicator of heart and artery health. • Blood pressure ranges are different for everyone. • The blood pressure gauge will allow you to read the systolic and diastolic pressures. • The systolic pressure is the first sound you hear. • The diastolic pressure is the last sound you hear. • Blood pressure is recorded as systolic/diastolic pressures in mm Hg. For example: 120/80.

27. Blood glucose/sugar measurement: • Blood glucose, measured by a finger stick test, indicates the amount of sugar in the blood. • This is often the first screening performed for diabetes. • Gloves must be worn as part of universal precautions during this test.

28. Summary: • To begin an interview, the first thing you should do is introduce yourself. • Active listening allows you to provide more effective and appropriate services. • It is completely appropriate to ask for clarification if you are not sure of what was meant. • You are responsible for making sure that the client understands the questions you are asking.

29. Summary (continued) • When ending an interview, don’t forget to thank the client. • Vital signs and blood glucose are used to screen for a wide range of health issues.