CDM follow up visit with Practice Nurse.
Current smoking status assessment. Stage of change: precontemplation /
contemplation / preparation / action / maintenance
Risks of smoking discussed. Need for a consultation with a smoking cessation
consultant / health educator discussed.
Importance of monitoring of discussed.
Discussion/education re: self-management. Assessment of the patient’s environment
and factors affecting ability for lifestyle modifications.
Costs advised.
Follow up confirmed, appointment.
Medicare item 10997 explained. Consented.
CDM follow up visit with Practice Nurse
BP status discussed as per Care Plan. Target: <130/80. Risks of poor BP management discussed. Importance of BP for Chronic disease management discussed. Medication adherence advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Current Asthma status and level of control assessment. Current clinical measurements, characteristics, signs and symptoms discussed as per Care Plan / Well managed / Managed / Poorly controlled Risks and complications of poor control discussed. Need for a consultation with a physio / exercise physiologist / specialist / health educator discussed. Importance of monitoring of Asthma parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for lifestyle modifications. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse CVD risk and current status assessment. Current clinical measurements, characteristics, signs and symptoms discussed as per Care Plan / Well managed / Managed / Poorly controlled Risks and complications of poor control discussed. Need for a consultation with a dietitian / physio / exercise physiologist / podiatrist / specialist / health educator discussed. Importance of monitoring of CVD parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for lifestyle modifications. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Diabetes assessment. Current level of control discussed as per Care Plan / Good control / Satisfactory / Poorly controlled Risks of poorly controlled diabetes discussed. Need for a consultation with a dietitian/ podiatrist /optometrist /exercise physiologist / physio / specialists / health educator discussed. Regular monitoring: blood, eye exam, feet exam discussed. Self-management / self-examination explained. Self-monitoring. Ability. Support. Importance of exercise and diet for Chronic disease management discussed. Complications management discussed: eyes, feet, kidneys, heart. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Eating habits/diet assessment. Current diet discussed as per Care Plan / Following dietary advice /Deviation from dietary regime / Contemplating / Poor diet Benefits and risks discussed. Need for a consultation with a dietitian/ health educator discussed. Importance of general and disease specific diet for Chronic disease management discussed. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Effects of MH problem on everyday life assessment as per Care Plan / Significantly affected / Somewhat affected / Not affected, well managed Risks and connection of MH issue with chronic illness discussed. Need for a consultation with a dietitian / exercise physiologist / physio / specialist / health educator discussed. Importance of emotional wellbeing for Chronic disease management discussed. Role of diet and exercise discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting emotional wellbeing. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse GORD current status assessment. Current clinical measurements, characteristics, signs and symptoms discussed as per Care Plan / Well managed / Managed / Poorly controlled Risks and complications of poor control discussed. Need for a consultation with a dietitian / physio / exercise physiologist / specialist / health educator discussed. Importance of monitoring of GORD parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for lifestyle modifications. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse IBS assessment. Current impact on everyday life, characteristics, signs and symptoms discussed as per Care Plan / Well managed / Managed / Poorly controlled Consequences of poor control discussed. Need for a consultation with a dietitian / physio / exercise physiologist / specialist / health educator discussed. Importance of monitoring of IBS parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for lifestyle modifications. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Lipid status discussed as per Care Plan. Target: as per Care Plan and the guidelines. Current clinical measurements discussed as per Care Plan / Well managed / Managed / Poorly controlled Risks of poor lipids management discussed. Importance of lipids management for CVD management discussed. Medication adherence advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Malignancy: current status assessment. Current stage, characteristics, management discussed as per Care Plan. Measures for better symptoms control discussed. Need for a consultation with a dietitian / physio / exercise physiologist / podiatrist / specialist / health educator discussed. Importance of monitoring of disease’s parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for optimal lifestyle. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Medications issues. Addressing risk of adverse medication event. Assessment of adherence to medication regimen. Risks of poor medication management discussed. Need for a consultation with a HMR pharmacist / specialist / health educator discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting medication management. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Osteoarthritis current status assessment. Current clinical measurements, characteristics, signs and symptoms, pain management discussed as per Care Plan / Well managed / Managed / Poorly controlled Risks and complications of poor control discussed. Need for a consultation with a dietitian / physio / exercise physiologist / podiatrist / specialist / health educator discussed. Importance of monitoring of OA parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for lifestyle modifications. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Osteoporosis risk and current status assessment. Current clinical measurements (scan, Vit D etc), characteristics, signs and symptoms discussed as per Care Plan / Well managed / Managed / Poorly controlled Risks and complications of poor control discussed. Need for a consultation with a dietitian / physio / exercise physiologist / specialist / health educator discussed. Importance of monitoring of Osteoporosis parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for lifestyle modifications. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Pain assessment. Current pain level, characteristics discussed as per Care Plan / Well managed / managed / Poorly controlled Risks and complications of chronic pain discussed. Need for a consultation with a physio / exercise physiologist / podiatrist / specialist / health educator discussed. Importance of pain control and self-management for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting pain. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Physical activity assessment. Current status of the level of physical activity discussed as per Care Plan /Active/ Contemplating/ No activity/ Exercise below target level Benefits and risks discussed. Safe exercise routine. Need for a consultation with physio/exercise physiologist discussed. Importance of general and disease specific physical activity for Chronic disease management discussed. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Risks associated with and current status assessment. Current clinical measurements, characteristics, signs and symptoms discussed as per Care Plan / Well managed / Managed / Poorly controlled Risks and complications of poor control discussed. Need for a consultation with a dietitian / physio / exercise physiologist / specialist / psychologist / health educator discussed. Importance of monitoring of Insomnia parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for lifestyle modifications. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Skin protection routine assessment. Sun protection discussed as per Care Plan / Following advice / Contemplating / Not using sun protection Benefits and risks of good sun protection routine discussed. Need for a consultation with a skin clinic / dermatologist discussed. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Sleep apnoea risk and current status assessment. Current clinical characteristics, signs and symptoms discussed as per Care Plan / Well managed / Managed / Poorly controlled Risks and complications of poor control discussed. Need for a consultation with a dietitian / physio / exercise physiologist / specialist / health educator discussed. Importance of monitoring of Sleep Apnoea parameters for Chronic disease management discussed. Discussion/education re: self-management. Assessment of the patient’s environment and factors affecting ability for lifestyle modifications. Costs advised. Follow up confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Vaccination status discussed as per Care Plan / Shingrix Benefits and risks discussed. Importance of immunisation for Chronic disease management discussed. Costs advised. Schedule confirmed, appointment. Medicare item 10997 explained. Consented. CDM follow up visit with Practice Nurse Vit D status discussed as per Care Plan. Target: >70.
Risks of Vit D deficiency discussed.
Importance and function of Vit D discussed.
Self-management, supplementation, safe exposure to sun discussed.
Medication adherence advised.
Follow up confirmed, appointment.
Medicare item 10997 explained. Consented.
CDM follow up visit.
Bowel screening status discussed as per Care Plan. Target: appropriate screening in
accordance with the current guidelines.
Risks of inadequate screening discussed.
Importance of Bowel screening discussed.
Adherence to the schedule advised. Various BCM techniques advised (e.g. FBOT, scope
etc.).
Follow up confirmed, appointment.
Medicare item 10997 explained. Consented.
CDM follow up visit.
Breast examination screening status discussed as per Care Plan. Target: appropriate
screening in accordance with the current guidelines.
Risks of inadequate screening discussed.
Importance of Breast screening discussed.
Adherence to the schedule advised. Self-breast examination technique reinforced.
Follow up confirmed, appointment.
Medicare item 10997 explained. Consented.
CDM follow up visit.
Cervical screening status discussed as per Care Plan. Target: appropriate screening in
accordance with the current guidelines.
Risks of inadequate screening discussed.
Importance of Cervical screening discussed.
Adherence to the schedule advised.
Follow up confirmed, appointment.
Medicare item 10997 explained. Consented.
CDM follow up visit.
Eye condition management and screening status discussed as per Care Plan.
Management: Poor/ Satisfactory / Good.
Risks of poor management discussed.
Importance of eye screening discussed. Need for specialist care and optometrist review.
Adherence to the schedule advised. Self-management advice.
Follow up confirmed, appointment.
Medicare item 10997 explained. consented.
CDM follow up visit.
Topic discussed:
Review/follow up: no change, better but above target range
Plan: cont change management/review/follow up – salt diet/exercise – walking
Reflecting listening
Change management
Stage of change:
Precontemplation ( not ready)
Contemplation (thinking)
Preparation
Action ( begin to act)
Maintenance
FLU vaccine IMMUNISATION CONSENT 2024
Patient confirms they have read and understood the information given to them about Flu
immunisation including the risk of the vaccination and the risk of not being vaccinated &
confirms they have been given the opportunity to discuss the risks and benefits with the
doctor.
Common side effects are usually mild: include swelling, redness &/or pain at injection
site.
Also tiredness, headaches, muscle aches or fever may occur and can start within a few
hours of the vaccination, lasts short time (few hrs to few days).
Rare side effects include anaphylaxis (a severe allergic reaction), also possible
association with Guillain-Barré syndrome (GBS), a rare and sometimes severe condition
affecting the body’s nerves. However, the link with vaccination (including with this
vaccine) is not definite (no higher rate than general community) and evidence shows that
you are 4-7 times more likely to contract GBS after an attack of actual influenza infection
than after the vaccine.
Contraindications: – anaphylaxis following a previous dose of any influenza vaccine – anaphylaxis following any vaccine component – severe allergy to eggs
Patient consents for Flu vaccine.
Patient is well.
Patient observed in the clinic for 15 min.