HLT54121 Diploma of Nursing

HLTENN036 | Apply Communication Skills in Nursing Practice

Assessment Task 1 of 3 — Case Study and General Questions

Section A — Course and Assessment Details

Qualification Code	HLT54121
Qualification Title	Diploma of Nursing
Unit Code	HLTENN036
Unit Title	Apply Communication Skills in Nursing Practice
Cluster Name	N/A — Standalone Unit
Assessment Type	Case Study and General Questions (Written)
Assessment Number	Assessment Task 1 of 3
Assessment Name	Case Study: Communication in Nursing Practice
Due Date	Week 5 — Sunday 11:59 PM AEST (refer to Connect for exact date)
Submission Method	TAFE Queensland Learning Management System (Connect): https://connect.tafeqld.edu.au
Result Type	Satisfactory (S) / Not Satisfactory (NS)
Number of Attempts	Maximum two (2) attempts. A second attempt will be arranged after assessor feedback on the first.
Reference Style	APA 7th Edition (where sources are cited)
RTO Number	0275
CRICOS Code	03020E

Student Declaration

Student Name:

Student Number:

I declare that this assessment is my own work. Any ideas and comments made by other people have been acknowledged as references. I understand that if this statement is found to be false, it will be regarded as misconduct and will be subject to disciplinary action as outlined in the TAFE Queensland Student Rules. I understand that by emailing or submitting this assessment electronically, I agree to this Declaration in lieu of a written signature.

Student Signature:

Date Submitted:

/ /

PRIVACY DISCLAIMER: TAFE Queensland is collecting your personal information for assessment purposes. The information will only be accessed by authorised employees of TAFE Queensland. Some of this information may be given to the Australian Skills Quality Authority (ASQA) or its successor and/or TAFE Queensland for audit and/or reporting purposes. Your information will not be given to any other person or agency unless you have given us written permission or we are required by law.

Section B — Instructions to Student

General Instructions

Read the case study scenarios on the following pages carefully before answering the questions. Answer all questions in the spaces provided (or in the Word document template uploaded to Connect). All parts of each question must be addressed. You may use dot points, short paragraphs, or tables where appropriate — unless a specific format is required in the question itself.

This is an open book assessment. You may refer to your learning materials, unit notes, and reputable nursing references while completing this task.
Responses must be in your own words. Do not copy and paste text directly from any resource, including textbooks, websites, or AI-generated tools. Direct copying will be treated as plagiarism under the TAFE Queensland Student Rules.
Where you draw on sources to support your answers, provide an APA 7th edition in-text citation. Include a reference list at the end of the document.
Recommended reference: Koutoukidis, G., Stainton, K., & Hughson, J. (2021). Tabbner’s Nursing Care: Theory and Practice (8th ed.). Elsevier.
Submission is via TAFE Queensland Connect (LMS). Username: 9-digit student number. Password resets: https://passwordreset.tafeqld.edu.au
If you are unable to submit by the due date, you must request an extension in writing via Connect at least 48 hours before the due date. Late submissions without an approved extension will receive an NS result.

What Do I Need to Do to Achieve a Satisfactory Result?

To achieve a satisfactory (S) result for this assessment, you must answer all questions correctly and to the standard described in the marking criteria. Where a response is assessed as not satisfactory (NS), your assessor will provide written feedback. You will have one (1) further attempt to resubmit those questions. A second NS result means the overall assessment is recorded as NS, and you must discuss next steps with your assessor.

Reasonable Adjustment

If you require a reasonable adjustment to this assessment due to a disability, health condition, or other circumstance, contact your assessor before the due date to discuss available options. Adjustments will be made in accordance with TAFE Queensland’s Reasonable Adjustment Policy.

Section C — Unit Overview and Performance Evidence

HLTENN036 Apply Communication Skills in Nursing Practice describes the performance outcomes, skills, and knowledge required to communicate effectively with people, families, carers, and other health professionals within health care settings. Communication in nursing practice encompasses both interpersonal skills used therapeutically in direct care and the use of information technology for documentation and referral.

To be assessed as competent in this unit, you must demonstrate evidence of the ability to:

Communicate effectively within the enrolled nurse scope of practice in a minimum of three (3) different clinical situations: at least one involving a person, family, or carer; at least one involving work colleagues.
Apply therapeutic communication strategies appropriate to the age, culture, literacy, language, cognitive ability, and emotional state of the person.
Use communication frameworks including SBAR/ISBAR, open disclosure principles, and the Communication for Safety Standard (NSQHS Standard 6).
Demonstrate professional, person-centred communication in written documentation and electronic health records.
Identify barriers to communication and apply strategies to overcome them in clinical contexts.
Maintain confidentiality and privacy when communicating patient information.

Section D — Case Study Scenarios

Read the following case study carefully. Answer all questions in Section E that relate to this scenario. Where additional case information is provided for specific questions, it will be labelled clearly.

CASE STUDY — Mrs. Amara Diallo

Communication Challenges in Acute and Aged Care Settings

Patient Profile

Mrs. Amara Diallo (she/her) is a 72-year-old West African woman who migrated to Australia 15 years ago. She has been admitted to the acute medical ward at Sunridge Hospital following a fall at home in which she sustained a fractured right neck of femur (NOF). She has been scheduled for a right total hip replacement (THR) the following morning. Amara speaks French and her local West African dialect (Wolof) as her primary languages, and has a limited but functional level of conversational English, particularly under stress. She becomes visibly anxious when she cannot understand what is being said to her.

Social and Family Background

Lives alone in a ground-floor unit; her adult daughter Fatoumata (45 years) is her primary carer and lives 20 minutes away.
Fatoumata accompanied her mother to hospital and is present on the ward. She speaks fluent English and acts as an informal interpreter.
Diallo is Muslim. She observes daily prayers and values modesty, requesting that female nurses and doctors attend to her personal care where possible.
She has no history of prior hospitalisation in Australia.

Medical History and Admission Data

Past Medical History	Vital Signs on Admission	Sign	Result
Type 2 Diabetes Mellitus	BP	Blood Pressure	142/88 mmHg
Hypertension (well controlled)	HR	Heart Rate	92 bpm (regular)
Osteoporosis	RR	Respiratory Rate	18 breaths/min
Mild cognitive impairment (MCI, diagnosed 2022)	SpO2	Oxygen Saturation	97% (room air)
Mild anxiety and low-grade depression (managed with Sertraline 50 mg)	Temp	Temperature	37.1°C
Hearing aid — right ear	BGL	Blood Glucose Level	9.1 mmol/L
Reading glasses (present at bedside)	Pain Score	Pain (NRS)	8/10 (right hip)

Current Doctor’s Orders

Bed rest (BR) — mobilise with physiotherapy assistance only
Nil by mouth (NBM) from midnight pre-operatively
IV morphine PCA (patient-controlled analgesia) post-operatively
Regular BGL monitoring (QID)
Anti-embolism stockings (TED) applied
Interpreter services to be arranged via the hospital Language Services team (Wolof and/or French interpreters)
Consent for surgery to be obtained — consent form to be explained with interpreter present
Physiotherapy and occupational therapy referrals placed

Scenario Addition — Nursing Incident

Incident Note (for Questions 7 and 8 only):

During the night shift, Mrs. Diallo called for assistance at 0230 hrs. The attending nurse, who was busy with another patient, did not attend for 18 minutes. When the nurse arrived, she found that Mrs. Diallo had attempted to get out of bed unassisted and had pulled her IV line. Mrs. Diallo was distressed and confused. Her daughter was not present. The nurse did not document the incident until her end-of-shift report, nearly 6 hours later.

Section E — Assessment Questions

Answer all eight (8) questions below. Use the spaces provided (or the submitted Word document). All answers must be in your own words. Where you draw on external sources, provide APA 7th edition in-text citations.

Question 1 — Barriers to Communication (approx. 150–200 words)

Referring to Mrs. Diallo’s admission profile, identify four (4) specific barriers to effective therapeutic communication that the nursing team may encounter when caring for her. For each barrier, briefly explain why it presents a challenge in this clinical context.

#	Barrier	Why It Is a Challenge in Mrs. Diallo’s Context
1.
2.
3.
4.

Question 2 — Therapeutic Communication Strategies (approx. 150–200 words)

Describe four (4) therapeutic communication strategies you would use when conducting an initial nursing assessment of Mrs. Diallo. In your response, relate each strategy directly to Mrs. Diallo’s specific needs and circumstances. Include reference to any communication aids, professional resources, or frameworks that would support your approach.

Answer:

Question 3 — Cultural Safety and Inclusive Communication (approx. 150 words)

Mrs. Diallo has expressed a preference for female nurses and doctors to attend to her personal care. In addition, she is Muslim and observes daily prayers.

Explain what the enrolled nurse’s responsibilities are when a patient expresses religious or cultural preferences related to their care.
Identify two (2) practical actions you would take during this shift to accommodate Mrs. Diallo’s cultural and religious needs, and explain how you would communicate these to the broader nursing team.

Answer:

Question 4 — Using Interpreters in Clinical Settings (approx. 150–200 words)

The medical team needs to explain the upcoming total hip replacement surgery to Mrs. Diallo and obtain informed consent. Fatoumata (Mrs. Diallo’s daughter) volunteers to interpret for her mother.

Identify two (2) risks associated with using a family member as an informal interpreter in a clinical consent discussion.

Describe the correct process you would follow to access a professional accredited interpreter for Mrs. Diallo at Sunridge Hospital. Refer to relevant national or institutional guidelines.
Once the interpreter is present, identify three (3) strategies you would use to communicate effectively through an interpreter during the consent process.

Answer:

Question 5 — ISBAR Clinical Handover (approx. 200–250 words)

You are handing over care of Mrs. Diallo to the incoming registered nurse and enrolled nurse at the commencement of the next shift. Using the ISBAR framework, complete each section of the handover template below.

I — Identity	Introduce yourself, your role, and identify the patient (name, DOB, UR number, bed)
S — Situation	Current clinical status, reason for admission, immediate concerns
B — Background	Relevant medical history, co-morbidities, medications, cultural needs, communication requirements
A — Assessment	Your clinical assessment, current vital signs, pain level, concerns
R — Recommendation	What actions are required, what needs to be monitored, who needs to be contacted

Question 6 — Communication with Cognitively Impaired Patients (approx. 150 words)

Mrs. Diallo has a documented history of mild cognitive impairment (MCI). Following her surgery, she is in the post-anaesthetic care unit (PACU) and appears confused and disoriented.

List three (3) communication strategies specific to caring for a person with cognitive impairment in an acute post-operative setting.

Describe how you would assess Mrs. Diallo’s level of orientation and document your findings in accordance with TAFE Queensland’s documentation standards.

Answer:

Question 7 — Open Disclosure and Incident Reporting (approx. 150–200 words)

Refer to the Nursing Incident described at the end of the case study (Section D).

Define ‘open disclosure’ as described in the Australian Open Disclosure Framework (Australian Commission on Safety and Quality in Health Care).

Describe what the responsible nurse should have done differently in relation to documentation and incident reporting following this event.
How would you communicate this incident to Mrs. Diallo and her daughter in a manner that is consistent with open disclosure principles and respectful of the patient’s cultural background?

Answer:

Question 8 — Communication with Colleagues: Delegation and Feedback (approx. 150 words)

Towards the end of your shift, you observe that a less experienced nursing student has been speaking to Mrs. Diallo without first ensuring the interpreter was present. Mrs. Diallo appeared confused and distressed during the interaction.

Describe how you would communicate your concerns to the student in a professional, constructive manner. What key principles of feedback would you apply?

Using the NMBA Enrolled Nurse Standards for Practice (2016), identify one (1) standard that is directly relevant to this situation and explain how it applies.

Answer:

Section F — Assessment Marking Criteria

All questions are assessed on a Satisfactory (S) or Not Satisfactory (NS) basis. To achieve an S result for each question, your response must address all components listed in the criteria below. Your assessor will provide written feedback on any NS responses.

Q	Focus	To Achieve Satisfactory (S) — Student Must:
1	Communication Barriers	Identify four distinct and clinically relevant barriers specific to Mrs. Diallo’s presentation (e.g., language/interpreter, hearing impairment, cognitive impairment, anxiety, cultural). Correctly explain the clinical relevance of each in her context.
2	Therapeutic Strategies	Describe four evidence-based therapeutic strategies contextualised to Mrs. Diallo. Reference appropriate frameworks, tools, or professional resources (e.g., interpreter services, health literacy tools, NSQHS Standard 6).
3	Cultural Safety	Correctly identify EN responsibilities regarding cultural and religious preferences. Describe two practical, patient-centred actions and explain how they would be communicated to the team.
4	Interpreter Use	Identify two risks of using informal family interpreters. Correctly describe the hospital interpreter access process. List three evidence-based strategies for communicating through an accredited interpreter.
5	ISBAR Handover	Complete all five ISBAR sections accurately and in clinically appropriate language. Include relevant observations, cultural considerations, communication requirements, and upcoming procedures.
6	Cognitive Impairment	List three appropriate communication strategies for MCI in an acute post-operative setting. Correctly describe orientation assessment and documentation in accordance with TAFE Queensland/facility standards.
7	Open Disclosure	Accurately define open disclosure referencing the Australian Open Disclosure Framework. Identify specific documentation/reporting failures. Describe a culturally appropriate and respectful approach to disclosure with Mrs. Diallo and her family.
8	Colleague Communication	Describe a professional and constructive approach to feedback using recognised principles (e.g., PACE or DESC model). Correctly identify and explain a relevant NMBA EN Standard for Practice.

Section G —

Note: The following passage is provided to support student understanding of key concepts tested in this assessment. It is not a model answer and must not be reproduced in your submission.

Effective therapeutic communication is a core clinical competency for enrolled nurses practising under the HLTENN036 unit within the HLT54121 Diploma of Nursing. When caring for patients such as Mrs. Amara Diallo, who present with language barriers, cultural considerations, and cognitive impairment, nurses must move well beyond routine task completion and engage in deliberate, person-centred communication. The use of accredited professional interpreters — rather than relying on family members — is mandated in consent discussions under the Australian Open Disclosure Framework and the National Safety and Quality Health Service (NSQHS) Standards, particularly Standard 6: Communicating for Safety (Australian Commission on Safety and Quality in Health Care, 2021, https://www.safetyandquality.gov.au/standards/nsqhs-standards/communicating-safety-standard). Families, however well-intentioned, may unintentionally filter or soften clinical information, which directly undermines the patient’s right to informed consent. Cultural safety in nursing practice requires more than awareness; it demands concrete action, including the documentation and communication of a patient’s cultural and religious preferences to all members of the care team. For patients with mild cognitive impairment presenting acutely post-operatively, nurses should speak slowly and clearly, use simple sentences, repeat key information, and offer written or pictorial aids where appropriate, consistent with current dementia and delirium communication guidelines from Dementia Australia. Structured handover frameworks such as ISBAR reduce the risk of critical information loss, and this is especially important when communicating across shifts about patients with complex communication needs, co-morbidities, and upcoming surgical procedures.

Section H References (APA 7th Edition)

Australian Commission on Safety and Quality in Health Care. (2021). Standard 6: Communicating for safety. ACSQHC. https://www.safetyandquality.gov.au/standards/nsqhs-standards/communicating-safety-standard

Australian Commission on Safety and Quality in Health Care. (2023). Australian open disclosure framework. ACSQHC. https://www.safetyandquality.gov.au/publications-and-resources/resource-library/australian-open-disclosure-framework

Koutoukidis, G., Stainton, K., & Hughson, J. (2021). Tabbner’s nursing care: Theory and practice (8th ed.). Elsevier.

Nursing and Midwifery Board of Australia. (2016). Enrolled nurse standards for practice. NMBA. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/enrolled-nurse-standards-for-practice.aspx

Pun, J. K. H., Matthiessen, C. M. I. M., Murray, K. A., & Slade, D. (2018). Factors affecting communication in emergency departments: Doctors and nurses’ perceptions of communication in a trilingual ED in Hong Kong. International Journal of Emergency Medicine, 11(1), 1–13. https://doi.org/10.1186/s12245-018-0165-5

Tuqiri, K. A., Hains, I., & Millard, L. (2020). Improving non-English speaking patients’ experience in healthcare: Challenges and strategies. BMC Health Services Research, 20, 1–9. https://doi.org/10.1186/s12913-020-05718-6