title: The consultative process used in outreach: a narrative account.
abstract: OBJECTIVE
  The aim of this paper was to provide a narrative account of the communication skills used in an effective outreach consultation utilizing Neighbour's consultative model. Other consultation models were considered; however, because of their overly comprehensive approach or emphasis on behaviour modification, these were deemed inappropriate.
  
  
  BACKGROUND
  The nursing profession has endured significant changes of late and as a result is developing more autonomous roles in both the community and the acute health care settings. In the past, the term consultancy was used within the medical context; nowadays, there are advance nurse practitioners for whom consultancy is an integral part of their role. Although every nursing interaction is in essence a consultation, the fact that nurses are taking up on new advanced roles highlights the necessity for nurses to develop their consultation skills even further. Therefore, it makes sense to explore what aspects of that consultancy role needs special consideration in order to ensure that positive outcomes are achieved.
  
  
  CONCLUSIONS
  This paper has used a narrative account to uncover those salient skills needed to enhance the therapeutic relationship with a patient requiring the services of outreach. Furthermore, the application of a recognized consultation model was used to elucidate the underpinning knowledge of systematic history taking and assessment as well as demonstrating the communication skills and strategies needed to increase the patient's participation and empowerment throughout the consultation.
  
  
  CONCLUSIONS
  Effective communication skills encompassed in a consultative model are integral to the success in safeguarding the well-being of patients requiring advanced levels of care. Prejudging or pre-empting information being conveyed can be detrimental to patient safety and may prolong or complicate treatment plans.
authors.affiliation: School of Health and Social Care, Bournemouth University, Bournemouth BH1 3LT, UK. mchristensen@bournemouth.ac.uk
authors.forename: Martin
authors.initials: M
authors.lastname: Christensen
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003142:Communication; D003159:Community-Institutional Relations; D003266:Continuity of Patient Care; D003422:Critical Care / Q000458:organization & administration / Q000523:psychology; D005181:Faculty, Nursing / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D016294:Models, Nursing; D033262:Narration; D024802:Nurse's Role / Q000523:psychology*; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010347:Patient Care Planning; D010351:Patient Discharge; D017009:Professional Autonomy; D012017:Referral and Consultation / Q000458:organization & administration*