Written Case Study Report

Application of health assessment, planning, implementation and evaluation of professional nursing care to a clinical deterioration patient scenario

Due date:         As specified by the Course Coordinator

Weighting:       Students must achieve a Pass grade (50%) for the Supplementary Assessment to achieve a Pass grade overall for the course.

Purpose:          This supplementary assessment task is designed to enable the student to meet the learning outcomes for the course by integrating theory into practical knowledge using a patient case scenario.

Word Count:    1500 words (+/- 10%)

Format:           The layout is a question and answer style; an introduction or conclusion is NOT necessary. However, should include logically structured discussion sections. May use diagrams in their answers where appropriate. You are strongly encouraged to use headings to assist in the flow of your writing, but they must conform to APA guidelines. The preferred layout of your paper should be double spaced with block paragraphing (no indenting). Do not indent the first line of each paragraph. Page numbers are to be included on the bottom left corner of the page.

Presentation: All work should be typed in 12-point font, double spaced; and written and presented according to the academic guidelines using APA (7th Edition) referencing. For further assistance in relation to academic writing and referencing, refer to the Federation University library home page. The length of the essay is 1500 words (+/- 10%). Any task that is under or over the allocated limits by 10% will attract a deduction from the final mark for the task.

References:     A minimum of 15 references must be used for the report. These should be no more than 7 years old unless of historical significance and/or of specific relevance to the topic (for example; the Ottawa Charter from 1986). These references must be a mixture of books and journals or Library database sources. Dictionaries or Wikipedia are not considered a primary reference and therefore will not be counted in the reference count. Direct quotes, appendices or the reference list, are not counted in the word limit. Direct quotes must be limited to no more than 50 words and be according to APA 7th Edition style. Please ensure that you adhere to the specific guidelines set out by the APA 7th Edition guidelines available within the general guide to referencing:

Submission:    All submission for the Supplementary Assessment are to be submitted before or on the due date and stipulated time and submitted electronically via Turnitin. Please ensure the first page of your submitted work includes the assessment title, due date, relevant academic, student name AND student ID number. When submitting online, please ensure that the file name includes the Course Code, Surname and Student ID number. For example: NURBN3030Smith30109999. Ensure there are no spaces or use of punctuation (!?/;_-).

Marks may be deducted if the file name does not conform to these instructions (presentation guidelines).

Turnitin:          Turnitin software will be used in this course and all essays submitted for marking must be submitted through the Turnitin software. For assistance with the use of Turnitin please see the section Assistance with Online Submission provided in this document. Students are required to submit their Essay as a Microsoft Word file (.doc/.docx) via the corresponding assessment task Turnitin dropbox within the Assessment Module of Moodle. Please note that your Essay will be graded within Turnitin using GradeMark and therefore you are no longer required to submit your work via the submission link in Moodle. The GradeMark® digital mark-up tool allows instructors to mark and grade papers online in a paperless environment. Instructors can create custom sets of comments and marks for grading as well as use rubric scorecards that feature quick scoring of student papers against a list of scaled criteria created by the instructor or educational institution. For instructions about using Turnitin, please go to the following link:

Please Note: If Turnitin prevents the electronic submission of your assignment (e.g. if either service is defective or unavailable) you should contact the ICT Service Desk and attempt to resolve the problem. If the problem cannot be resolved, you must email an electronic copy of your final assignment directly to the Course Coordinator before the due date. The Course Coordinator or the assessor of the assignment may then elect to submit the assignment to Turnitin on your behalf. Please note you will need to indicate in a covering email with the assignment submission, the date, time and circumstances of the reason that you could not submit your assignment to Turnitin. Please note that you should always attempt to complete and submit your assignment as early as possible to avoid any potential problems. Please note that written work not submitted to Turnitin will not be marked, and therefore result in a zero grade.

Marking:          Marking of essays will be completed by relevant academics and feedback will be provided both via electronic track changes and on the marking guide (see final page of this document). The marking guide will demonstrate assessment standards for expected content as well as

structure, grammar and spelling. Referencing will also be assessed. Assessment grades will be provided to students via Moodle Turnitin. Marking is to be completed and grades allocated within approximately 2 weeks of submission as per university policy.

Final grade:     If the students passes the supplementary assessment (grade > 50/100), their overall grade will be amended to a Pass grade. Students who fail to submit the scheduled supplementary assessment or if the student fails the supplementary task (grade <50/100), the student will be amended to a grade of Marginal Fail (MF) and has failed the course overall.

Appeals:          In accordance with the Student Appeals Procedure, an appeal against a final grade must be submitted in writing and lodged within 10 working days of the publication of the final grade or result. Following due consideration (within 30 days) the student will be provided with a written response to the appeal, including reasons for the decision. The School must notify Student Administration of any amended results following an appeal. If the student is not satisfied with the decision, they can submit an appeal to the Appeals Committee in accordance with Regulation 2.2.

Description:

This assessment task allows students to demonstrate theoretical clinical knowledge around nursing assessment, pathophysiology of factors impacting on clinical deterioration, planning of nursing care, nursing and medical management, and evaluation of care. Students are required to answer the case scenario questions provided.

Students should attempt all questions in the case study:

…Sharon is a 66-year-old, admitted to the medical ward with a diagnosis of Right Pulmonary Embolism (PE). She has been commenced on Apixaban 10mg PO BD for 7 days to treat her PE.

• History of presenting complaint: increased right sided chest pain and increased shortness of breath for 1 week.
• Past Medical History: Previous Deep Vein Thrombosis (DVT) & hypertension

• Regular Medications: Micardis,

• Nil Known Allergies.

Sharon is resting in bed. You attend to her routine vital signs, which reveal the following:

• Conscious state – Alert

• Temperature: 36.3

• Pulse: 98 bpm and regular

• Blood Pressure: 110/62mmHg

• Respiration: 22 bpm

• SpO2: 91% on room air (Fi02 21%)

• Pain: 3/10

Question 3: Review Sharon’s vital signs above. Using your knowledge of reversible causes of patient deterioration (one of the 4H’s & 4T’s), discuss the following:

• Describe ONE reversible cause Sharon is experiencing and describe the pathophysiology that occurs which results in patient deterioration. (200 words)
  • Describe the impact of a pulmonary embolism on the Ventilation/Perfusion (VQ) Ratio and link to the above vital signs. (200 words)

Question 4: Discuss TWO PRIORITISED nursing assessments that would be prioritised for

Sharon’s present deterioration (excluding vital signs). For EACH nursing assessment, ensure your discussion includes a description of the assessments in the context of Sharon condition AND clear rationale as to why these assessments would be priority. (200 words)

Question 5: Discuss TWO PRIORITISED nursing interventions that YOU as a Registered Nurse could initiate to manage Sharon’s deterioration. For EACH intervention, ensure your discussion includes link to evidence-based practice AND provides rationale as to how it would improve the physiological outcomes of Sharon’s condition. (200 words)

*Nursing interventions would include nursing activities or actions that the nurse could initiate in response to nursing assessment findings. Note: please be aware of the difference between an assessment and an intervention.

Question 6: Describe TWO relevant nursing evaluations that you would complete in response to the interventions you have just described. For EACH evaluation, provide a brief rationale as to how these evaluations will assist in preventing the further clinical deterioration of Sharon. (100 words).

NURBN3030 SUPPLEMENTARY TASK- CLINICAL CASE STUDY RUBRIC
	0 MARKS	2 MARKS	4 MARKS	6 MARKS	8 MARKS	10 MARKS
Q1- Discussion of PE	Nil discussion provided.	Poor exploration of PE	Minimal exploration of PE	Moderate exploration of PE	Substantial exploration of PE	Excellent exploration of PE
		demonstrated	demonstrated	demonstrated	demonstrated	demonstrated with
		through limited	through weak	through weak	through links to	clear links to
		patient links in	patient links in	patient links and/or	patient, and	patient, and clear
		discussion	discussion and/or	unclear discussions.	concise discussions	and concise
		and/or no	limited support by	Further support by	supported by	discussions
		support by	evidence provided.	evidence required.	evidence.	supported by
		evidence				evidence.
		provided.
Q2- Use of Apixaban	Nil discussion provided.	Poor discussion the action of	Minimal discussion the action of	Moderate discussion the	Substantial discussion the	Excellent discussion the action of
		medication	medication linked	action of	action of	medication linked
		linked to patient.	to patient. Few	medication linked	medication linked	to patient. All
		Few indications,	indications, side	to patient. Most	to patient. Most	indications, side
		side effects and	effects and	indications, side	indications, side	effects and
		contraindications	contraindications	effects and	effects and	contraindications
		were discussed	were discussed but	contraindications	contraindications	were all discussed
		at length.	not at length.	were discussed but	were discussed at	at length.
				not at length.	reasonable length.
Q3- Reversible causes	Nil discussion provided.	Poor exploration or incorrect	Minimal exploration or	Moderate exploration of the	Substantial exploration of the	Excellent exploration of the
		pathophysiology	incorrect of the	relevant	relevant	relevant
		of deterioration	pathophysiology of	pathophysiology of	pathophysiology of	pathophysiology of
		demonstrated	deterioration	deterioration	deterioration	deterioration
		through limited	demonstrated	demonstrated	demonstrated	demonstrated well
		patient links in	through weak	through weak	through patient	through linked to
		discussion	patient links in	patient links and/or	links, with concise	patient, with clear
		and/or no	discussion and/or	unclear discussions.	discussions	and concise
		support by	limited support by	Further support by	supported by	discussions
		evidence	evidence provided.	evidence required.	evidence.	supported by
		provided.				evidence.
Q4- Nursing	No	Unclear	Unclear	Clear identification	Good	Excellent and
assessments	appropriate	identification of	identification of 2	of 1 appropriate	identification of 2	thoughtful
	nursing	1 inappropriate	inappropriate	nursing	mostly	identification of 2
	assessments	nursing	nursing	assessments of	appropriate	appropriate
	identified	assessments of	assessments of	patient	nursing	nursing
	related to	patient	patient	presentation.	assessments of	assessments of
	patient	presentation.	presentation.	Some rationale for	patient	patient
	presentation.	No clear	Poor or incorrect	priority.	presentation.	presentation.
	No rationale	rationale for	rationale for		Reasonably clear	Clearly and
	for priority	priority.	priority.		rationale for	correctly
	applied.				priority.	explained with
						rationale for
						priority.

Q5- Nursing Interventions	No appropriate nursing interventions identified related to patient presentation. No rationale applied.	Unclear identification of 1 inappropriate nursing interventions for patient presentation. No clear rationale.	Unclear identification of 2 inappropriate nursing interventions for Patient presentation. Poor or incorrect rationale	Clear identification of 1 appropriate nursing interventions for patient presentation. Some reasonable rationale presented	Good identification of 2 mostly appropriate nursing interventions for patient presentation. Reasonably clear rationale.	Excellent and thoughtful identification of 2 appropriate nursing interventions for patient presentation. Clear and correctly explained rationale for priority.
Q6- Nursing evaluations	No appropriate nursing evaluations identified related to patient presentation. No rationale applied.	Unclear identification of 1 inappropriate nursing evaluations for patient presentation. No clear rationale.	Unclear identification of 2 inappropriate nursing evaluations for Patient presentation. Poor or incorrect rationale.	Clear identification of 2 appropriate nursing evaluations for patient presentation. Some reasonable rationale presented.	Good identification of 2 mostly appropriate nursing evaluations for patient presentation. Reasonably clear rationale.	Excellent and thoughtful identification of 2 appropriate nursing evaluations for patient presentation. Clear and correctly explained rationale for priority.
Writing /Presentation	0 MARKS	1 MARK	2 MARKS	3 MARKS	4 MARKS	5 MARKS
Readability: Structure Elements	Structure displays no planning or structure, jumping from one topic to the next with no linking dialogue.	Structure lacks evidence of a sequenced plan. Minimal linking dialogue between topics of discussion.	Structure lacks evidence of a sequenced plan. More attention required to link topics of discussion.	Structure requires a more structured and sequenced plan, and/or has some elements missing.	Moderate structure that includes all elements and mostly follows a logical sequence and linking dialogue.	Excellent structure that includes all elements and follows a logical sequence with linking dialogue.
Readability: Professional Prose	Inconsistent levels of articulation and expression, numerous spelling, and grammatical errors and/or lack of sentence or paragraph structure	Poor level of articulation and expression, with considerable sentence or paragraph structure unclear, and/or numerous spelling or grammatical errors.	Minimal level of articulation and expression, with some sentence or paragraph structure unclear, and/or several spelling or grammatical errors.	Moderate level of articulation and expression, requiring sentence and paragraph structure to be more concise, and/or several spelling or grammatical errors.	Substantial level of articulation and expression, with clear and concise sentence and paragraph structure, and minimal spelling or grammatical errors.	Excellent level of articulation and expression, with clear and concise sentence and paragraph structure, and no spelling or grammatical errors.
Readability: Fluency	The arrangement of content is illogical.	Sentence and/or paragraph structure is often undefined, lack structure, or are too long or too short. The	Sentence and/or paragraph structure is sometimes undefined or lacks clarity through not providing introductory or	Moderate sentence and paragraph structure requiring more clarity with introductory and linking sentences.	Sentence and paragraph structure are mostly well-defined and clear with	Sentence and paragraph structure is well- defined and clear with introductory and linking dialogue. Key

		arrangement of content is haphazard and difficult to follow.	linking sentences. Some paragraphs are too long/short.	Some paragraphs are too long/short.	introductory and linking sentences.	definitions are addressed.
References: Minimum Number	No references provided.	Less than 15 minimum references used to support presentation material or offer direction for further information.	Minimum 15 references used to support presentation material or offer direction for further information.	More than 15 minimum references used to support presentation material and offer direction for further information.
References: Selection & Credibility	No references reputable, current, extensive, or credible, and/or the connection between the articles and the purpose is missing.	Many references are NOT reputable, current, extensive, or relevant, and/or the connection between the articles and the purpose is poorly demonstrated.	Some references are reputable, current, extensive, and relevant, and/or the connection between some of the articles and the purpose is unclear.	Most references are reputable, current, extensive, and relevant, and/or the connection between some of the articles and the purpose is developing.	All references are reputable, current, extensive, and relevant. All articles are relevant to the purpose.
References: APA style	Incorrect APA referencing style for in-text citations quotes and/or references.	Numerous errors noted in APA referencing of in- text citations, quotes, or references.	A couple of errors noted in APA referencing of in- text citations, quotes, or references.	All in-text citations, quotes and references are in APA style.
Academic Requirements: Presentation	Nil submission.	Paper does not conform to presentation requirements as set out in Assessment outline.	Significant number of areas of paper do not conform to requirements as set out in Assessment outline.	A few areas of paper do not conform to requirements as set out in Assessment outline.	Paper mostly conforms to presentation requirements as set out in Assessment outline.	Paper conforms to all presentation requirements as set out in Assessment outline.
Total marks	/90	Pass 50% = 45/90

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