Evidence-based practice case study

Evidence-based practice case study

NSB132

ASSESSMENT TASK 2

Assessment name:Evidence-based practice case study
Task description:This assessment requires you to choose one (1) priority problem. Then use the two (2) case studies to apply your knowledge of evidence-based nursing practice and the clinical reasoning cycle to demonstrate your understanding of how to plan and evaluate person centered care for each person.
What you need to do:Step One Select one (1) priority problem from this list: Potential for impaired safety: increased falls riskPotential for impaired skin integrityImpaired hydration   Step Two Thoroughly read and compare the two (2) case studies (see the end of the task description).   Step Three Use the following headings (tasks i-iv) and address points in relation to your chosen problem and the two (2) case studies. Support your responses using peer reviewed, current and relevant literature   Interpretation of Assessment Data Explain what pathophysiological changes have occurred for the two cases to experience the chosen problem. Identify and discuss the similarities and differences between the presenting assessment data related to the chosen problem for each case. In you discussion you must demonstrate your understanding of age and developmental based differences between the cases and the presentation of assessment data relevant to the chosen problem.   Development of Goal for Care using SMART Framework From the position of your chosen problem, use the SMART framework to write a goal for care for each case (i.e. there will be two goals). The goal for care should consider the uniqueness of each case. The SMART framework headings MUST be used to present your goal. Supporting evidence is NOT required for task (ii).   Evidence-Based and Person-Centred Interventions to Address the Goal for Care: Choose two (2) evidence-based interventions (at least one must be nurse initiated) to address the goal of care.
 Justify your choice of intervention and discuss how the two (2) interventions need to be modified to meet the unique needs of the cases based on their age and developmental differences.   Note: The same two interventions will be recommended for both cases, but you need to discuss how these would be modified to suit the needs of the individual.   iv.      Evaluation of the Efficacy of Interventions: Discuss how a nurse would evaluate the efficacy of the two interventions and the similarities and differences in the approach to evaluating the cases based on their age and developmental differences. For each case identify the expected positive changes in assessment data indicating the intervention was effective.   This is an individual assessment
Length:1500 words +/-10% (word length includes in-text referencing and excludes your reference list)
Estimated time to complete task:Approximately 25-30 hours
Weighting:50%
How will I be assessed:+/- 7 point grading scale using a rubric
    Due date:This assignment is to be submitted Friday 23rd September 2022 (week 9) by 11:59pm. Assessments are to be submitted via Turnitin in your NSB132 Blackboard site. More information about Turnitin is available on the FAQs about Turnitin page.
Presentation requirements:There are four (4) parts to this assessment. Headings can be used to structure your responses. Your assignment must be written in CiteWrite APA 7 style and prepared as follows: Make your own cover sheet with the assessment title, your name, student number, tutor name and word count (excluding reference list).Include a ‘footer’ on each page with your name, student number, unit code and page number.2 cm margins on all sides, double-spaced textUse font, such as Times New Roman, Arial or Calibri; font size 12CiteWrite APA 7 style referencing. Note it is a requirement that you include page numbers for all in-text references (see http://www.citewrite.qut.edu.au/) Conventions of academic writing with a comprehensive response to each task is required. Formal essay style with an
 introduction and conclusion is not necessary but each response needs to follow conventions of English grammar i.e. the response to each task must use correct and logical paragraph structure that supports the development of your discussion. Use of appendices, figures or tables, and dot points are NOT acceptable Be submitted in electronic format via Turnitin.
What you need to submit:One-word document that contains: Assignment Cover SheetYour response to the task.A reference list using APA 7th reference guidelines   If you have an approved extension, a screen shot or copy of the approval certificate must be included at the front of your assessment.

Case Study 1

Introduction: Sam is a three-year-old boy admitted to the Children’s Hospital emergency department (ED).

Situation: Sam was brought to the ED by his mother because he has been vomiting and had diarrhoea for 2 days and he has become increasingly irritable today.

Background: Sam is usually a well and active three-year-old who attends day care where there has been an outbreak of norovirus. Sam started vomiting two days ago and has had diarrhea.

Assessment:

Weight: 15kg

Medical History: Nil significant; Nil allergies; up to date with all current vaccinations Current medications: 225mg Paracetamol oral given on admission (1 hour ago) Nutrition & Elimination: Nil orally since arriving at ED and decreased intake for past two days. Complains of feeling thirsty but take small sips of water only – estimate 150mls in 24 hours. Mother reports Sam last vomited 8 hours ago and had a large BO Type 7 while in the ED and soiled himself. Usually is toilet trained and does not have any special nutrition or hydration considerations.

Vital signs: Temperature 37.9 degree Celsius; Blood pressure 95/54; Pulse rate 124, Respiratory rate 32, SPO2 100% on room air.

Oral mucous membranes are dry, skin turgor less than 2 seconds, last voided 6 hours ago and no palpable bladder. Extremities are cool to touch.

Neurological: V; cries and is irritable when woken, sitting on mother’s lap or in cot. Pain: 5/10 (FLACC scale), occasional grimace and cries when awake and difficult to console; states ‘my tummy hurts’.

Recommendations: Sam will be observed for the next 8-hours in hospital where you need to conduct the appropriate assessments and provide care. His doctors have stated that intravenous fluid therapy (IVT) is not necessary at present.

Case study 2

Introduction: Sandra is an 83-year-old woman admitted to the Emergency Department (ED)

Situation: Sandra was brought to the ED by her daughter because she has been vomiting and has had diarrhea for two days and she has become increasingly drowsy and disorientated today.

Background: Sandra lives alone and is usually able to manage independently with occasional assistance from her daughter who lives in the next suburb. Her daughter’s children had norovirus 4 days ago and Sandra started vomiting and having diarrhea 2 days ago.

Assessment:

Weight: 70kg

Medical History: Nil significant, Nil allergies; up to date with all current vaccinations Current medications: 1G Paracetamol oral given on admission (1 hour ago) Nutrition & Elimination: Nil orally since arriving at ED and reduced intake for 2 days. Taking sips of water only – estimate 300mls in 24 hours. Last vomited 6 hours ago and had a large BO Type 7 while in the ED and was incontinent. Is usually continent for urine and faeces and does not have any special nutrition or hydration considerations.

Vital signs: Temperature 37.3 degree Celsius; Blood pressure 105/80 (lying); 95/54 (standing); Pulse rate 98, Respiratory rate 18, SPO2 99% on room air.

Oral mucous membranes are dry, skin turgor greater than 2 seconds, last voided 6 hours ago and no palpable bladder. Extremities are cool to touch.

Neurological: V; GCS – 14; 4AT – 8 – drowsy and disorientated to time.

Pain: 7/10 (Abbey pain scale); states she has abdominal cramps. Recommendations: Sandra will be observed for the next 8-hours in hospital where you need to conduct the appropriate assessments and provide care. Her doctors have stated that intravenous fluid therapy (IVT) is not necessary at present.

NSB132 ASSESSMENT TASK 2 RUBRIC

Learning Outcomes Assessed:1, 2, & 3Weighting:50%
Criteria+/- 7+/- 6+/- 5+/- 4+/- 3+/- 2 – 1
Interpretation of Assessment Data 25%You present an insightful analysis of the case studies and have drawn accurate conclusions. You fully apply the priority health problem to the cases and use evaluation of the underlying pathophysiology to guide your comparison. All similarities and differences are identified and explained. You have applied a wide range of peer reviewed, current and highly relevant evidence to build a convincing argument.You present an analysis of the case studies and have drawn accurate conclusions. You apply the priority health problem to the cases and use evaluation of the underlying pathophysiology to guide your comparison Nearly all similarities and differences are identified and explained. You have applied a range of peer reviewed, current and relevant evidence to build a convincing argument.You present an analysis of the case studies and have drawn mainly accurate conclusions. You make some links to the priority health problem with the cases and use evaluation of the underlying pathophysiology to guide your comparison. Most similarities and differences are identified and an attempt to explain these has been made. You have applied peer reviewed, current and relevant evidence to build an argument. Some points needed further developmentYou present a summary of assessment data and have drawn mainly accurate conclusions. You make some links to the priority health problem with the cases and use evaluation of the underlying pathophysiology to guide your comparison. Some omission of key points. Most similarities and differences are described with limited explanation. Most points are supported by peer reviewed, current and relevant evidence although mainly descriptive. Some points needed further developmentYou present a description rather than analysis of the case studies. Some understanding of pathophysiology present but may not be the most relevant to the case/s. Little supporting evidenceYou present a description rather than analysis of the case studies. Little understanding of pathophysiology present but may not be the most relevant to the case/s. No supporting evidence
Development of Goal for Care using SMART Framework 10%You present a well- thought out and logical goal that is relevant to the chosen problem and meet the unique needs of the cases. The SMART framework has been used effectively.You present a logical goal that is relevant to the chosen problem and meet the needs of the cases. The SMART framework has been used effectively.You present a clear goal that is mainly relevant to the chosen problem and meet most of the needs of the cases. The SMART framework has been used. Minor points missedYou present a goal that addresses most aspects of the chosen problem and has some relevance to the cases. The SMART framework has been used. Some important points missed.Your goal has limited application to the chosen problem and/or relevance to the cases. Limited use of the SMART framework has been used. Many points missed.Goal for care not attempted or not related to the cases. The SMART framework not used.
Criteria+/- 7+/- 6+/- 5+/- 4+/- 3+/- 2 – 1
Evidence-Based and Person Centred Interventions to Address the Goal for Care 25%Your plan contains two highly appropriate interventions that are evidence-based and informed by best practice. Choices of interventions are justified using peer reviewed, current and highly relevant evidence. At least one of these is nurse initiated.Your plan contains two appropriate interventions that are evidence-based and informed by best practice. Choices of interventions are justified using peer reviewed, current and relevant evidence. At least one of these is nurse initiated.Your plan contains two interventions that have supporting evidence and have some relevance to best practice. Choices of interventions are justified using mainly peer reviewed, current and highly relevant evidence. At least one of these is nurse initiated.Your plan contains two interventions that are safe in approach with some link to best practice. An attempt to justify the choice of intervention has been made although limited peer reviewed, current and relevant evidence used. At least one of these is nurse initiated.Your plan contains one or two interventions; at least one of these may be unsafe in their approach or not relevant. Choice of interventions had limited supporting evidence or evidence not peer reviewed, current and/or relevant. May or may not be nurse initiated.Your plan did not contain interventions. If present intervention/s may be unsafe in their approach or not appropriate.
Evaluation of the Efficacy of Interventions 25%You provide a clear and accurate evaluation strategy to assess the effectiveness of your proposed care plan/s. All evaluation data are discussed, and expected outcomes clearly and correctly identified with consideration of age and developmental differences The evaluation strategy is heavily linked to research and discussion.You provide an evaluation strategy that is accurate and will assess the proposed care plan/s. Nearly all evaluation data are discussed, and expected outcomes correctly identified with consideration of age and developmental differences The evaluation strategy is strongly linked to research and discussion.You provide an evaluation strategy that is mainly accurate and will assess the proposed care plan/s. Most evaluation data are discussed, and expected outcomes identified with consideration of some age and developmental differences The evaluation strategy makes some links to research and discussion.You propose an evaluation strategy. Some elements may not adequately assess the effectiveness of your proposed care plan/s and or there are minor inaccuracies. Some evaluation data are discussed, and mostly correct outcomes and age and developmental differences described Some basic links drawn between research and discussion.You propose an evaluation strategy that would not adequately assess your proposed care plan/s. Little evaluation data and expected outcomes identified with minimal consideration of age and developmental differences Little to no links drawn between research and discussion.You do not propose an evaluation strategy to assess your care plan/s.
Communication & Academic Integrity 15%Logically and succinctly responded to each task. Makes no significant grammatical, spelling or communication errors. Full adherence to task requirements including word limit (+/-10%). QUT APA guidelines are followed without error.Logical structure in the response to the task Few grammatical, spelling or communication errors. Adherence to task requirements including word limit (+/-10%). QUT APA guidelines are followed with minor errors when applying convention.Mainly logical structure in the response to the task. Minor grammatical, spelling or communication errors. Consistent adherence to task requirements including word limit (+/-10%). QUT APA guidelines are followed with minor errors when applying convention.Used some structure to provide some clarity to your response. Some problems with spelling, grammar, expression that do not detract from meaning. You have complied with many task requirements, including word limit (+/- 10%). QUT APA guidelines are followed. Some errors when applying convention.Some structure present but meaning is often unclear. Spelling, grammar, expression are below an acceptable standard for an academic essay. Lacks adherence to task requirements, including word limit (+/-10%). Referencing is not compliant with QUT APA guidelines.Lack of structure present Poor spelling, grammar, and expression that make meaning unclear. Little to no adherence to task requirements, including word limit (+/-10%). Referencing is not compliant with QUT APA guidelines.

Satisfactorily complied with the Academic Integrity standards outlined in the MOPP C/5.3 Academic Integrity.

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