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.
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|
|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|
|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|
|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|
|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|
|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|
|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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