NRS82005 Transformative Clinical Practices

Weighting: 50% of overall grade

Length: 1500 words

Individual Assignment

Due: 11^th July, 2020 by 1700hrs

For this assignment, you will utilize the Clinical Reasoning Process (Levett-Jones, T, 2013) to think critically about an episode of clinical patient deterioration that you have encountered whilst on clinical placement. You will then write a report demonstrating a systematic approach to clinical problem solving.

Once you have chosen a case study you will need to follow the Clinical Reasoning Process and:

1. Consider the patient
2. Collect cues
3. Process the information
4. Understand the patient’s problem or situation
5. Plan and Implement interventions
6. Evaluate outcomes
7. Reflect and learn from the process.

This assignment will enable students to:

• Develop critical thinking skills by using a systematic approach to clinical problem solving.
• Understand how evidence in the literature can inform and underpin nursing practice
• Further develop and utilise skills in literature searching, academic writing, critical analysis, evaluation and referencing.

TASK: Case Study Report

PART 1: Collecting the Clues

Choose a patient that you observed to have a “clinical deterioration” whilst on placement. It can be whilst on your Acute or Aged Care placement. Be wise in your choice of patient and do not choose a complex event as it will require complex discussion. Your discussion will be given in 3^rd person using academic writing. Therefore you will not use “I” or “we” to discuss the case study.

1. Introduction: (100 words) You will provide a brief introduction explaining the content of this report. The sensitive information of the patient must remain confidential, e.g. name, DOB and MRN and does not need to be discussed in the assignment.

2. Consider the patient: (150 words ) In this stage of the Clinical Reasoning Cycle you will discuss your initial impression:
   • Describe or list facts about the patients reason for admission, including:
     1. Reason for Admission
     2. Patient History

• Social History

3. Collect Cues: (150 words) This will include collecting relevant information about the patient and summarising the clinical situation. This information may be sought from: Documented history, clinical documentation, medical and nursing notes, handover report or other available information.
   • Discuss the events that led to this clinical deterioration:
     1. Patient status at the commencement of shift
     2. Handover report from the previous shift

• Observations of the patient at the time of deterioration

4. Process the information: (150 words) This will require you to carefully analyse changes from normal, recognise patterns and develop a hypothesis about the situation.
   • Discuss changes that you have observed:
     1. Changes in patient behaviour: Physically or mentally
     2. Changes in observations

5. Understand the patient’s problem: (150 words) This will require you to synthesize the information to identify the most important problem for this patient and support with evidence.
   • From your analysis, discuss the most important issue in the clinical deterioration.
   • This MUST be supported by evidence from the literature therefore in-text referencing will be evident in the discussion.

PART 2: Planning Care and Evaluating Outcomes

6. Plan and implement interventions:  (300 words) The student will need to prioritise goals of care depending on the urgency.
   • Interventions must demonstrate patient-centred care and MUST be supported by evidence from the literature therefore in-text referencing will be evident in the discussion.
   • These goals can be related to Australian Nursing standards.
   • You must decide who is best placed to undertake the interventions, who should be notified and when.
7. Evaluate outcomes: (150 words) You must re-evaluate the situation once the patient has been stabilised.
   • Discuss how have the observations changed and whether the patient’s condition has improved.
   • Observe the patients current status in order to determine how effective the nursing interventions have been.
8. Reflect and learn from the process: (200 words) You must critically reflect on the situation to learn from the event.
   • Explore your understanding of what you did or the team did
   • Explore the impact that this event had on you.
   • Discuss your communication strategies and how effective they were.
   • This can be written in 1^st person, e.g. “I felt that…”

PART 3: Quality of Written Expression and Conclusion

9. Conclusion: (100 words) Conclude the assignment by summarising the content of the assignment and the most important lessons learned in the process of clinical reasoning.

PART 4: Reference List

Your assignment will also have a reference list at the end. Ensure all references that appear in the Case Study assignment are listed in your reference list.

• The Case Study must include at least 5 reputable references to support your statements.
• The articles will be no more than 10 years old.
• Use APA 6th reference style.
• Ensure the reference list is on a new page and they are listed in alphabetical order
• The full APA 6th edition bibliographic details for each article and all headings are excluded from the total word count.
• In-text referencing will be required for the section called “Relevance to Australian Nursing Standards” when making direct links to any of the NMBA codes, studies and guidelines.
• For access to the online APA 6th style of referencing guide use this link: http://libguides.scu.edu.au/content.php?pid=161580

Submitting your Assignment:

• Formatting your Work:
  • Your assignment must be submitted via Turnitin from the link on the Blackboard learning site. No assignment will be accepted via email attachment.
  • It must consist of 1500 words. Excessive words will not be marked. A leeway of +/-10% total words will be acceptable.
  • You will need to use these Headings for each article’s annotation
  • Attach a Coversheet to the beginning of your assignment. This coversheet will be available from the blackboard learning site in the section called “Assessment Details.” Do not submit the coversheet as a separate document from your assignment.
  • Your assignments must be submitted as either Word documents (with .doc extension, or .docx). PDF / Note pad assignments will not be accepted. No handwritten assignments will be accepted.
  • Include either a Header or Footer with your name, student ID number and the page number
  • Use size 12 Calibri font throughout the assignment
  • Use either 1.5 line spacing or Double spacing.
• Special Consideration:
• All assignment extension requests must be initiated by the Special Consideration process. Late assignments without an approved extension from the Unit Assessor will receive a penalty of -10% per day including weekends & holidays.
• To locate the Special Consideration application forms: http://scu.edu.au/students/index.php/dds “Application to Vary Assessment Due Date or Consideration in Marking” (PDF). Students must carefully review the grounds for applying for a Special Consideration.