Managing Complex Care: A Case Study of a Patient's Admission for a Right-Sided Subdural Hematoma

Essay Instructions:

Use the "build on case study" file for information needed information for writing the essay. I can also be contacted for any information. Thank you. ******The case study is an academic essay not a reflective piece of work and must be written in 3rd person supported by relevant references. The case study must be based on a nursing intervention related to the achievement of proficiency(s) during placement 1 by a student nurse under supervision of a registered healthcare professional. This may involve a single or group of individuals depending on the care environment. It should not cover the whole of the patient’s stay in hospital or be descriptive of care that you have provided over 1 shift. The case chosen must enable discussion of the skills that were employed by the student to demonstrate ability to take work independently managing patient care effectively which encompasses coordinating, delegation, decision making, prioritisation, supervision, collaborating and managing risk to maintain patient care. Throughout the case study the focus must remain on the patient/case and role played by the student nurse. Do not simply describe tasks rather discuss/debate/critique rationale behind your actions supported by references in line with evidence-based practice. Always maintain confidentiality. Proof-read your work and ensure that it is grammatically sound, and that citations and references are recorded correctly in line with APA format. ***** Introduction (approximately 200 words) The introduction must outline what proficiency the case study about. Who is involved? What elements of the learning outcome will you cover (e.g., ‘This essay will discuss/examine/consider…’). It then includes several sentences which describe the main ideas (elements of the learning outcomes) of the essay and the order in which they will appear (e.g., ‘First the essay will explore…. Then/Secondly it will…. Finally, /Lastly it will….’). State overall focus that it is a case study based on achievement of a specific proficiency(s) or that it concerns patients or clients for whom you have provided care. Include statement of maintenance of confidentiality (NMC, 2018) Do not identify the person: Use a ‘pseudonym’ e.g., Joe or Mary. State within your introduction that you are using a ‘pseudonym’ with this being supported by your citing the Nursing and Midwifery Council’s (NMC) The Code (NMC, 2018) in that you are respecting people’s right to privacy and confidentiality. Likewise, you must NOT identify your practice placement or any staff with whom you have been working. Set the scene. Patient details Set the scene/Patient details. 2nd paragraph- Outline your patient case including medical history (physical/ psychological), significant events, main issue, relevant anatomy and physiology or co-morbidities, social history. Condition succinct (1 paragraph should suffice)!!!! only include details that are relevant to the proficiency (s) and student nurse’s role. Body (approximately 700 words) The body of an essay consist of paragraphs that are organised into main ideas (please use provided essay planning template to develop your ideas). Paragraphs must discuss one main idea at a time. The idea must relate to the patient/case and the student nurse’s involvement in the aspect of care. When moving on to a new paragraph/main idea within the body of the essay, use signal phrases such as ‘first’, ‘secondly’, ‘next’ or ‘finally’, along with the key words of the next main idea. These topic sentences make it clear to the reader that the essay is moving from one idea to another. Throughout discussions do not just describe tasks aim to critique, analyse, or evaluate by considering relevant theory and related arguments. Ensure to make obvious how it all links with the case study and student’s role. In this way, you are integrating theory with practice and your case study will not just be descriptive. Areas for consideration within the body (this is not exhaustive): • Were any tools of assessment used or employed by the student nurse? (Reference them) to demonstrate ability to manage the patient condition? What is the relevant theory and related arguments? How was the assessment recorded? • What communication skills the student employed to engage patient/client, family/carer if involved, collaborate with multidisciplinary team etc (check full details of areas to consider in the learning outcomes) for the patient care interventions they participated in for example; personal care needs, assisted with medication etc, did the patient/client co-operate? or any barriers hindering effective care delivering or is it straightforward? were there opportunities for the patient/client to consider or adopt other lifestyle? • Throughout discussions consider the policies, laws, guidelines that informed all the students’ knowledge and understanding above. • Throughout discussions consider who else was involved and what role they played in assisting the student to achieve the proficiency (s) and include applicable supervision arrangements to maintain safety • Was the student’s able to work more independently in the provision of care and decision-making process? If there are barriers or challenges? How were these overcome? What learning from this episode of care could be transferred to other areas of practice? Link to the proficiencies for this placement. Conclusion (approximately 100 words) State the main points gleaned from the case study. Do not introduce new material OR idea.

Essay Sample Content Preview:

Managing Complex Care: A Case Study of a Patient’s Admission for a Right-Sided Subdural Hematoma Author’s Name The Institutional Affiliation Course Number and Name Instructor Name Assignment Due Date Introduction The present case study centres around nursing proficiency by a student nurse (STN) under the direct supervision of the head nurse on call. The patient was presented with a right-sided subdural hematoma and acute aspiration pneumonia after an incident where the patient fell. The study will discuss the STN’s capabilities in handling patient care and rapid actions in response to the changes in patient physiology, as per the Student Nurse Position Description (University of Pittsburgh, n.d). For confidentiality purposes, the patient will be kept anonymous, and the pseudonym “Lucy” will be used instead, as per the Nursing and Midwifery Council’s (NMC) Code of Conduct (NMC, 2018). Firstly, the essay will discuss STN’s role in fulfilling her physical duties, including taking timely patient measurements, evidenced by her strong grip on clinical knowledge. The essay will next highlight the social attributes and critical skills of both the STN and the team on call, which led to the prompt treatment of Lucy and control over her symptoms. Patient Details The 87-year-old patient named “Lucy”, a female, was brought to the hospital. She ended up in Ward 15, specifically for early patient treatment. At first, she was diagnosed with right-sided subdural hematoma, head injury, and aspiration pneumonia. Lucy also displayed symptoms of slight confusion, drowsiness, and potential for seizures. As discussed in the study of Woe et al. (2017), seizures were a common occurrence in patients with subdural hematoma. Mild signs of nausea were also observed. Assessment and Delivery of Care At the beginning of the shift, the Registered Nurse (RN), Healthcare Assistant (HCA), and the first-year STN introduced themselves to each of the four patients in the bay. The STN separated each patient’s area by closing the curtain to keep it private from the rest of the patients, per the NICE guidelines (2021). The use of curtains for discretion is consistent with recognized confidentiality practices for patients. As documented by the STN, Lucy had an Early Warning Score (EWS) (Appendix 1) of 0 before the incident. The incident was initiated when Lucy’s son called for help. It appeared that Lucy was choking on food. The STN immediately responded to the call and, realising the intense situation alerted the head nurse. After the choking incident, the STN utilised neurological observations to assess Lucy’s condition after the incident. The vital signs were monitored and recorded as BP 201/100, pulse 107, respiration rate 22, and temperature 36.7°C. As per the NEWS2, a high blood pressure and pulse rate value indicate cardiovascular stress, leading to a declining patient’s health (Royal College of Physicians, 2017). Furthermore, after thoroughly utilising the ACPVU assessment (see Appendix 2), which is recommended in cases of adult patients (Peate & Brent, 2021), the STN called to alert the team after pressing the emergency button. The entire healthcare team displayed collaborative effort, which was crucial in dealing with the situation systematically. A joint effort is essential in healthcare to ensure timely treatment (O’Daniel & Rosenstein, 2008). The physician on call immediately suggested an ECG, which displayed normal readings. However, to ensure an accurate diagnosis, the doctor requested additional MRI and CT scan reports (Rasuli & Gaillard, 2008). Upon the doctor’s assessment, Lucy’s condition was indicative of bleeding and buildup (see Appendix 3) on the right sight of the brain. Therefore, the STN was instructed to conduct a BCG blood test to ensure proper clotting function (Cedars Sinai, 2022). The doctor performed speech-language therapy (SLT), occupational therapy, and physical therapy (OTPT) examinations to further evaluate Lucy’s present state. Meanwhile, the STN stabilised Lucy by administrating 15L of oxygen via a reservoir mask once the head nur...

Updated on May 11, 2024

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