Welcome to Assessment Task 2 your Final Task for NRSG374
Case Study
Critique of care scenario
. Case Study of Tyler need to be read through-Complex. Clinical Practice guidelines to be followed
Care may or not provided for the patient. Look at literature-_ read disease progression, Pathophysiology
Example Neuropathy_ why it is happening. National Palliative Care Standards
Direct Care provision. Journal Article. Quality or NMBA Standards
Partnering with consumers. Talk and support in detail. Look at Clinical Practice guidelines. Care provision
What is recommended. Care gabs missed
Literature. Evidence based Literature..CRC I dentification latest, Tyler Information
.Thursday to MONday..Foucus in Issue ..National Pallative Care Standards 1-6 ..NMBA Standards 1-7
What we need to Know and What is Nice to know or see.
Choose from
Care of Dying Patient
.. OR End of Life
Appendix B Assessment Task 2: Written Critique of care provided to a Palliative Care Patient
Lets breakdown the requirements of task 2
NRSG374 Unit Outline Assessment Task 2 Details
Students are to provide an 1800-word critique of the provided case study using only ONE CPG.
· The CPGs to select from are:
· Care of the Dying patient
· End of Life Care
To complete this task, you will need to discuss and critique relevant elements of the CPG and case study whilst upholding the National Palliative Care Standards at least one of: the below standards.
NSQHS
NMBA standards and/or
Do we need to use all these standards to do well?
· As the rubric states if you provide Outstanding knowledge of themes and principles associated with palliative care this will demonstrate an outstanding application of your knowledge to practice therefore using standards from more than one of the above and relating them together to uphold your critique of the patient care and support the clinical practice guideline selected will demonstrate excellent knowledge and understanding. Using one standard from one of the above will not provide strong application of knowledge. However, a comparison of multiple standards that as registered nurses we are required to uphold will absolutely demonstrate very strong knowledge and understanding, if you link them together well with evidence-based practice (EBP)
Where do I find all these standards?
You should be aware of all of the standards above as they have been discussed in many units throughout your degree, so now it is time to demonstrate your knowledge and bring them together. to assist you We have provided links below to each of the standards we would like you to utilise in your critique.
NSQHS
Eight National safety and Quality Health Service Standards to provide a nationally consistent level of care that can be expected by all consumers from all health organisations
https://www.safetyandquality.gov.au/standards/nsqhs-standards
NMBA
Seven Standards that all Registered nurses must uphold to ensure that they maintain their registration and provide person centred and evidence-based preventative, curative, supportive, formative and palliative elements to their practice
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
National Palliative Care Standards
Nine National palliative Care standards that you know well as they have formed the framework of NRSG374 and were fundamental for assessment task 1
https://palliativecare.org.au/standards
How do I relate these standards to the case study?
This is where your critical thinking and application of theory to practice is required, we cannot tell you how to do this, as a final year nursing unit it is essential that you are aware of how all of these standards, uphold and maintain, patient centred care, dignity, patient assessment and safety to name a few. Spend some time reviewing these and map out the ones that you believe are important for your critique.
Purpose
Students are required to demonstrate an understanding of how theory translates into practical nursing care and how evidence underpins best practice. Each student will review and critique the care given in the Case Study provided according to their choice of ONLY ONE of the provided Clinical Practice Guidelines (CPGs) best suited to the highlighted discussion.
Where will I find the CPGs that you want me to use?
You are provided with CPGs for this task, in this booklet.
You need to choose one of these only to demonstrate the area of care that you are providing a critique of. You are not expected to look for other CPGs to support your work, however evidence based practice of peer reviewed journal publications are expected to further reinforce the critique.
· Aetiology of Motor Neurone Disease
· Consider the Patient Situation
· Collect Cues and Information
· Processing Information
· Identifying problems/issues
· Establishing Goals and Taking Action
· Evaluating and Identifying new problems
· Reflection
· Clinical Practice Guidelines
· References
ASSIGNMENT 2
Written Critique Review and critique of a case study that depicts the care provided to a patient and their family in a palliative setting. Critical analysis will be based upon a Clinical Practice Guideline(CPG) to improve patient care
Due date: Tuesday 03 October 2021 at 9am
Weighting: 50%
Length and/or format: 1800 word +/- 10%
Purpose: XXXXXXXXXXEach student will review and critique the care given in a Case Study to be provided. It is essential for students to demonstrate an understanding of how theory translates into practical nursing care. The critique will utilise contemporary evidence-based literature and standards to support the selection of ONLY ONE suitable Clinical Practice Guideline (CPG) relating to the care needs of the patient and family presented.
Learning outcomes assessed: XXXXXXXXXXLO1, LO5, LO7
Assessment criteria: The assessment will be marked using the criteria-based rubric.
Please note that all materials need to be referenced according to
ACUs APA 7th referencing guidelines.
WORD COUNT
Writing requires skill and being able to write within a specified word limit is an essential component of professional and academic work. Reading and writing critically are fundamental skills which demonstrate an understanding and an ability to make judgements and solve problems, hence why only 10% of a word count should be direct quotes. That is, if the word count is 1500 words only 150 of those words should be direct quotes. Word counts provide students with an indication of the amount of detail and work required for each assessment item.
What is included in a word count?
Essentially, all text within an assessment item from the introduction through to the conclusion is
counted in the word count. This includes all in-text citations, direct quotes and headings. The wordcount does not include the following:
Title page
Reference list
Appendices
Tables
Figures and legends
REFERENCING
This unit requires you to use the APA Standard 7 referencing system. See the Academic referencing page of the Student Portal for more details.
Recommended references
Case study need to be cited when referring to it in the critique.
ACU Case study reference to be used as well.
Each time referring to a source it should be cited. The author should be read as ACU, and year is 2021, the title would be Assessment Two case Study Information. ACU documents as Reference. Intext citation for care of the dying patient CPG (ACU),2018). Intext citation for END of Life Care CPG (ACU,2021) Intext citation for Case study (ACU,2021)
Reference List Case Study: Australian Catholic University XXXXXXXXXXNRSG374 Assessment Task 2 Case Study. XXXXXXXXXXHttps://leo.acu.edu.au/mod/book/view.php?id=3754387
Reference List CPG: ACU Clinical Practice Guidelines XXXXXXXXXXCare of the Dying Patient. XXXXXXXXXXhttps://leo.acu.edu.au/pluginfile.php/4991074/mod_resource/content/1/Care%20of%20the%20Dying%20Patient%20CPG.pdf Paula J
Appendix B Criterion Referenced Rubric: Assessment Task 2 Written Critique
RUBRIC
Assessment Criteria
Sequencing: Sentence and paragraph structure & intelligibility (15 marks)
The content in the critique matches the outline presented in the introductory paragraph. Organised paragraphs with an excellent progression of ideas. The content flows from one paragraph to the next on all occasions. The critique ends with a concise, and rational conclusion
Knowledge and u
nderstanding (35 marks)
The critique provides a well-articulated understanding of how contemporary evidenced based theory translates into practical care.
Excellent knowledge of National Palliative Care Standards aligned with at least one of NSQHSS and/or NMBA standards are demonstrated using a palliative approach within the critique.
Critical thinking, reasoning, and evaluation of evidence (35 marks)
A critical analysis and presentation of the case study with precise links between the details and care provided aligning with the principles of palliative care practice is formulated
An applicable clinical practice guideline is selected supporting an excellent critique of the case study provided. Excellent identification of limitations, omissions and/or inaccuracies of care supported by contemporary credible literature and the selected Clinical Practice Guideline.
Sources and Referencing (10 Marks)
Credible and relevant references are used comprehensively. Accurate use of APA 7 referencing style in all instances. A range of in-text citations has been used comprehensively
Mechanics (Grammar, Spelling and Punctuation) (5 Marks)
There are no errors with grammar, spelling and punctuation, the meaning is easily discernible. The critique reads without interruption.
.
Assessment Two Case Study Information Interactive Book
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Aetiology of Motor Neurone Disease
Motor neuron disease (MND) is a progressive neurological disorder characterised by loss of motor neurons (Brown, Edwards, Buckley & Aitken, XXXXXXXXXXThere are 4 main types of MND, depending of the level of motor neurone involvement and where symptoms begin. These include:
· Amyotrophic lateral sclerosis (ALS)
· Progressive bulbar palsy (PBP)
· Progressive muscular atrophy (PMA)
· Primary lateral sclerosis (PLS)
MND usually leads to death 20-48 months after symptoms begin, however 5%- 10% of patients may survive for more than 10 years (MND New Zealand, XXXXXXXXXXThe onset of MND is usually between 40 and 70 years of age and is more common in men than women by a ratio of 2:1 (MND Australia, XXXXXXXXXXThe prevalence is approximately 8.7 in XXXXXXXXXXin Australia (MND Australia, 2018).
Motor neurons in the brainstem and the spinal cord gradually degenerate. Dead motor neurons cannot produce or transport signals to muscles. Consequently, electrical and chemical messages originating in the brain do not reach the muscles to activate them. The typical symptoms for diagnosis of MND are limb weakness, dysarthria and dysphagia (Brown et al., XXXXXXXXXXMuscle wasting and fasciculations results from the denervation of the muscles and lack of stimulation and use. Other symptoms include pain, sleep disorders, spasticity, drooling, emotional liability, depression, constipation and oesophageal reflux (Brown et al., XXXXXXXXXXDeath usually results from respiratory tract infection secondary to comprised respiratory function.
Throughout the illness trajectory for MND, the patient remains cognitively intact while physically declining. The patient should be encouraged to partake in moderate intensity, endurance type exercise for the truck and limbs as this may help reduce MND spasticity.
Nursing interventions include but are not limited to (Brown et al., 2017):
· Facilitating communication
· Reducing risk of aspiration
· Facilitating early identification of respiratory insufficiency
· Decreasing pain secondary to muscle weakness
· Decreasing risk of injury related to falls
· Providing diversional activities such as reading and companionship
Assessment Two Case Study Information Interactive Book
? Previous: Aetiology of Motor Neurone DiseaseNext: Collect Cues and Information ?
Consider the Patient Situation
(Levett-Jones, 2018)
The Patient:
Tyler Morton is a 40-year-old man who spent is childhood and teenage years in Brisbane. Tyler, whilst growing up excelled in all sports and represented QLD in the state Cricket Team. Upon completing high school, Tyler graduated from the University of Queensland with a Bachelor of Business Management before joining the Royal Australian Airforce as a Pilot in 2004. Whilst training to become a Pilot, Tyler met is future wife Catherine in Newcastle and this is where the couple settled to commence their family. Tyler and Catherine have 3 Children. Catherine is a stay at home Mum to:
· Andrea (8 Years)
· Jessica (5 years)
· Erin (2 Years)
Being from Newcastle, Catherines Family is very close to Tyler and Catherine and spend a lot of time together. Tylers Family is in Brisbane and has only minimal contact with Tyler and his young Family. Unfortunately, Catherine and Tylers mother Joyce do not get along and this causes a lot of conflict in the marriage.
18 months ago
Tyler experienced some weakness in his left hand. His grip strength was not a strong as his right hand and he found he would be dropping anything that he picked up. Tyler also noted he was getting short of breath without exertion. Considering his general fitness is quite good, this was highly abnormal. Tyler made an appointment with the GP on the Airforce base to discuss this concern.
After multiple MRIs and blood tests and lumbar punctures (over a 3-month period), Tyler was diagnosed with Amyotrophic lateral sclerosis (ALS). At the time of diagnosis, Tylers weakness in his left hand had progressed to his right hand and he had developed a foot drop in his left ankle.
Upon diagnosis, Catherine was adamant that the children were not going to be told the reason that Dad is no longer working. Tylers diagnosis also caused more stress and tension with the relationship between Catherine and Joyce. Joyce wanted to visit and be there with her son, however Catherine was not supportive of Joyce and Tylers brothers visiting.
12 months ago
Around 6 months after initial symptoms and 3 months after diagnosis, Tylers condition had deteriorated. Tyler now required a walking frame to mobilise. His dyspnoea has increased, he was suffering from headaches and was generally fatigued. Tyler was being assessed by a respiratory specialist for the requirement of Non-invasive ventilation (NIV) especially at night. Tyler now suffers from dysphagia and was being assessed in consultation with the respiratory specialist and dietician for the need for a gastrostomy.
6 months ago
Tylers condition has continued to deteriorate. Due to insufficient nutritional intake secondary to dysphagia, Tyler had a gastrostomy inserted. Since insertion, he has had numerous infections at the insertion site. Tyler also requires assistance of NIV mainly at night, however the demand has increased significantly over the last couple of weeks. Tylers mobility is limited. He walks intermittently with the use of an aid and one person. His mobility is limited due to progressive foot drop and increased dyspnoea. With his condition worsening, Tyler initiated the difficult conversation with Catherine about his mortality. Catherine is still not accepting of Tylers condition nor is she wanting the Children to know the extent of Tylers condition. Tyler completed an Advanced Health Care Directive and he ensured both Catherine and his mother Joyce had a copy. Tyler is currently visited weekly by the Community Palliative Care Team and he has daily support from Community nurse to assist with his activities of daily living.
Despite Tylers progressive physical deterioration and the ongoing tensions with Catherines inability to accept his condition, Tyler values the time he gets to spend with his 3 girls. Watching them play together and their interactions are invaluable to Tyler. Tyler has insisted that his mother and brothers are able to visit monthly. When his family visit, Catherine generally takes the girls and leaves Tyler at home. Although this an ideal situation, Tyler has come to accept the conflict between Catherine and Joyce. Tyler is also still in contact with his colleagues from the Airforce who visit him frequently.
Assessment Two Case Study Information Interactive Book
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Collect Cues and Information
(Levett-Jones 2018)