Clinical Reasoning Cycle Complex Scenario

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Assessment item 1 – Clinical Reasoning Cycle Complex Scenario

Value: 50%

Due Date: 29th March 2023

Return Date: 21st April 2023

Length: 1800 words

Group Assessment: No

Submission method options: Turnitin Assignment Portal

TASK

This assessment task requires you to utilise the case study provided on the NRS387 subject Interact2 site and use the template provided under assessment 1 to address each of the following points:

Describe – provide an overview of the scenario (consider the person and context. Location – people – situation (approx. 150 words)

Collect Cues – Collect relevant assessment cues and identify additional assessment data that may be required (approx. 100 words)

Process Information – compare any abnormal assessment findings with normal or expected findings and describe why the findings are of importance. Reference/s needed (approx. 250 words)

Synthesise – Identify the main clinical issues for the patient.  Identify and provide an overview of the pathophysiology of the main health challenge evident in the case study. Reference/s needed (approx. 250 words)

Establish goals -identify three (3) person-centered desired outcomes for this patient that are relevant to the scenario (approx. 200 words)

Select a course of action – outline three (3) nursing interventions, one (1) for each goal, that will assist the patient to meet the desired outcomes and provide basic evidence-based rationales for each. These interventions should be prioritised according to clinical urgency. Reference/s needed.  (approx. 150 words/intervention, 250 words/rationale)

Evaluate outcomes – Explain the process for evaluating the desired outcomes in this scenario (approx. 150 words)

Reflect – reflect on what you have learned from completing this task and how it will contribute to your future practice. (You should use an established model of reflection and reference it) (approx. 300 words)

 

You are to support your work with academic sources, use in-text references and provide a reference list.

All sources must be correctly referenced in-text and in the reference list in accordance with APA 7th Edition referencing style.

SUBJECT LEARNING OUTCOMES

This assessment task will assess the following learning outcome/s:

  • be able to identify and apply assessment frameworks and techniques to the care of infants, children, adolescents, adults and older people in a simulated environment.
  • be able to identify and demonstrate selected evidence-based nursing interventions to promote safety, healing and caring in practice for infants, children, adolescents, adults and older people in a simulated environment.
  • be able to apply the Clinical Reasoning Cycle to interpret assessment findings, plan, justify and evaluate care in the context of complex clinical scenarios in a simulated environment.

GRADUATE LEARNING OUTCOMES

This task also contributes to the assessment of the following Charles Sturt Graduate Learning Outcome/s:

  • Academic Literacy and Numeracy (Skill) – Charles Sturt Graduates demonstrate the literacy and numeracy skills necessary to understand and interpret information and communicate effectively according to the context.
  • Professional Practice (Knowledge) – Charles Sturt Graduates possess the knowledge and understanding of the discipline and the nature of professionalism required for the given profession or discipline in contemporary societies.

 

PRESENTATION

All items of assessment must be word processed and not handwritten. In addition:

  • Leave 2 cm margins and double line space your work
  • Font must be 12pt, unless otherwise indicated.
  • All pages must be numbered.
  • Student name and number must be included in the header or footer of every page of every assignment.
  • A title page must accompany your written assessment task and include the subject name and code, title of the assessment task, due date, lecturer’s name, student name and student number.
  • Assessment must be uploaded as a MS WORD document.

 

Below are further written information to guide you in the assessment task. Each marking criteria will be explored.

 

Criteria

 

 High Distinction

(85 – 100%)

 Distinction

(75-84.5%)

 Credit

(65-74.5%)

 Pass

(50-64.5%)

 Fail

(0 – 49.5%)

 Marks

 
Describe

–provide an overview of the scenario

 

 You have used a holistic approach to analyse the patient situation, and derived

components of the patient’s context that will impact care.

(7.1 – 8 marks)

 

 You have used a holistic

approach to examine the

patient situation.

A description of the facts

and the patient’s context

has been included.

(6.1 – 7 marks)

 

 You have used a

holistic approach to describe the patient situation.

The facts and the patient’s context have

been included.

(5.1 – 6 marks)

 

 You have

described the

patient situation,

including some

aspects of the

patient’s social

circumstances.

(4 – 5 marks)

 

 You have not

described the

patient situation

or you have

paraphrased

the content of the case study to describe some of the facts.

(0 – 3.9 marks)

 /8

 

 

Describe – provide an overview of the scenario (consider the person and context. Location – people – situation (approx. 150 words)

In this section I want you to be able to describe who Roger is, why is he in hospital, what are the factors that influence how Roger is feeling now when you are taking over care. Using a holistic approach, how has Roger’s persona and lifestyle influenced how he is now and is that what you expect from what you can read about him?

Criteria

 

 High Distinction

(85 – 100%)

 Distinction

(75-84.5%)

 Credit

(65-74.5%)

 Pass

(50-64.5%)

 Fail

(0 – 49.5%)

 Marks

 
Collect cues

Collect relevant

assessment cues and identify

additional

assessment tools

that may be

required.

 

 Relevant assessment cues have been identified, following an analysis of the case study. Identified cues have been presented systematically. Additional relevant assessment tools have been identified to address subtle cues. A rationale for additional assessment tools is included.

(9.1 – 10 marks)

 Relevant assessment cues have been identified, following an analysis of the case study. Identified cues has been prioritised systematically. Additional relevant assessment tools have been identified to address subtle cues.

(7.6 – 9 marks)

 Relevant assessment cues have been identified. Some subtle cues have

been overlooked.

Identified cues have been Presented systematically.

Additional relevant

assessment tools have been identified.

(6.6 – 7.5 marks)

 Relevant assessment cues have been identified. Some cues have been missed but will not impact immediate care. Additional relevant assessment tools have been identified. (5 – 6.5 marks) Relevant assessment and important cues have been missed.

Additional relevant

assessment tools have not been identified or

additional assessment tools of questionable

relevance to the case study.

(0 – 4.9 marks)

 /10
Processing

Compare any

abnormal

assessment

findings with

normal or

expected findings

and describe why

the findings are

of importance

 

 Recognises subtle

deviations from

expected patterns in identified cues and assess why the findings are of importance.

Supported by high quality references.

(9.1 – 10 marks)

 

 Recognises patterns and

deviations in the

identified cues and

describe why these

findings are of

importance. Supported by

quality references.

(7.6 – 9 marks)

 

 Recognises

obvious patterns

and deviations in

the identified

cues. Deviations

from

expectations

have been

identified and

supported by

references.

(6.6 – 7.5 marks)

 

 Obvious patterns

and deviations in

the identified

cues have been

identified. A

description of the

importance of these findings are

included with

limited

referencing.

(5 – 6.5 marks)

 

 Patterns and

deviations from

expectations are not

clearly identified. Or

there is no

description of the

importance of these

findings. No

references.

(0 – 4.9 marks)

 

 /10

 

 

Collect Cues – Collect relevant assessment cues and identify additional assessment data that may be required (approx. 100 words)

What are the cues you need to collect in order to provide appropriate care for Roger? Remember that normal vital signs are also cues Explore both signs and symptoms

Process Information – compare any abnormal assessment findings with normal or expected findings and describe why the findings are of importance. Reference/s needed (approx. 250 words)

What does the cue indicate, why is this of concern? (References needed)

Collect cues (this is only examples and not taken form the scenario) Process information
Normal /abnormal These findings indicate
T(36.5oc)P(91)RR(15)BP(132/76) Normal values No concerns (reference)
Pain 6/10 Moderate/high pain level due to ……(reference)
urine output 400ml/12hours Moderate concern. Urine output less than 0.5ml/hour dehydration (reference)
↑Confused Infection/delirium/alcohol withdrawal (reference; reference)
Additional assessments required

Pain assessment

Delirium assessment

Remember that these are just examples, not taken from the scenario

 Criteria

 

 High Distinction

(85 – 100%)

 Distinction

(75-84.5%)

 Credit

(65-74.5%)

 Pass

(50-64.5%)

 Fail

(0 – 49.5%)

 Marks

 
Synthesise

Identify the main clinical issues for the patient and

outline why this

is an issue for the patient.

 

 You are able to identify and interpret the main

clinical reason behind the

patient’s current state and has analysed the patterns in the patient’s cues to

provide an in depth

rationale as to why this is an issue for the patient.

(10.6 – 12 marks)

 You are able to identify and interpret the main clinical reason behind the patient’s current state and has explained the patterns in the patient’s cues to provide a rationale as to why this is an issue for the patient.

(9.1 – 10.5 marks)

 You are able to identify the main clinical reason

behind the patient’s current state and have

described the patterns in the patient’s cues to

provide a rationale as to why this is an issue for the patient.

(7.6 – 9 marks)

 You have

identified the

main clinical

issues and

outlined why

this is an issue

for the patient.

(6 -7.5 marks)

 

 You have not

identified the main clinical issues for the patient and/or not outlined why this is an issue for the patient.

(0 – 5.9 marks)

 /12

 
Outline the

pathophysiology

of one

presenting

health challenge

 You have analysed

The pathophysiology of the presenting health challenge.

(9.1 – 10 marks)

 You have explained the pathophysiology of the

presenting health challenge.

(7.6 – 9 marks)

 You have described the pathophysiology

of the presenting

health challenge.

(6.6 – 7.5 marks)

 You have outlined

the pathophysiology

of the resenting health challenge.

(5 – 6.5 marks)

 You have not provided any outline or

description of the pathophysiology of the presenting health challenge. No supporting referencing.

(0 – 4.9 marks)

 /10

 

 

Synthesise – Identify the main clinical issues for the patient. 

 

This is where you draw the conclusion from all the cues you have collected. You can include more than one clinical issue, but the focus must be on the main clinical issue. What ‘cues’, ‘patterns’ have you collected to confirm your decision? And how do these cues /values influence Roger’s current health status?

 

Identify and provide an overview of the pathophysiology of the main health challenge evident in the case study. Reference/s needed (approx. 250 words)

What is the pathophysiology of Roger’s main health problem.

 

Criteria

 

 High Distinction

(85 – 100%)

 Distinction

(75-84.5%)

 Credit

(65-74.5%)

 Pass

(50-64.5%)

 Fail

(0 – 49.5%)

 Marks

 
Establish SMART

Goals

Using SMART

goals process,

identify and

prioritise three

(3) desired

outcomes for the patient according to clinical urgency. Provide a rationale for your desired

outcomes.

 You are able to

develop and prioritise three SMART goals for

the patient according to clinical urgency.

Comprehensive and in depth rationale is provided for each

desired outcome.

(9.1 – 10 marks)

 

 You are able to demonstrate prioritisation

of three SMART goals for the patient according to clinical urgency.

Comprehensive rationales is provided for each desired outcome.

(7.6 – 9 marks)

 

 You are able to prioritise three SMART goals for the patient according to clinical urgency.

A complete rationale is provided for each desired

outcome.

(6.6 – 7.5 marks)

 

 You have identified three SMART goals for the patient

according to clinical urgency. A rationale is provided for each

desired outcome.

(5 – 6.5 marks)

 

 You have not been

able to identify and

prioritise three (3)

desired outcomes,

using SMART goals

process, for the

patient according to clinical urgency and /or no rationale is provided.

(0 – 4.9 marks)

 

 /10

 
Select a course

of action

Outline one (1)

evidence based

nursing

intervention,

with rationale to address each goal. These

interventions

should be

prioritised

according to

clinical urgency.

 Three relevant

Nursing interventions have been identified and expertly supported by high quality up to date evidence which has been integrated

seamlessly into the nursing care of the

patient.

(10.6 – 12 marks)

 

 Three relevant nursing

interventions have been

identified supported by

high quality up to date

evidence which has been

integrated into the nursing care of the patient.

(9.1 – 10.5 marks)

 

 Three relevant nursing

Interventions have been

identified and supported by good quality up to date evidence which has been included in the nursing care of the patient.

(7.6 – 9 marks)

 

 Three relevant nursing intervention have been identified

and supported by up to date evidence.

(6 – 7.5 marks)

 

 The nursing

interventions are not relevant and/or not evidence based.

(0 – 5.9 marks)

 

 /12

 
Evaluate

Explain the

process for

evaluating

outcomes of the

nursing

interventions.

 

 Clear, relevant and accurate measures

have been identified and described to

evaluate the desired outcome for each goal.

(9.1 – 10 marks)

 Clear and relevant

measures have been

identified to evaluate the desired outcome for each goal.

(8.1 – 9 marks)

 

 Relevant measures have been identified to evaluate the desired outcome for each goal.

(6.6 – 8 marks)

 

 Relevant measures to evaluate the

outcomes have

been listed.

(5 – 6.5 marks)

 

 Evaluation of the desired outcome

has not been

identified.

Evaluation of desired outcome is superficial and/or not relevant.

(0 – 4.9 marks)

 /10

 

 

 

 

Establish goals -identify three (3) person-centered desired outcomes for this patient that are relevant to the scenario (approx. 200 words)

 

When you write a SMART goal you do not need to write out the S-specific, M-measurable, A-attainable, R-realistic, T-timely, but you MUST be able to answer the questions: is it specific? Is it measurable? Is it attainable? Is it realistic? And, is it timely?

 

Select a course of action – outline three (3) nursing interventions, one (1) for each goal, that will assist the patient to meet the desired outcomes and provide basic evidence-based rationales for each. These interventions should be prioritised according to clinical urgency. The rationale needs Reference/s.  (approx. 150 words/intervention, 250 words/rationale)

Evaluate outcomes – Explain the process for evaluating the desired outcomes in this scenario (approx. 150 words)

 

Next WHAT are you going to do to reach your SMART goal? (Intervention) Followed by WHY are you doing it (Rationale)

Below are examples Not from the clinical scenario. This is from a cardiac scenario, all the interventions but mainly the rationales need a more in-depth explanation on why you are doing it, (including references)

 

And last, how do you know if your goal was reached? (Outcome)

 

Goal 1

Increase oxygen saturation immediately (This is a SMART goal because I can answer ‘yes’ to all the questions)

 Goal 2

Decrease heart workload immediately ((This is a SMART goal because I can answer ‘yes’ to all the questions)

 Goal 3

Cardiac monitoring Immediately ((This is a SMART goal because I can answer ‘yes’ to all the questions)
Select a course of action (intervention)
Intervention 1 for goal 1

Provide oxygen via NP (2 l/min)

 Intervention 2 for goal 2

Administer Nitro-glycerine as per protocol sublingually

 Intervention 3 for goal 3

Attach cardiac electrodes
Rationale 1

Body need oxygen (reference)

 Rationale 2

Dilute arteries(reference)

 

 Rationale 3

Needed for continuous cardiac monitoring and collection of an ECG. (reference)
Evaluate outcomes
Outcome 1

Spo2 to increase to above 95%

 Outcome 2

Decrease pain

 Outcome 3

ECG completed and continuous cardiac monitoring without interference

 

Criteria

 

 High Distinction

(85 – 100%)

 

 Distinction

(75-84.5%)

 

 Credit

(65-74.5%)

 

 Pass

(50-64.5%)

 

 Fail

(0 – 49.5%)

 

 Marks

 
Reflection

Reflect on what you have learned

from completing

this task and how it will contribute to your future

nursing practice.

 You have identified and evaluated significant learning outcomes and

reflected critically on them in a deep and significant way. You have related the reflection to your learning experience and influence on your future nursing practice.

(7.1 – 8 marks)

 You have evaluated

significant learning

outcomes and reflected on them in a significant way. You have related your reflection to your future nursing practice.

(6.1 – 7 marks)

 

 Your reflection evaluates

Learning outcomes and how it will influence and

contribute to your future

nursing practice.

(5.1 – 6 marks)

 

 You reflect on learning outcomes form completing this

task and how it will contribute to your future nursing practice.

(4 – 5 marks)

 

 Student makes little attempt to

personally relate events during the

learning experiences and makes few attempts to critically analyse these situations. Few attempts are made to examine the reasons why the learning experience did not work out well or explore alternatives to find ways as to how they could have been improved. No supporting reference.

(0 – 3.9 marks)

 /8

 

Reflect – reflect on what you have learned from completing this task and how it will contribute to your future practice. (You should use an established model of reflection and reference it) (approx. 300 words)

Last you should reflect on what you have learned in this assignment the will be beneficial for you in your future as a nurse (use reflective writing (I feel….., I think …., I believe…

And you must use a reflective tool that is referenced, or you will receive a fail mark.

 

In your referencing you need to use peer reviewed journal articles or textbooks. Do not use information webpages. It is not only about the number of references it is also about the quality. Remember if you use an edited textbook you need to refence it accordingly

 

The three last marking criteria is the standard that is included in each marking criteria and should not need any explanation.

 

Criteria

 

 High Distinction

(85 – 100%)

 

 Distinction

(75-84.5%)

 

 Credit

(65-74.5%)

 

 Pass

(50-64.5%)

 

 Fail

(0 – 49.5%)

 

 Marks

 
Communicates

Professionally

(Academic

writing and

presentation).

 

 Language features

and structures are

used to convey

meaning effectively, clearly, unambiguously,

concisely, and in a

formal academic

style, with few

spelling, grammatical, or punctuation errors.

Presentation guidelines have been followed.

(4.6 – 5 marks)

 Language features and

structures are used to

convey meaning

effectively, clearly,

unambiguously, and in a

formal academic style,

with occasional minor

spelling, grammatical, or punctuation errors.

Presentation guidelines

have been followed.

(4.1 – 4.5 marks)

 

 The meaning is

apparent to the

reader, although

text contains minor errors in spelling,

grammar, word choice, and/or structure, and

lacks clarity occasionally.

Presentation guidelines have been followed.

(3.5 – 4 marks)

 

 The meaning is

apparent to the

reader, although

text contains

many errors in

spelling, grammar, word choice, and/or structure, and lacks clarity occasionally.

Presentation

guidelines have

been followed.

(2.5 – 3.4 marks)

 Presentation

guidelines have not

been followed with

multiple errors.

Frequent, intrusive

errors in spelling,

grammar, punctuation, word choice and/or

structure prevents

the meaning from

being apparent to

the reader.

(0 – 2.4 marks)

 /5

 
Uses evidence to support and

build knowledge

in practice

(Academic

referencing).

 

 The assessment is

supported by & related to a wide variety of peer reviewed references which include journal

articles, professional

manuals and documents,

textbooks, and

module readings.

Referencing is

comprehensive,

demonstrates

academic integrity,

and is error free for the APA 7th ed. style conventions.

(4.6 – 5 marks)

 

 The assessment is supported by & related to a variety of peer reviewed references which include journal articles, professional manuals and documents, textbooks, and module readings. Referencing is comprehensive,

demonstrates academic

integrity, and conforms to APA 7th ed. style

conventions, with one or two errors.

(4.1 – 4.5 marks)

 

 The assessment is supported by at least 15 peer reviewed references from module readings, textbooks, and professional manuals and documents. Referencing is comprehensive and mostly accurate

according to APA 7th ed. Style conventions.

Up to 5 minor errors or

omissions in style and

formatting choices have no impact on the

transparency and

traceability of the source, or the demonstration of academic integrity.

(3.5 – 4 marks)

 

 The assessment is

supported by at least 12 peer reviewed

references from

module readings,

textbooks, and

professional

manuals and

documents.

Referencing is

Comprehensive and mostly accurate

according to APA 7 th ed. style

conventions with few minor errors.

Up to 8 minor errors or omissions in style and formatting

choices that have no impact on the

transparency and

traceability of the source, or the

demonstration of academic integrity.

(2.5 – 3.4 marks)

 The assessment is

supported by less than 12 peer reviewed references

from module

readings, textbooks,

and professional

manuals and

documents, and/or

no references are evident.

Referencing is not accurate according

to APA 7th ed. style

conventions.

Errors or omissions

in style and

formatting choices

have an impact on

the transparency

and traceability of

the source, or the

demonstration of academic integrity.

(0 –2.4 marks)

 /5

 
Academic

Integrity

Turnitin report

indicates

adherence to

academic

integrity

principles and

referencing

conventions.

 Turnitin report indicates a clear attempt has been made to adhere to academic integrity and referencing conventions and avoid plagiarism. It is evident that the student has taken steps to show respect for and acknowledge others’ work appropriately, as per the Charles Sturt Academic Integrity Policy https://policy.csu.edu.au/document/viewcurrent.php?id=387.

 

SY

 

 

 Turnitin report indicates the student has not adhered to the Academic Integrity

Policy.

 

US

 

 SY/US

 
       

/100

 

 

 

REQUIREMENTS

Referencing

Correct and consistent referencing is an important component of producing professional and credible academic work. Marks will be awarded for high quality referencing.

Please refer to the following text for information on how to reference your paper:

American Psychological Association (APA). (2019). Publication Manual of the American Psychological Association (7th ed.). APA.

Students may also access CSU’s Academic Referencing Tool (ART) which provides detailed referencing examples for the referencing style – APA 7. This resource can be accessed via the library website.