Nursing Case Study Assignment Sample – NUR231 Assessment Task 3 – Written piece (50%)

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The below example is representative of a nursing case study assignment. In the sample, the instructions indicate the required format.

Assessment Name

Written piece

Goal

In your future role as a registered nurse or midwife, you will be required to interpret and use pharmacotherapeutic information and reliable clinical evidence to support patients or the pregnant woman in the quality use of medicines. You will interpret and use evidence to inform safe and comprehensive practice when designing person-centred care (nursing) or woman-centred care (midwifery) and managing a medication regimen.

Product

Written Piece

Length

2000 words

Weighting

50%

Individual/Group

Individual

Formative/Summative

Summative

How will I be assessed

5-criterion grading scale using the rubric provided

Due Date:


Presentation requirements

This assessment task must:

Be a written academic essay responding to the Task 3 instructions.

Use Times New Roman font, size 12 with 1.5 line spacing

Adhere to the word limit (+/-10%)

Use APA referencing style

Be submitted by the due date in an electronic format as a word document via SafeAssign

What you need to do

1.Read the Task 3 instructions for Group A or Group B below. They provide guidance for responding to the correct Task for the group you are enrolled in.

2.Create a fictitious case and write an essay that includes a discussion of all the concepts listed in the Task 3 instructions.

3.Support all discussion with scholarly academic sources cited using the APA referencing style in the text and reference list.

4.Adhere to the recommended word limit (+/- 10%).

Suggested Case Study Format

Present the case study explained in the guide below (200 words).

Write an academic essay that responds to the Task 3 instructions (1800-words).

Use evidence from scholarly health literature to support and justify your discussions and practice recommendations. (Intext references are included in the word counts. The reference list is not included in the word count. The word count leniency is +/- 10%)

Resources needed to complete the task

Task 3 assessment guide

USC APA referencing guide: https://www.usc.edu.au/current-students/student-support/academic-and-study-support/referencing-guides-and-academic-integrity/apa

NMBA Registered Nurse Standards of Practice

NMBA Midwife Standards for Practice

Task 3 instructions for Grp A

Discuss the professional knowledge, skills and attitudes required for safe medication practice by creating a case study that includes the administration of amoxycillin, cimetidine, salbutamol and paracetamol and exploring the core concepts from the course that are listed below. The case study should be realistic and include the context of care. Provide details of the client’s presenting health issues. Make the case study complex enough to enable discussion of the following concepts: Pharmacotherapy, Quality use of medicines, medication errors, anti-microbial stewardship, professionals standards, and person-centred or woman-centred care. Describe and discuss the concepts related to the case in an essay style written piece. Include person-centred or woman-centred practice interventions in the discussion (1800-words)

Task 3 instructions for Grp B

Discuss the professional knowledge, skills and attitudes required for safe medication practice by creating a case study that includes the administration of Flucloxacillin, ibuprofen, pholcodiene, and promethazine and exploring the core concepts from the course that are listed below. The case study should be realistic and include the context of care. Provide details of the client’s presenting health issues. Make the case study complex enough to enable discussion of the following concepts: Pharmacotherapy, Quality use of medicines, medication errors, anti-microbial stewardship, professionals standards, and person-centred or woman-centred care. Describe and discuss the concepts related to the case in an essay style written piece. Include person-centred or woman-centred practice interventions in the discussion (1800-words)

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Task 3 Assessment – Case Study Example

Name

 Institutional Affiliation

Course

 Instructor

Date

Task 3 Assessment – Case Study

Case Study

            John (synonym), a 67-year old male is presenting various symptoms, which include a fever and sweating, an unproductive cough, shortness of breath, and a sharp chest pain. The patient states that he has been smoking cigarettes for more than 42 years. Furthermore, the patient states that he suffers from heart disease. Moreover, the patient also states that he had been hospitalized because of his diabetes getting out of hand, and that he suspects that he started developing the symptoms while admitted. However, he never thought that the symptoms were serious, and thought that he had a normal cold. Besides, while admitted at the hospital, he states that his doctor informed him that he had a suppressed immune system and that needed to eat many greens and other healthy food options of his immunity was to become stronger. Based on the presenting symptoms, it appears that the patient acquired the infection that is causing the presenting symptoms while he had been admitted at hospital. Moreover, John reveals that he is an ethnic minority and has certain beliefs and values regarding medications and treatment. Thus, it is imperative to use a patient-centered approach while administering the medications to the patient.

Medication Administration

Pharmacotherapy

            The various medications are used in the treatment of the symptoms that John is presenting. One of these medications is Phenergan, a drug whose active ingredient is promethazine hydrochloride (NPS Medicinewise, n.d.). Promethazine is an antihistamine that is used for treating medical conditions such as allergies, nausea, and vomiting, and respiratory symptoms. One can also use the drug to treat some of the symptoms of common cold (Baumann-Birkbeck et al., 2014). Moreover, pholcodine is a medication that is an opioid that is usually used as a cough suppressant. The drug assists with the suppression of unproductive coughs and it tends to have a mild sedative effect (Katelaris et al., 2014). Furthermore, another medication involved in the treatment of John is ibuprofen, which is a painkiller for certain types of pains and aches, including back pain (Alcohol and Drug Foundation, 2016). Moreover, the medication is also used for treating fever, inflammation, including sprains and strains, as well as pain from arthritis (Healthdirect Australia, 2019). The drug is available in the form of capsules, tablets, or one can administer it as a syrup.

            Another medication used in the treatment of John is fluclocacillin, which is a type of antibiotic that is used for treating certain types of chest infections, including pneumonia, bone infections, and skin infections (Jager, 2020). It can be administered as an injection, drinkable liquid, or as a capsule. Some of the important considerations for the administration of the drug include the need for ensuring that the patient is on an empty stomach before taking it. This implies that it needs to be taken around two hours after a meal, or around 30-60 minutes before taking a snack or a meal (NPS Medicinewise, n.d.). The various medications may have some side effects, hence the need to ensure that the patient does not experience serious side effects.

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Anti-Microbial Stewardship

            Since John’s treatment involves the use of an antibiotic (fluclocacillin), it is imperative to demonstrate anti-microbial stewardship. Recent data suggests antimicrobials are highly misused and the problem is widespread in different healthcare settings. Furthermore, studies suggest that the increasing misuse of antimicrobials has significantly contributed to the emergence of certain drug-resistant organisms, which tends to threaten the medical advances achieved during the last few decades (Dyar et al., 2017). As such, it has become increasingly important to use antibiotics while ensuring full adherence to the specifications in terms of aspects as dosage and the duration of using the drugs. The concept of antimicrobial stewardship refers to the various interventions aimed at promoting the optimal and proper use of antimicrobial agents, including aspects such as dosing, drug choice, administration duration, and administration route (Dyar et al., 2017).

As such, it is imperative for all healthcare professionals to be antimicrobials stewards by prescribing them optimally, while at the same time education their colleagues, patients, regarding the proper use of antimicrobial agents. The purpose of the stewardship is to enhance patient outcomes through the effective antimicrobials use, reduction of microbial resistance, while at the same time reducing infection spread especially because of multi-drug resistance organisms (Schuts et al., 2016). Thus, while administering the antibiotic to John, anti-microbial stewardship will be demonstrated, including ensuring the patient gets the right dosage, during the right period, and the appropriate antibiotics are used.

Quality Use of Medicines

            While administering the medications, it is imperative for nursing professionals to respect the various patient rights. These rights will be applied when administering the four medications to the patient. One of these rights to safe medication is the administering the medicine to the safe patient. This involves asking the patient his first and his last names to ensure that is the right one for the medication. Furthermore, it is also imperative to ascertain that the order matches the patient, which would involve comparing the medication with the symptoms that the patient is presenting. Additionally, it is also imperative to check whether one is administering the right medication (Hikaka et al., 2021). For instance, after ordering the medication to administer from the pharmacy, it is imperative to ensure that it is the correct one. One of the elements to lookout for is the label, where one has to ensure that it matches the order. Another consideration is to ensure that the medicine are not different and only look or sound like the intended medicine (Holloway et al., 2020).

            Another right to safe medication is ensuring that patients get their medicine in the right dosage. Before administering the medicines to John, it will be imperative to ascertain whether he needs to take whole, half, or multiple tablets to ensure he gets the right dose. Besides, one has to heck whether the dosage and the strength of the medication drug match with what is prescribed on the order (Hikaka et al., 2021). Check that the medication is administered during the right time is also imperative. When administering the medication to John. It will be imperative to verify whether the timing is correct, including aspects such as whether the medication needs to be taken before or after meals. It is also imperative to ensure that the specified interval passes, and that the patient had not taken similar medication before completion of the set interval. Ensuring that the medication is administered using the right route is also an important patient right. Furthermore, ensuring that the route matches the order, including considering elements such as whether one should mix the medication with other substances is critical. The final right when administering the medication includes ensuring that one maintains the right documentation, and documents after administering the medication (Hikaka et al., 2021).

Safety Considerations

            Furthermore, in line with evidence-based best practices, one will observe various safety measures while administering medication to the patient. One of these is planning the medication administration properly to avert any disruptions. It is imperative for nursing professionals to plan properly to ensure that disruptions do not affect the safe administration of medication, additionally, to avoid most disruptions, the dispensation of the medication will be in a quite area. It will also involve avoiding conversations with other people while administering the medication. Furthermore, it is also imperative to prepare the medications for a single patient at a time (Martyn & Paliadelis, 2019). This is critical for one to minimize the risk of mixing up medications, which can lead to unwanted outcomes.

Patient Centered-Care

            Furthermore, while administering the medications, it is imperative to use a patient-centered care. The concept refers to the recognition of the patient or designee as one who has the source of full control, as well as a full partner in the provision of coordinated and compassionated care that is based on elements such as respect for patient’s needs, values, and preferences (Håkansson Eklund et al., 2019). While treating John, it is imperative to integrate understanding of the various patient-centered care dimensions including their individuals, family, or community values and preferences, coordination as well as integration of care, education, communication, and information, family and friends’ involvement, and transition and continuity (Håkansson Eklund et al., 2019). Thus, in line with the concept of patient-centered care, some of the important considerations while treating John will include ensuring the patients values and preferences are considered, respecting and encouraging him to express his values, needs, and preferences. Others include valuing his expertise regarding his symptoms and health, and respecting the attitudes that he holds related to his social, cultural, or ethnical background.

Professional Standards

            Additionally, while planning to administer the medication to John, it is imperative to adhere to the seven rights involved in medication preparation. The initial one involves checking to ensure that the medication has not expired. Such medications may be less effective because of reduced strength, or they can be risky because of the various changes in the chemical composition of the involved drugs. Furthermore, studies have shown that some curtain medications that have expired tend to be at risk of bacterial growth, while expiration can also lead to sub-potent antibiotics, which are unable to treat infections. This can lead to antibiotic resistance and severe illnesses (Martyn & Paliadelis, 2019). The next important step is performing the appropriate hand hygiene before administering the medication. The step is instrumental to minimize the risk of passing infections to the patient (Oliveira et al., 2018).

            Moreover, before administering the medication, it is imperative to introduce myself to John. The step should be followed by checking of the allergy band for any types that the patient may be having. Such should include asking the patient regarding the types or the severity of reactions that they have for certain drugs or substances. Certain drugs are associated with some allergies, and it is imperative for nursing professionals to be aware whether patients are allergic to those drugs (Martyn & Paliadelis, 2019). Additionally, it is also imperative to conduct the appropriate focused assessments, vital signs, or laboratory values and to document them properly before the administration of the medications (Oliveira et al., 2018). Providing patient education to John would also be instrumental. At the same time, while administering the medications, it will be imperative to stop and not administer if the patient expresses some concerns or ask some questions regarding the medication.

Medication Errors

            While administering the medications, one of the most important elements that a nursing professional needs to be wary of is medication errors. It refers to the different types of preventable events that can lead to or cause inappropriate medication usage, or even harm when the medications is under the control of a consumer, patient, or healthcare professional. Medication errors can occur in any of the different phases involved in the medication use system including during the prescription of a drug, while entering details into a computer or databases, during the preparation or dispensation of a drug, or even when a giving the drug to a patient, or when the patient is taking it. Each year, numerous cases of medication errors are reported, which implies that the problem is widespread considering there are multiple cases that go unreported. Some of the outcomes of medication errors may include disability, death, hospitalization, or life threatening situations (Tariq & Yevgeniya Scherbak, 2019). Thus, while administering the various medications to John, it is imperative to be careful to avoid medication errors. Some of the steps to be taken to minimizing the chances of such errors occurring include ensuring patient information and drug information are accurate, effective communication with other team members including pharmacists and physicians, and ensuring that drug packaging, nomenclature, and labelling are accurate (Tariq & Yevgeniya Scherbak, 2019).

Conclusion

            Therefore, the case highlights the importance of following the appropriate medication administration procedures. The case involves a 67-year-old patient named John. The patient is presenting characteristics, and it is suspected that he acquired the infection causing these symptoms while previously admitted in hospital.  Furthermore, four medications are in treating the patient, and it is imperative to apply the appropriate quality and safety standards while administering the medications. Additionally, it is imperative to demonstrate antimicrobial stewardship considering treating the patient involves the use of an antibiotic. Besides, it is imperative to use a patient centered approach while administering the medications, which involves ensuring that one respects the views, values, and preferences of the patient.

References

Alcohol and Drug Foundation. (2016). ADF – Drug Facts – Ibuprofen. ADF – Alcohol & Drug Foundation. https://adf.org.au/drug-facts/ibuprofen/

Baumann-Birkbeck, L., Grant, G. D., Anoopkumar-Dukie, S., & Kavanagh, J. J. (2014). Drowsiness and motor responses to consecutive daily doses of promethazine and loratadine. Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology125(12), 2390–2396. https://doi.org/10.1016/j.clinph.2014.03.026

Dyar, O. J., Huttner, B., Schouten, J., & Pulcini, C. (2017). What is antimicrobial stewardship? Clinical Microbiology and Infection, 23(11), 793–798. https://doi.org/10.1016/j.cmi.2017.08.026

Håkansson Eklund, J., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., Sundler, A. J., Condén, E., & Summer Meranius, M. (2019). “Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Education and Counseling, 102(1), 3–11. https://doi.org/10.1016/j.pec.2018.08.029

Healthdirect Australia. (2019, December 23). Ibuprofen. Www.healthdirect.gov.au. https://www.healthdirect.gov.au/ibuprofen

Hikaka, J., Jones, R., Hughes, C., Connolly, M. J., & Martini, N. (2021). Ethnic Variations in the Quality Use of Medicines in Older Adults: Māori and Non-Māori in Aotearoa New Zealand. Drugs & Aging, 38(3), 205–217. https://doi.org/10.1007/s40266-020-00828-0

Holloway, K. A., Ivanovska, V., Manikandan, S., Jayanthi, M., Mohan, A., Forte, G., & Henry, D. (2020). Identifying the most effective essential medicines policies for quality use of medicines: A replicability study using three World Health Organisation data-sets. PLOS ONE, 15(2), e0228201. https://doi.org/10.1371/journal.pone.0228201

Jager, N. (2020). OUP accepted manuscript. Journal of Antimicrobial Chemotherapy. https://doi.org/10.1093/jac/dkaa187

Katelaris, C. H., Kurosawa, M., Moon, H.-B., Borres, M., Florvaag, E., & Johansson, S. G. O. (2014). Pholcodine consumption and immunoglobulin E-sensitization in atopics from Australia, Korea, and Japan. Asia Pacific Allergy4(2), 86–90. https://doi.org/10.5415/apallergy.2014.4.2.86

Martyn, J.-A., & Paliadelis, P. (2019). Safe medication administration: Perspectives from an appreciative inquiry of the practice of registered nurses in regional Australia. Nurse Education in Practice, 34(), 111–116. https://doi.org/10.1016/j.nepr.2018.11.007

NPS Medicinewise. (n.d.-a). APO-Flucloxacillin Capsules. NPS MedicineWise. https://www.nps.org.au/medicine-finder/apo-flucloxacillin-capsules

NPS Medicinewise. (n.d.-b). Phenergan [9202]. NPS MedicineWise. Retrieved May 8, 2021, from https://www.nps.org.au/medicine-finder/phenergan-tablets

Oliveira, J. K. A. de, Llapa-Rodriguez, E. O., Lobo, I. M. F., Silva, L. de S. L., Godoy, S. de, & Silva, G. G. da. (2018). Patient safety in nursing care during medication administration. Revista Latino-Americana de Enfermagem, 26(0). https://doi.org/10.1590/1518-8345.2350.3017

Schuts, E. C., Hulscher, M. E. J. L., Mouton, J. W., Verduin, C. M., Stuart, J. W. T. C., Overdiek, H. W. P. M., van der Linden, P. D., Natsch, S., Hertogh, C. M. P. M., Wolfs, T. F. W., Schouten, J. A., Kullberg, B. J., & Prins, J. M. (2016). Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis. The Lancet Infectious Diseases, 16(7), 847–856. https://doi.org/10.1016/s1473-3099(16)00065-7

Tariq, R. A., & Yevgeniya Scherbak. (2019, April 28). Medication Errors. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065/

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