Patient-Centred Case Study and Practice Assessment Document

1) Patient centred case study (3000 words). The focus will be on one patient the student has cared  for on a medical or surgical nursing ward/unit/ in the community in theatres/recovery or in a  prison.

2) Practice Assessment Document (to be handed to the Faculty Office with a Header sheet) date to be advised.

The 4 Learning Outcomes that are assessed by the patient centred case study include:

1) Demonstrate explicit knowledge of the principles of surgical and medical care in adult nursing  both within the hospital and the community

2) Apply the principles of surgical and medical nursing to assess and develop care plans in  partnership with multi agency team for various medical and surgical conditions within the hospital  and the community setting

3) Demonstrate explicit knowledge and understanding of national policies and local strategies and  how these impact on the individual patient.

4) Implement national and local guidance and strategies to support practice within the students'  sphere of practice.

1) Select a patient they have cared far on a medical or surgical ward/unit/other area.

2) Identify how the patient was admitted to hospital, their presenting complaint and the care  pathway they followed.

3) Discuss the overarching nU7sing assessment used to identify the patients* problems on admission.

4) Critically analyse one element of care given to the patient during their admission.

5) Ensure the discussion refers to relevant local and national policies and strategies and multi  professionals involved in the patients care.

6) Analyse any potential discharge plans that may be requifed to ensure the patient remains safe  when they return home,

Case Study: Introduce your chosen patient, explain how and why they presented to the hospital.(Remember your chosen patient has to have a medical or surgical condition and a reason for admission to hospital/unit/prison).

Specify the following information (you should be able to derive this information from the patients  medical and nursing admission notes):

1) What was their admission care pathway? Were they referred by their GP, via A+E, via outpatients  or another route? Did they come by ambulance or public transport?

2) What was there presenting complaint and associated symptoms? Why do they need admission, what is the definitive diagnosis and medical plan of care?

3) Who was involved in their admission process? Who were they admitted under? E.g. cardiologist.

What type of ward were they admitted to, was this the correct clinical area? Were they transferred  from one ward to another before arriving with you? Why was this?

Patient-Centred Case Study

For Example: (This is a very brief example, yours should be about 500 words long with references,  be sure to include all the information required in the 3 questions above.

"On admission to the surgical assessment unit a full nursing assessment was carried out using the  nursing model introduced by Roper et al (1996). This model assesses the 12 activities of daily  living which is important to determine the care needs of the patient. Mr Smith had been placed on a  nil by mouth order until the cause of the abdominal pain could be determined. This was deemed necessary by the Surgeon in case Mr Smith required emergency surgery in which case he would need  ro/ost/or at least 6 hours to reduce the volume of stomach acidity and Contents prior to general  anaesthesia (Brady et al, 200JJ. Therefore, it could be argued that Mr Smith had very specific care  needs in relation to eating and drinking ond this is the chosen activity of daily living rhot will  be critically analysed and discussed in this case study.

It is impartant for nurses to remember that fasting should be kept to a minimum amount of time  where possible and IV fluids should be given to maintain hydration (Long et al, 2011). There is  also clear guidanCe from National Institute of Clinical Excellence (NICE) regarding fasting times  and what fluid replacement therapy should be given to patients whilst they remain nil by mouth  (NICE, 20O8J.”

This needs to be a summary of your findings in relation to the nursing care given 1o  your chosen patient for the one element of care you identified. There should be nothing new here  and no new references. Please refer to all 4 learning outcomes, as you did in the introduction.

This case study has explored the nursing care delivered to a patient who was admitted to a surgical  assessment unit with central abdominal pain. Mr Smith was assessed used a nursing model designed by  Roper et al (1996). This assessment determined an immediate care need in relation to eating and  drinking. As Mr Smith was admitted with abdominal pain and he was kept nil by mouth until the cause  of his pain could be determined. In accordance to national guidance for the management of acute  abdominal pain (NICE, 2012), Mr Smith was prescribed IV fluids to maintain his hydration whilst nil by mouth. This wa› important to ensure his condition was not exacerbated by dehydration. Whii t « the unit, Mr Smith was referred to the dietician to ensure that his nutritional needs could be met whilst he remained nil by mouth. As the role of the nurse is to ensure the safety of patients ‹n regards to all their care needs it is vital to ensure that all needs are addressed and that local and national policy/strategyand guidelines are adhered to where appropriate.