Case Study – Nursing Assignment

NSB204 Mental Health: Self and others

Bachelor of Nursing

Assessment Task 2

 

Assessment name: Case study

Learning outcomes measured:

1. Apply principles of cultural safety and reflect on self to articulate the role of self in person-centred mental health care and therapeutic use of self.

2. Demonstrate and apply knowledge of the challenges

and factors that can compromise mental health for ourselves and others in order to promote positive mental health and wellbeing.

3. Conduct a biopsychosocial and mental status assessment to create a clinical formulation, informed by the recovery model, to enhance the provision of consumer focused care.

4. Describe key mental health issues and work with consumers and carers to address needs and promote recovery across the care continuum applying the Recovery Model.

5. Explain and apply knowledge of the Mental Health Act and mental health standards for practice.

Length: 1,800 words

Estimated time to complete task:

30 hours

Weighting: 40%

Individual/Group: Individual

Authentic Assessment: Yes

Formative/Summative: Formative and Summative

How will I be assessed: 7 point grading scale using a rubric

Due date: Friday 27th October submitted via Turnitin in your NSB204 Blackboard site by 4 pm. More information about Turnitin is available on the FAQs about Turnitin page.

Presentation requirements:

This assessment task must:

 be written in academic and second person style

 be written as an essay using full sentences and paragraphs

 the assignment cover sheet must be included as the first page of your document

 use 12 point font

 

 

 

 

NSB204 Mental Health: Self and others

Bachelor of Nursing

 use double line spacing

 include page numbers

 have headings to guide your work

 include your word count after each section. The assignment word count includes any words in the body of the assignment, including headings, in-text references and quotations. It does not include the title page, reference list or appendices.

 include a reference list on a new page

 use QUT APA referencing for citing academic literature

 be submitted in electronic format as a PDF document via Turnitin.

 Use QUT APA referencing for citing academic literature.

Task description: Aim

The aim of this assignment is to help you to begin to use your professional and clinical judgement and to think like nurses working in mental health settings and/or in relation to the mental health needs of people regardless of the setting. In order to achieve this aim, everyone will be assigned a case scenario involving a person who is experiencing difficulties relating to one of the various disorders commonly encountered in clinical practice. Case Study – Nursing Assignment

 

Description

This is an individual assignment of 1,800 words in two parts, each with several steps. Follow the steps for each part carefully.

 

Your assignment will demonstrate a sound grasp of the following as they relate to the person in your case scenario and include:

 a Mental Status Examination(MSE)  a clinical formulation including biopsychosocial

history and your own MSE observations leading to the clinical formulation

 a nursing orientated handover  use of Maslow’s hierarchy of needs to identity and

prioritise the person’s needs  recognising and responding to the mental health

needs of the identified person by identifying best practice nursing interventions

 how to engage a person in a therapeutic relationship

 the application of cultural safety  the application of the recovery model/philosophy

 

 

 

 

 

NSB204 Mental Health: Self and others

Bachelor of Nursing

You will need to justify your ideas with reference to relevant literature. Students who plan to do well in this assignment, will read and use the unit’s required readings as well as additional items drawn from respected academic sources.

What you need to do: Please follow the steps outlined below to answer this assignment question.

PART 1 Holistic assessment and planning: (1000 words +/- 10%)

This part does not always require full paragraphs. Use appropriate templates/tables to set out the MSE and 5Ps.

1.1 Introduction [150 words +/- 10%]

The introduction should briefly introduce the person set out in the case study materials. Following this, provide a synopsis of what you have written in your assignment. An introduction is not an outline of the assignment question. The Introduction needs to provide a brief story to the reader (your tutor) about the key points covered in your assignment. Case Study – Nursing Assignment

 

1.2 The Mental Status Examination [250 words +/- 10%]

• Provide a brief preamble about the importance of comprehensive assessment to mental health nursing care

• using the MSE format in your weekly tutorial guide provide a complete Mental Status Examination (MSE) of the person

• use specific examples from the case study materials to illustrate each part of the MSE

• you must use and define psychiatric terms accurately (e.g. Instead of “talks fast”, use the correct term “pressure of speech“, define it properly and cite your sources)

 

1.3 Clinical Formulation Table [200 words +/- 10%] • use information gathered from the MSE and the

biopsychosocial assessment (history of presenting complaint, family and social history, current living situation, the person’s strengths and coping strategies,

medical history) to complete a table under the headings of presenting, precipitating, predisposing, perpetuating and protective factors (5Ps) relevant to the clinical presentation of the person described in your case study.

 

1.4 Plan for Nursing Care [250 words +/- 10%]

1. • using Maslow’s Hierarchy of Needs, identify the nursing

 

 

 

 

NSB204 Mental Health: Self and others

Bachelor of Nursing

care needs of the person.

2. • identify the two (2) highest priority nursing care needs for the person and clearly indicate why they are the highest priority.

3. • outline your nursing care, focusing on one (1) nursing intervention for each of these needs and your rationale for each. That is, describe how the intervention assists the person to address or meet each need. Interventions must be nursing related, detailed, practical and within your scope of practice. Use relevant literature to support your chosen interventions.

4.

** NOTE: in part two you will be explaining how you would develop and use a therapeutic relationship with this person, and how cultural safety and the recovery model influenced your nursing care and choice of interventions

 

1.5 Clinical handover [150 words +/- 10%]

Synthesise (consider together) the results of your MSE and clinical formulation to construct a paragraph describing the person and their main concerns that you could present at a clinical handover meeting.

 

Note: This is not merely a repetition of the case study material – it is an analysis and synthesis of the material and the MSE to produce the clinical formulation that answers ‘why this person, why now, why with this presenting situation’. This is the information your colleagues need to know so they can continue working with the person when you go home. Remember to keep a nursing focus.

 

 

PART 2: Therapeutic engagement and clinical interpretation: (800 words +/- 10%)

5. This part of the paper is to be written in properly constructed sentences and paragraphs under each subheading (not dot points) and is to provide further description and depth to the assessment and care planning identified in Part 1. Case Study – Nursing Assignment

 

2.1 The Therapeutic Relationship [250 words +/- 10%]

6. Explain how and why a therapeutic relationship will be established with the person in your care. This must not be a general description of therapeutic relationships but demonstrate that you are applying therapeutic skills to this person. Then describe at least one (1) specific strategy appropriate for the development of a therapeutic relationship with this specific person and how it was

 

 

 

 

NSB204 Mental Health: Self and others

Bachelor of Nursing

applied in the nursing care interventions you described in Step 1.

7.

2.2 Cultural Safety [200 words]

8. Describe the first step you would take to ensure that you deliver culturally safe care to this person.

9. Then identify and describe one (1) issue that working with this person might present for you. Describe which of the principles of cultural safety you used in applying cultural safety in the nursing care interventions you described in Step 1.

10.

2.3 Recovery-oriented Nursing Care [350 words]

Consider the nursing interventions you developed in Step 1. Describe how these nursing interventions take the principles of the Recovery Model/Philosophy into account and relate these to your specific person’s recovery process. Case Study – Nursing Assignment

 

Conclusion

There is no requirement for a conclusion for this assignment.

Resources needed to complete task:

 The readings, lectures and tutorial materials provided on BB. Remember, this assignment is designed to assess how well you have learned the information presented throughout this unit.

 Learning through reflection web site.

 QUT Cite|Write APA guide.

 Turnitin Tip Sheets.

 

 

 

 

 

NSB204 Mental Health: Self and others

Bachelor of Nursing

NSB204 Mental Health: Self and Others – Rubric for Assessment Task 2

Name:

Learning outcomes assessed: 1, 2, 3, 4 and 5 Weighting: 40%

Criteria 7 6 5 4 3 2 – 1

MSE & Clinical Formulation (CF)

Weighting: 25%

LO: 2, 3

In your assessment you: Used the MSE effectively to present a complete mental status assessment & accurately developed and presented a table addressing all 5Ps, always using examples from the case study materials. You clearly defined and referenced major terms and applied them accurately.

In your assessment you: Used the MSE appropriately to present a mental status assessment & accurately developed and presented a table that mostly addressed the 5Ps often using examples from the case study materials. You defined and referenced major terms and used them accurately.

In your assessment you: Used the MSE to present a partial mental status assessment & developed a table that partially addressed the 5Ps using examples from the case study materials. You mostly used and referenced psychiatric terms.

In your assessment you: Used the MSE to present aspects of a mental status assessment & attempted a table of the 5Ps, occasionally using examples from the case study to illustrate several items in the MSE. You sometimes used and referenced psychiatric terms accurately.

In your assessment you: Failed to use/misunderstood the MSE & misunderstood the 5Ps & did not use examples from the case study to illustrate the items in the MSE. You used vernacular only and/or misunderstood/ misused psychiatric concepts and did not reference them.

In your assessment you: Did not meet the requirements of the set task.

Planning and Prioritising Care

Weighting: 20%

LO: 4, 5

Accurately identified needs by correctly applying Maslow’s Hierarchy. Complete understanding demonstrated through accurate prioritising of care. Provided a comprehensive, entirely relevant clinical handover.

Provided a substantial assessment of needs using Maslow’s Hierarchy. A high level of understanding demonstrated through accurate prioritising of care. Provided a thorough, very relevant clinical handover.

Provided an assessment of needs using Maslow’s Hierarchy. A good level of understanding demonstrated through prioritisation of care. Provided a very good clinical handover.

Identified some needs but they were not correctly prioritised. An adequate level of understanding demonstrated by some prioritisation. Provided an adequate clinical handover.

Incorrectly identified needs and incorrectly prioritised those needs. Little or no understanding demonstrated. Poorly constructed clinical handover.

Did not meet the requirements of the set task. Case Study – Nursing Assignment

 

 

 

 

NSB204 Mental Health: Self and others

Bachelor of Nursing

Therapeutic Relationship & Cultural Safety

Weighting: 20%

LO: 1

Accurately described issues concerning the therapeutic relationship and cultural safety. You fully understood key issues and related these to the person discussed. Your discussion was always supported by reference to high quality literature.

Accurately described issues concerning the therapeutic relationship and cultural safety. You mostly understood key issues and related these to the person discussed. Your discussion was often supported by reference to high quality literature.

Provided a mostly accurate description of the issues concerning the therapeutic relationship and cultural safety. You partially understood key issues and related these to the person discussed. Your discussion was mostly supported by reference to good quality literature.

Provided an adequate description of the issues concerning the therapeutic relationship and cultural safety. You superficially understood some of the issues related to the person discussed. Your Discussion was rarely supported by reference to literature.

Did not provide a description of the issues concerning the therapeutic relationship and cultural safety. You did not demonstrate understanding of the issues related to the person discussed. Your discussion was not at all supported by reference to literature.

Did not meet the requirements of the set task.

Recovery-oriented Nursing Care

Weighting: 20%

LO: 1, 2, 3, 4

Provided accurate, comprehensive nursing interventions for each of the two priorities of care, carefully supported by quality literature.

Accurately linked nursing care to the recovery principles to demonstrate recovery- oriented care.

Provided well developed nursing interventions for each of the two priorities of care, well supported by the literature.

Accurately linked nursing care to the recovery principles to demonstrate recovery- oriented care.

Provided very good nursing interventions for each of the two priorities of care, well supported by the literature.

Accurately linked nursing care to the recovery principles to demonstrate recovery-oriented care.

Provided adequate nursing interventions for each of the two priorities of care, with occasional reference to the literature. Case Study – Nursing Assignment

Linked nursing care to the recovery principles to demonstrate recovery- oriented care.

Provided nursing interventions that were not well linked to the person’s nursing care needs.

Did not demonstrate an understanding of recovery-oriented nursing care.

Did not meet the requirements of the set task.

Communicates in writing incorporating expected information literacy standards

Weighting: 15%

 

Maintained appropriate standards of academic integrity. Met the presentation requirements. Consistently used professional non-discriminatory language. Expressed your ideas clearly, concisely and fluently with correct

Maintained appropriate standards of academic integrity. Met, for the most part, the presentation requirements. Almost always used professional non-discriminatory language. Expressed your ideas concisely and fluently

Maintained appropriate standards of academic integrity. Met several aspects of the presentation requirements. Mostly used professional non-discriminatory language. Usually expressed your ideas clearly with correct spelling and grammar.

Maintained appropriate standards of academic integrity.

Met a few aspects of the presentation requirements. Sometimes used professional non-discriminatory language. Expressed your ideas clearly.

Suspected failure to maintain appropriate standards of academic integrity.

Met few aspects of the presentation requirements. Rarely used professional non-discriminatory language. Ideas were not

Suspected failure to maintain appropriate standards of academic integrity.

Ignored presentation requirements. Did not use professional non-discriminatory language. Ideas were not expressed clearly.

 

 

 

 

NSB204 Mental Health: Self and others

Bachelor of Nursing

spelling and grammar. Consistently and accurately cited sources & applied QUT APA style of referencing.

Kept to word limit.

with correct spelling and grammar. Almost always cited sources correctly & applied QUT APA style of referencing.

Kept to word limit.

Mostly cited sources correctly and applied QUT APA style of referencing.

Kept to word limit.

Occasionally cited sources and sometimes correctly applied QUT APA style of referencing.

Kept to word limit.

expressed clearly. Rarely cited sources or correctly applied QUT APA style of referencing.

Was under or over the word limit.

Rarely cited sources or correctly applied QUT APA style of referencing.

Was significantly under or over the required word limit.

 Satisfactorily complied with the Academic Integrity standards outlined in the MOPP C/5.3 Academic Integrity.

 

 

 

 

Tania

Tania is a 20 year old woman who is studying to be a lawyer. She lives in the city area with her parents who are both busy doctors, and her younger brother Dylan, who s h e describes as outgoing and popular and who is also studying law. Tania describes the family as very close and loving despite both parents working long hours. Tania began preparing meals for the family 12 months ago but now refuses to eat with them. S he p ref er s to t a ke he r me a ls i nto he r be dr oom a nd cla im s tha t she i s s tud yin g whi le sh e eat s . Her weight has dropped from 66kg to 40kg in the past year. She is 164cm tall. Case Study – Nursing Assignment

The parents are very concerned about Tania’s weight loss, her food restrictions and what they describe as excessive exercising over the last six months. They point out that she has been dieting off and on since she was 14 years old but this is the first time that they have been troubled by such “severe weight loss”. The parents report that Tania had been an exceptional child who achieved all of her developmental milestones in good time. Tania denies vomiting or laxative abuse but believes she needs to continue losing weight as she is “fat”. She believes her parents are making a fuss over nothing and she cannot understand their concerns. She believes they are interfering in her life and simply can’t accept that she is now an independent adult. This is causing increasing disharmony and arguments between the family members. Tania appears very thin and looks much younger than her 20 years. She has dark circles under her eyes, obscured initially by wearing dark sunglasses into the room. She has soft downy hair apparent on her arms otherwise there are no remarkable distinguishing marks, scars or tattoos apparent. She wears a little makeup that is appropriately applied and has her long brown hair pulled back into a pony tail. She is wearing gym wear with a loose and baggy sweat shirt on top. Tania reports that she does not smoke cigarettes or use drugs. She has not consumed alcohol for more than a year because “they are empty calories”. She is not prescribed any medications but says she takes a multivitamin and spirulina tablets daily. She has a few close friends and some acquaintances at uni. She has not gone out with her friends in recent months because she says she has felt under pressure with her studies.

Tania describes her childhood as “wonderful” and without any traumatic events. She says she has a loving family and felt well supported until recently. She did well at school and has been doing exceptionally well at uni. She is completing the second year of Law and currently has a GPA of 6. However, she admits that she has been having difficulty concentrating recently and has had to apply for assignment extensions. Tania does not have a history of mental illness or mental health concerns. There is no family history of mental illness either. She is usually physically well but she has been seen by the family GP over the last two months for gastrointestinal disturbances (feeling bloated and constipated) and feeling faint on some occasions. She was advised to eat more fiber and to have an ECG. Case Study – Nursing Assignment