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Medicare, Medicaid, and most private health insurers provide a variety of end-of-life (palliative) care services for patients who are hospitalized or in hospice care, and families can also qualify for caregiver support services. The types of services and out-of-pocket expenses vary widely, though, with debates about responsibilities and costs.

In this assignment, you will select a case for which you are familiar or have an interest involving end-of-life care decisions. You will prepare a case analysis using the IRAC (Issue, Rule, Analysis, Conclusion) method.

Step 1. Research
Using the ACE online library, research the cases involving Karen Ann Quinlan, Nancy Cruzan, and other similar cases.

Step 2. Analyze
Using the IRAC method (Issue, Rule, Analysis, and Conclusion), provide an analysis of a case. See information about the IRAC method linked on the Learning Objects page.

Step 3. Discuss
Discuss the role of culture, ethics, and law in the decision-making process.

Step 4. Summarize
Summarize the case and describe the impact of the case on today's laws on end-of-life care decisions.

Step 5. Reflect
Write a conclusion reflecting on the status of healthcare regulation and its effects on ethical considerations such as end-of-life decisions. What do you feel is the role of a healthcare administrator in influencing regulations and ethics within healthcare organizations? See the Learning Objects page for some possible resources to consider in your reflection.

Step 6. Compile
Compile all content from Steps 1-5 into a 2-to-4-page, APA-formatted paper along with title and references pages.

Assessment Task:

Purpose: This assessment enables students to demonstrate a clear understanding of the application of professional ethics in healthcare practice. The focus will be on balancing the principles of beneficence and non-maleficence, and the professional responsibilities that arise when these principles intersect.

Task:
Students will reflect on the provided case study and answer the following questions:

1. Briefly explain how the principles of beneficence and non-maleficence apply to the provided case study.
   (250 words)

2. Discuss three (3) ethical dilemmas that may arise from the healthcare professional's actions in relation to these principles.
   (350 words)

3. Identify and discuss two (2) professional virtues (e.g., honesty, integrity) that were either upheld or violated in this scenario, and explain how they contributed to the outcome.
   (400 words)

4. Provide two (2) recommendations for healthcare professionals to better balance beneficence and non-maleficence in their practice, with practical examples for improvement.
   (400 words)

5. Reflect on the role of patient autonomy in this case and outline three (3) ways it can be respected while ensuring patient safety.
   (350 words)

Submission Guidelines:

• Submit the completed assignment via the provided template.
• Use a minimum of 10 high-quality, peer-reviewed sources to support your arguments.

Assessment 2: Project

Purpose: This assessment enables students to demonstrate sound understanding of the application of professional nursing standards, national health standards, and organizational policy related to patient deterioration and a sentinel event. Students are given the opportunity to complete a root cause analysis (RCA) for one of two provided case study options.

Task:
Students will complete a root cause analysis, following the instructions below:

1. Briefly discuss how the identified root cause has led to the outcome for the patient.
   (250 words)

2. Discuss three (3) contributing factors which have likely led to this sentinel event.
   (350 words)

3. Identify and discuss two (2) separate NMBA RN Standards which were not practiced or maintained by the nurse(s) involved in this sentinel event, that may have led to the identified root cause. You need to identify and discuss specific sub-standards (e.g. standard 7.2, not just standard 7).
   (400 words)

4. Identify and discuss two (2) separate National Safety and Quality Health Service (NSQHS) Standards which were breached (or not met) in this scenario, that may have led to the identified root cause. You need to identify and discuss specific actions items (e.g. Clinical Governance Standard, action 1.03).
   (400 words)

5. Outline three (3) recommendations to address the contributing factors you identified from the chosen case study (from question 2). These recommendations need to include practical examples and identify who is responsible for actioning these recommendations.
   (350 words)

Submission Guidelines:

• Use the provided template to complete the assessment.
• Include at least 15 high-quality sources in the reference list.

NRSG378 Extended Clinical Reasoning – Assessment 2 Project Root Cause Analysis (RCA) Report

Using the provided case study on either Mrs Bentley’s surgical infection or Mr Jeffries’ medication error, address the following questions and instructions:

1. Discussion of Identified Root Cause: Based on the case study, identify the primary root cause of the incident. Discuss how this root cause led to the adverse outcome, considering relevant medical knowledge and patient data. (400 words)

2. Identification and Discussion of Contributing Factors: Identify at least two contributing factors that exacerbated the incident. Discuss how each factor played a role in the outcome and connect them to evidence from healthcare practice or literature. (500 words)

3. NMBA RN Standards for Practice: Identify and explain which Nursing and Midwifery Board of Australia (NMBA) Registered Nurse Standards for Practice were breached in this case. Provide detailed examples from the scenario that demonstrate the breach of each standard. (300 words)

4. Links to National Safety and Quality Health Service (NSQHS) Standards: Identify and discuss two specific NSQHS Standards that were not met in the scenario and how they relate to the root cause. Mention the specific action items from the NSQHS Standards. (400 words)

5. Recommendations: Provide three recommendations to address the contributing factors identified. Include practical examples of how these recommendations can be implemented and identify who will be responsible for carrying out each recommendation. (400 words)

NRSG378 Assessment 2: Root Cause Analysis Project

Based on the case study options provided, complete the following tasks:

1. Case Study Selection: Choose either Case Study Option 1 (Mrs Bentley’s surgical incident) or Case Study Option 2 (Mr Jeffries’ medication error). Clearly identify which case study you have selected.

2. Incident Overview: Provide a brief summary of the incident, including the key events and patient outcomes. Ensure that your summary highlights the main issue in the case study. (300 words)

3. Root Cause Identification: Using the information from the case study, identify the root cause of the incident. Explain why this was the root cause, considering all contributing factors, such as human error, environmental factors, or procedural failures. (400 words)

4. Implications for Patient Safety: Discuss the implications of the identified root cause for patient safety. How did this issue affect the patient’s health, and what potential risks could it pose in similar situations? (350 words)

5. Preventative Measures: Recommend at least two strategies or preventative measures that could have been implemented to avoid this incident. Justify your recommendations using evidence from the literature. (400 words)

6. Conclusion: Summarize the key points discussed in your response, including the importance of root cause analysis in preventing similar incidents in healthcare settings. (200 words)

Assessment Task – Qualitative Research Interviews

Using the guidance provided in the article "Twelve Tips for Conducting Qualitative Research Interviews" by Cormac McGrath, Per J. Palmgren, and Matilda Liljedahl (2019), address the following questions:

1. Interview Appropriateness: Identify when it is appropriate to use qualitative research interviews as a data-collection method. Provide examples where qualitative interviews would be most effective in understanding a phenomenon. (250 words)

2. Preparation as an Interviewer: Describe the importance of preparing yourself as an interviewer. What practical and conceptual steps should you take to ensure successful interviews? Provide references to the article to support your explanation. (300 words)

3. Interview Guide Construction: Explain how to construct a semi-structured interview guide. What are the key considerations when developing questions, and why is it important to test them before actual interviews? (300 words)

4. Cultural and Power Dynamics: Discuss the role of cultural and power dimensions in qualitative interviews. How can an interviewer address potential challenges related to these factors? (200 words)

5. Data Co-Creation and Listening: Explain the role of the interviewer as a co-creator of data and the importance of listening more than talking during the interview process. Provide strategies for effective listening and data collection. (350 words)

6. Handling Emotions and Early Analysis: Describe how an interviewer should handle unexpected emotions from interviewees and explain why it is important to initiate data analysis early. (300 words)

Provide detailed answers, and reference the original article where necessary. Ensure that your responses reflect a clear understanding of the concepts outlined in the article.

Discharge Planning Checklist

Health Support Medication Equipment

During your hospital stay, your health team will work with you to create a plan for your discharge. Preparing to leave hospital is important because it assists in a smooth transition from hospital and helps prevent readmission.

Things to consider when planning for your discharge are:

Your Health

• Have all your questions about the health condition that brought you to hospital been answered?
• Do you know what symptoms to watch for when you go home? It is important to understand when you might need medical assistance.
• Are there dietary requirements you need to prepare for?
• What exercises do you need to continue at home?
• Do you have all the information you need to stay safe when you leave hospital? For example: preventing falls.
• Is there any education or training to prepare you for your return home?
• Do you have any concerns about how you and your family are coping with your health? If you do, ask your health team for information about support groups and other resources you may be able to access.

Your Health Records

• Ask for a copy of your discharge summary.
• Ask for a copy of your Patient Medication List.
• Ask for copies of any x-rays, scans, and/or test results.

Your Transport

• Have you confirmed transport from hospital to your destination?
• Are there any transport costs you need to prepare for?
• If you live in a regional area, do you need to access the Patient Assisted Travel Scheme?
• Will you need to organise transport to get to appointments, collect medications, and other essential items?

Your Support Needs

• Have you confirmed with your support networks (family, carer, friends) who can help with daily tasks when you return home?
• Are you connected with the appropriate services?
• Have your support networks and service providers been trained by hospital staff to:
  • Use any new equipment you will require at home?
  • Assist with daily health-related tasks? For example: changing a bandage, giving an injection, and wound care.
• Are you eligible for any outpatient or at-home programs provided by the hospital?

Your Medications

• Do you have any questions about the medications on your Patient Medication List? This includes any changes to medications, vitamins, and/or supplements you were taking before your hospital stay.
• If you need assistance with your medications when you leave hospital, has the person assisting you been properly trained?
• Will you be provided with any medications on discharge?
• How will your medications be packaged and stored when you leave hospital? For example: Webster pack or an automated dispensing kit.
• Ensure you have prescriptions and/or referrals for medications and supplements before you leave hospital.

Your Equipment and Home Modifications

• Ask your health team when your equipment and home modification needs will be assessed.
• Ask for an equipment and home modification schedule:
  • What is needed?
  • When will it be provided?
  • What are the costs?
  • How will any equipment and home modifications be funded?
  • Who will organise hire and/or purchase of the equipment?
  • How will any new equipment be transported to your home?
  • Who will be coordinating any home modifications?

Your Appointments

• Do you have a list of appointments and referrals scheduled after you leave hospital? What is the appointment, who is the appointment with, and where is the appointment?
• Make sure any referrals for outpatient services have been made. Confirm where your outpatient services will be provided.

Download the Manage My Care App

This is a free app that can track public outpatient appointments and referrals in WA. For more information, visit www.healthywa.wa.gov.au/Managemycare

Final Checks Before Leaving Hospital

• Don’t be afraid to ask questions.
• It is important to be honest about how you feel.
• An advocate is a person who can help you with a problem. It may be a family member, friend, or professional advocate. They will speak up for your rights and interests, for example: by supporting you at meetings.
• To find a professional advocate, search on the Ask Izzy website: www.askizzy.org.au

NRSG372: Chronic Illness and Disability
ASSESSMENT INFORMATION

Assessment Title
Assessment Task Two - Written Assignment

Purpose
This assessment will enable students to articulate their knowledge and understanding of the management of patients with chronic illness and disability. The task provides students with an opportunity to engage with a health consumer and gain insight into the impact chronic illness and/or disability has on the consumer’s life. Students are expected to plan person-centered care and patient education in partnership with the consumer. Students must apply specific selected frameworks (e.g., health behavior theory) to demonstrate critical thinking, clinical reasoning, and the principles of caring for people with chronic illness or disability.

Time Due
14:00

Weighting
50%

Length
2000 words (+/- 10%; includes in-text citations, excludes reference list)

Assessment Rubric
Available via the ‘Rubrics’ tab of the NRSG372 Canvas unit.

Resources
A National Q&A Session will be held during week seven (7) of the semester. The Q&A session will unpack the assessment requirements, providing an opportunity to ask questions or seek clarifications. You are strongly encouraged to attend this session. A recording of the session will be made available post-event on the ‘Modules’ tab under Assessment 2: Explanatory Video and Q&A.

LOs Assessed
LO1, LO2, LO3, LO5, LO6

Task
You are required to conduct a face-to-face, phone, or video call interview with a real person in your community who has a chronic illness or disability to discover the impact this has on their life. Prepare thoroughly for the interview by reviewing McGrath, Palmgren & Liljedahl's (2019) twelve steps for conducting research interviews (linked in Canvas). Based on the interview and in collaboration with the interviewee, identify two (2) relevant care priorities.

For each identified care priority:

• Outline and discuss one (1) SMART goal.
• Develop one (1) health education plan relevant to help the person meet the SMART goal.

You are expected to incorporate relevant nursing literature to support all aspects of the assignment, including pathophysiology, priorities, SMART goals, health behavior theory, and education plan.

Consent Form
You must gain written consent from your interviewee prior to conducting the interview and inform them they may be contacted to confirm consent. Evidence of the interview should be demonstrated through the consent form and unique circumstances outlined in your essay. Without a consent form, the assignment will receive a zero (0).

Safety

• Confidentiality must be maintained, and pseudonyms should be used.
• You are not to diagnose conditions or suggest treatments to the interviewee.
• People under 18, carers, ACU students, or those with mental health conditions are not to be interviewed.
• Do not approach strangers for interviews or put yourself at risk. Contact the LIC if your interviewee becomes upset.

Paragraph Structure

• Introduction: Introduce the interviewee with a pseudonym, their condition(s), and the two care priorities.
• Para 1: Overview of the interviewee and their condition, including where they sit on the Roper Logan Tierney Model of dependence/independence.
• Para 2: Overview of the pathophysiology of the chronic condition, relating it to the interviewee's experience.
• Para 3: Discuss the first care priority and why it is relevant.
• Para 4: Describe the first SMART goal and how it addresses the first priority.
• Para 5: Detail the health education plan for the first SMART goal, incorporating health behavior theory.
• Para 6: Discuss the second care priority and its relevance.
• Para 7: Describe the second SMART goal and its connection to the second priority.
• Para 8: Detail the health education plan for the second SMART goal, incorporating health behavior theory.
• Conclusion: Summarize the key points and next steps.

Submission
Submit your assignment via the 'Assignment' tab on Canvas. Include two files:

1. The completed consent form.
2. The written assignment.

FORMATTING

• File format: .doc or .docx
• Font: 11-point Calibri or Arial
• Spacing: 1.5 spacing including the reference list
• Paragraph: Indent the first line of each paragraph 1.27cm

REFERENCING

• Style: APA 7th
• References: Minimum of 18 high-quality resources, published in the last 5 years

ADMINISTRATION

• Late penalties will apply, starting from 14:01 on the due date.

Final Assignment Marks
Marks for the final assessment will be withheld until after grade ratification.

Assessment 2: Written Assignment

Weighting:
50%

Length and/or Format:
2000 words +/- 10%

Purpose:
This assessment will enable students to articulate their knowledge and understanding of the management of patients with chronic illness and disability. The task provides students with an opportunity to engage with a health consumer and gain insight into the impact chronic illness and/or disability has on the consumer’s life. Students are expected to plan person-centered care and patient education in partnership with the consumer. Students must apply specific selected frameworks (e.g., health behavior theory) to demonstrate critical thinking, clinical reasoning, and the principles of caring for people with chronic illness or disability.

Assessment Task Guide:
Please carefully review the assessment task guide, which can be accessed and downloaded here.

Assessment Task Rubric:
Please carefully review the assessment rubric, which can be accessed and downloaded here.

Learning Outcomes Assessed:
LO1, LO2, LO3, LO5, LO6

How to Submit:
The assessment is to be submitted via the 'Assignment' tab of the NRSG372 Canvas unit. Refer to the assessment task guide for detailed submission instructions.

Consent Form:
You must submit a consent form that has been completed by your interviewee. The consent form can be accessed here.

Return of Assignment:
Feedback and marks for the final assessment (assessment two) of NRSG372 will be withheld until after grade ratification and release.

Preparing for the Interview – Tips and Tricks:
Click here to view the file on preparing for the interview.

Submit your completed assignment through the designated Canvas dropbox and ensure that your work is organized, supported by credible sources, and follows the required format.