NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit
Grand Canyon University NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit –Step-By-Step Guide
This guide will demonstrate how to complete the Grand Canyon University NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit
Whether one passes or fails an academic assignment such as the Grand Canyon University NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit
The introduction for the Grand Canyon University NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
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How to Write the Body for NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit
After the introduction, move into the main part of the NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NRS 460 Benchmark – Case Study: Timothy Smith – Medical Surgical Unit
PART II: Critical Thinking Activity
Use the findings from your evaluation to complete the following:
Plan of CareWhen assuming care of this patient, you were told that the plan for Mr. Smith is to be discharged home tomorrow. This was not the plan when you took care of Mr. Smith yesterday. | |
| Part 1: Evaluate Outcomes of Care 1. Evaluate Mr. Smith’s readiness for discharge based on the information provided in the case study. Based on your findings, evaluate health goals for this patient. Discuss how you would modify the plan of care. Your response should be a minimum of 200 words. | Adequate discharge planning is important in Mr. Smith’s case study. The planning is an interdisciplinary process that promotes successful patient transition from the hospital to post-hospital care. Successful discharge planning also influences other outcomes such as recovery, readmission rate, patient satisfaction, and complication rates. I believe that Mr. Smith is not ready for discharge. Dimensions of readiness for discharge such as physical, psychological, adequate support, and social and organizational determinants have not been met. For example, satisfactory physical functioning has not been established in Mr. Smith’s case. He has not been educated and shown how to use assistive devices, which will improve his functioning post-discharge. The healthcare team has not weaned him off oxygen. They have not established care teams that will ensure his follow-up post-discharge. Mr. Smith’s family has not been adequately involved in the discharge planning process. The nurse has also not established support systems and care options that would facilitate Mr. Smith’s recovery. Mr. Smith’s psychosocial needs have also not been met. The psychiatrist established mental health problems, which should be managed before his discharge (Gledhill et al., 2021). Therefore, his readiness for discharge has not been established. Mr. Smith’s health goals are varied. One of them is to ensure that he is competent in the use of assistive devices. The other goal is to ensure that Mr. Smith is free from ventilator support. The third goal is to ensure that adequate psychosocial support is available for Mr. Smith following his hospital discharge. The other goal is to ensure Mr. Smith’s smooth transition from hospital to post-hospital care. I would modify the discharge plan by involving an interdisciplinary team. I will seek their input in assessing if Mr. Smith meets the requirements for hospital discharge. I will also collaborate with the interdisciplinary team in developing appropriate interventions to achieve pre-hospital discharge goals (Weiss et al., 2020). I will involve Mr. Smith’s family in the discharge planning process. |
| 2. Based on your assessment, how would you recommend modifying the plan of care to meet Mr. Smith’s needs? Your response should be a minimum of 150 words. | One of the modifications that I would recommend for Mr. Smith’s needs is ensuring that physical therapy is involved in the discharge planning process. The physical therapist should assess Mr. Smith’s ability to use assistive devices such as crutches before discharge. The second recommendation would be to involve Mr. Smith’s mother in the discharge planning process. Mr. Smith’s mother will help determine adequate support available for Mr. Smith and alternative discharge pathways that might be considered. Thirdly, I would recommend a psychiatrist to be involved in the discharge planning. The psychiatrist will provide an accurate assessment of Mr. Smith’s psychological health and his acceptance level. The psychiatrist will also help determine the care pathways that would be incorporated into the discharge plan for optimum care outcomes. The other recommendation would be adopting a step-down approach to Mr. Smith’s respiratory support. Mr. Smith is currently on 2L oxygen via a nasal cannula. The oxygen should be decreased gradually while his respiratory status is monitored to prevent complications post-discharge (Sakkers et al., 2021). These considerations would ensure a smooth transition from hospital to post-hospital care. |
| Part 2: Protocol What protocol would you use to implement your recommendations for Mr. Smith’s updated plan of care? Your response should be a minimum of 200 words. | I would use the Plan-Do-Study-Act (PDSA) model to implement my recommendations. The PDSA is a framework used in healthcare to make positive changes in healthcare systems and processes. The framework promotes rapid improvements in healthcare systems. It recognizes outcome improvements through small and frequent changes instead of big moves. I will incorporate interdisciplinary collaboration when implementing changes using the PDSA framework. Specifically, I will guide the interdisciplinary team to answer questions related to the goal of the changes, assessing if the goals have been achieved, and the things that must be done to achieve the goals. We will utilize the model by engaging in several steps. The first one would be assessing the scope and nature of the problem. The nature and scope of the problem would be Mr. Smith’s lack of readiness for hospital discharge. As a result, the interdisciplinary team will collaborate in assessing Mr. Smith’s needs and changes that must be implemented to ensure readiness for hospital discharge. The interdisciplinary team should then plan specific strategies that must be implemented, team members to be involved, and measures to be used to determine if the goals have been achieved or not. The change strategies before hospital discharge will then be implemented, data collected, and be used to indicate readiness for hospital discharge (Moullin et al., 2020). The PDSA framework will promote systematic improvements in the approaches utilized in determining the readiness for the discharge of patients in the facility. |
Recovery and Response to TreatmentConsider Mr. Smith’s history of PTSD and depression. | |
| Discuss the impact his PTSD and depression history might have on his recovery and response to treatment. Your response should be a minimum of 150 words. | PTSD and depression might affect Mr. Smith’s recovery and response to treatment. Patients with PTSD and depression have a depressed mood. They might also have other symptoms such as lack of motivation and energy, helplessness, guilt, and lack of interest and pleasure. These symptoms might affect Mr. Smith’s treatment adherence and, hence, outcomes. Patients with major depression might also have suicidal thoughts, attempts, or plans. Mr. Smith suffered multiple injuries from the accident, which predisposed him to worsening depression. He is also likely to suffer poor quality of life, decreased functioning, and dependence on others. The changes in his functioning and quality of life are likely to result in poor treatment adherence and adverse events such as suicidal attempts, which would affect recovery and treatment. Studies have shown the increased risk of complications such as surgical site infections, wound complications, and non-union, emergency department visits among patients with comorbid depression post-hip fracture surgery (Broggi et al., 2021). Therefore, PTSD and depression might affect negatively Mrs. Smith’s recovery and treatment response. |
ComplicationsConsider Mr. Smith’s history of PTSD and depression in addressing the following questions. | |
| Discuss the overall complications that may affect Mr. Smith’s motivation, compliance, and psychological well-being. Your response should be a minimum of 150 words. | One of the complications that would affect Mr. Smith’s motivation, compliance, and psychological well-being is decreased functioning. Mr. Smith’s functioning in areas such as social, occupational, and interpersonal relationships will decline post-hospital discharge. These changes will translate into a poor quality of life, which would worsen his major depression and PTSD symptoms. The other complication that might affect Mr. Smith’s motivation, compliance, and psychological well-being is the lack of social support. Mr. Smith requires adequate support from his family, friends, and members of the society. The support includes physical, social, emotional, and spiritual support. Inadequate social and family support will worsen his mental health and well-being. Isolation will also affect his motivation to comply with the prescribed treatments, hence, poor outcomes. The other complication that might affect outcomes in Mr. Smith’s treatment is inadequate medical management and provision of the desired rehabilitation services. Inadequate medical management would increase the risk of complications such as poor wound healing and sepsis (Broggi et al., 2021). Inadequate rehabilitation services will affect Mr. Smith’s return to baseline functioning. |
| Put together an interdisciplinary team to support all areas of his recovery, including mental health support. Provide a rationale for your response by referencing his assessment findings. Your response should be a minimum of 150 words. | An interdisciplinary team should be involved in Mr. Smith’s care. The team members should comprise registered nurses, physicians, counselors, psychiatrists, physical therapists, wound care specialists, orthopedics specialists, and respiratory therapists. Registered nurses will be involved in all aspects of Mr. Smith’s care such as care coordination, health education, follow-up, assessment of treatment compliance, monitoring, and evaluating treatment outcomes and needs. A psychiatrist and counselor will ensure the treatment of major depression and PTSD and provide psychotherapy for effective coping with complex health needs. Physicians will assess, plan, monitor, evaluate, and recommend any new treatments that might be required in Mr. Smith’s care. They will collaborate with other members of the interdisciplinary team to ensure patient-centered care. A physical therapist will ensure that Mr. Smith can use assistive devices and help him return to his baseline functioning. A wound care nurse is needed to provide the required wound cleaning and dressing and recommend additional treatments to facilitate recovery (Sakkers et al., 2021). Orthopedic specialists will assess his recovery following ORIF surgery. A respiratory therapist will assess Mr. Smith’s respiratory status and recommend appropriate treatments to optimize his functioning and health. |
Smoking and Drug UseConsider Mr. Smith’s history of smoking and recreational drug use. | |
| History of Smoking How might his history of smoking impact the healing of the bones? Your response should be a minimum of 150 words. | Smoking affects bone healing. Firstly, smoking affects bone mineral density. It hinders the deposition and absorption of calcium in the bones. Smoking also lowers the levels of available vitamin D. Reduced vitamin D levels lower the absorption of calcium into the bones via the gastrointestinal system. Smoking also changes the levels of hormones needed for bone strength. This includes estrogen levels, which predispose patients to fractures. Smoking also reduces body mass among smokers. This affects calcium and vitamin D bioavailability. Smokers who experience fractures also experience slower wound healing and bone nonunion compared to non-smokers. In some cases, smoking might contribute to subsequent risks or occurrences of bone fractures. This is because of continued bone di-mineralization with smoking, which predisposes smokers to recurrent bone fractures (Hernigou & Schuind, 2019). Evidence shows that most smokers who experience fractures have slowed bone healing due to delayed union, non-union, and the development of bone complications such as osteomyelitis. Smoking also affects bone stability. It impairs stability factors such as the production of growth factors, osteogenic cells, and osteoconductive scaffold, which determine bone health (Xu et al., 2021). |
| Cessation of Smoking 1. Discuss how you would integrate smoking cessation and rehabilitation experts into Mr. Smith’s recovery team. Your response should be a minimum of 150 words. | Smoking cessation and rehabilitation experts should be part of the interprofessional teams involved in Mr. Smith’s recovery. Smoking cessation and rehabilitation experts should collaborate with psychiatric mental health nurse practitioners in helping Mr. Smith overcome his smoking problem. The experts should educate Mr. Smith about the health effects of smoking and its impact on bone healing and the available smoking cessation options he might consider. The experts should also educate Mr. Smith about the available social support groups for smoking cessation. Support groups would help Mr. Smith identify effective strategies for overcoming smoking. The psychiatric mental health nurse practitioner and the smoking cessation experts would collaborate in developing appropriate care plans that would facilitate smoking cessation. For example, it might be necessary to incorporate other treatments such as psychotherapy into the plan to prevent relapse in smoking cessation. Other healthcare providers, including physicians, must consider the prescribed treatments for smoking cessation to prevent drug interactions and adverse outcomes. |
| 2. How might Mr. Smith’s past usage of recreational drugs impact his pain management? Your response should be a minimum of 150 words. | Previous recreational drug use will affect Mr. Smith’s pain management. Mr. Smith’s previous recreational drug use must be considered when prescribing him pain medications. This is because issues such as addiction increase opioid tolerance. Patients with a history of addiction might need a high opioid dose for them to control their pain. Increased demand for opioid doses predisposes Mr. Smith to safety and quality concerns in his care. This is because it might be difficult for the healthcare provider to determine if the increased demand for opioid dosage is due to a new substance abuse problem or disease progression. Therefore, healthcare providers should mitigate these risks by prescribing a specific amount of opioids with strict dosage instructions (Urits et al., 2021). They should also establish a contract with Mr. Smith on issues related to inappropriate opioid use. |
| Balancing Discuss how the nurse would balance promoting smoking cessation for Mr. Smith while respecting his self-determination in his healthcare decisions. Your response should be a minimum of 150 words. | The nurse should balance promoting smoking cessation for Mr. Smith while respecting self-determination in his healthcare decisions. One of the strategies the nurse can adopt to achieve this objective is to ensure that he establishes rapport and trust with Mr. Smith. The nurse should be non-judgmental and strive to create an honest relationship with Mr. Smith. Trust and honesty will make Mr. Smith feel supported and be willing to discuss his concerns and options that might be considered for his problems. The other strategy is providing patient-centered health education. The nurse should provide Mr. Smith with evidence-based information about the risks of smoking on his health and recovery and strategies that can be adopted to overcome his addiction. Health education would increase his awareness level and stimulate motivation for behavioral change. The nurse should also collaborate with Mr. Smith to identify barriers to smoking cessation. They should also identify patient-specific strategies that can facilitate incremental success in smoking cessation (Abadi et al., 2020; Linnet Olesen & Jørgensen, 2023). The use of these strategies would ensure patient-centered approaches that promote sustainable change in addressing Mr. Smith’s smoking problem. |
Psychosocial and Spiritual ConsiderationsProviding holistic nursing care for patients with complex conditions requires that the nurse takes into account the patient’s psychosocial and spiritual needs. | |
| Given the patient’s current situation, discuss ways in which the nurse can take into account and address the patient’s psychosocial and spiritual needs. Your response should be a minimum of 150 words. | The nurse should address Mr. Smith’s psychosocial and spiritual needs. The nurse should first assess Mr. Smith’s spiritual and psychosocial issues to identify his needs. He should undertake a comprehensive assessment by focusing on areas such as cultural and spiritual values, beliefs, and preferences, and the available social support systems for Mr. Smith. The nurse should use the assessment data to develop a care plan that addresses Mr. Smith’s prioritized and potential needs. The other strategy to address Mr. Smith’s psychosocial needs is the use of effective communication skills. The nurse should incorporate communication skills such as active listening, empathy, and encouraging Mr. Smith’s expression of his concerns. Effective communication skills make Mr. Smith feel valued and enable the nurse to create an effective caring environment that fosters active collaboration. The nurse must also ensure that the developed care plans align with Mr. Smith’s spiritual and cultural values (Bhuiyan et al., 2022). For example, strategies such as involving the chaplain in meeting his needs can be considered to meet Mr. Smith’s spiritual needs. |
Care Planning and InsuranceNurses have to have an awareness of the socioeconomic impact of care delivery, especially when planning care for patients with complex needs. | |
| Who would you need to involve if you discover that the patient is uninsured? Your response should be a minimum of 150 words. | Health insurance is important for increased access to healthcare that Mr. Smith needs. Insurance will help Mr. Smith and his family to overcome the financial hardships that would be encountered in managing his complex health needs. I would involve some experts should I discover that Mr. Smith does not have insurance. Firstly, I will involve the case manager or social worker in the issue. A social worker or case manager can help assess Mr. Smith’s economic status and recommend appropriate health insurance to help him overcome barriers to healthcare. This will include determining Mr. Smith’s eligibility for insurance such as Medicaid and private insurance should he afford them. The hospital administration should also be involved if Mr. Smith does not have insurance. The administration will assess the potential social determinants of health such as income and employment status, which might be contributing to Mr. Smith’s lack of insurance. The hospital will use Mr. Smith’s data to determine the determinants of healthcare access and strategies to overcome them in the communities it serves. Lastly, local community organizations might be involved in addressing Mr. Smith’s non-insurance status. Local organizations such as religious institutions and non-governmental organizations might provide Mr. Smith with the support he needs with his insurance problems. They might pay for his medical bills and support his adjustment to the new needs following the accident. |
| How would this impact the socioeconomic aspect of Mr. Smith’s care plan moving forward? Your response should be a minimum of 150 words. | A lack of medical insurance affects Mr. Smith’s care planning moving forward. Medical insurance such as Medicaid and Medicare eliminate barriers to healthcare such as costs for vulnerable populations. These insurances will ensure that Mr. Smith accesses the healthcare services he needs for his continued management of complex health needs. However, a lack of medical insurance will imply that Mr. Smith and his family will incur high costs in accessing the care he needs. His out-of-pocket spending for emergency department visits, hospitalization, and medication refills will be significantly high. Therefore, Mr. Smith and his family are likely to suffer from a high disease burden. A lack of insurance will also affect the timeliness of healthcare services for Mr. Smith. This can be seen from increased incidences of missed or delayed care being offered to Mr. Smith. Missed and delays in healthcare access will affect other aspects of Mr. Smith’s care such as recovery and assessment of treatment response. The nurse and other members of the interprofessional team will experience problems in coordinating his care. This is because of the fragmentation of the different aspects of care that Mr. Smith needs for his optimum recovery and functioning (Wei et al., 2020). Therefore, a lack of medical insurance will affect Mr. Smith’s care planning moving forward. |
ReferencesAbadi, T. S. H., Nia, M. N., & Mazlom, S. R. (2020). Effect of self-determination theory-based discharge program on lifestyle and readmission of patients with heart failure: A clinical trial. Evidence Based Care Journal, 10(1), Article 1. Bhuiyan, N., McNeill, L. H., Bopp, M., Downs, D. S., & Mama, S. K. (2022). Fostering spirituality and psychosocial health through mind-body practices in underserved populations. Integrative Medicine Research, 11(1), 100755. https://doi.org/10.1016/j.imr.2021.100755 Broggi, M. S., Oladeji, P. O., Tahmid, S., Hernandez-Irizarry, R., & Allen, J. (2021). Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures. Geriatric Orthopaedic Surgery & Rehabilitation, 12, 21514593211016252. https://doi.org/10.1177/21514593211016252 Gledhill, K., Hanna, L., Nicks, R., & Lannin, N. A. (2021). Defining discharge-readiness from subacute care from all stakeholders’ perspectives: A systematic review. Disability and Rehabilitation, 43(22), 3127–3134. https://doi.org/10.1080/09638288.2020.1733107 Hernigou, J., & Schuind, F. (2019). Tobacco and bone fractures. Bone & Joint Research, 8(6), 255–265. https://doi.org/10.1302/2046-3758.86.BJR-2018-0344.R1 Linnet Olesen, M., & Jørgensen, R. (2023). Impact of the person-centred intervention guided self-determination across healthcare settings—An integrated review. Scandinavian Journal of Caring Sciences, 37(1), 37–59. https://doi.org/10.1111/scs.13138 Moullin, J. C., Dickson, K. S., Stadnick, N. A., Albers, B., Nilsen, P., Broder-Fingert, S., Mukasa, B., & Aarons, G. A. (2020). Ten recommendations for using implementation frameworks in research and practice. Implementation Science Communications, 1(1), 42. https://doi.org/10.1186/s43058-020-00023-7 Sakkers, R. J., Montpetit, K., Tsimicalis, A., Wirth, T., Verhoef, M., Hamdy, R., Ouellet, J. A., Castelein, R. M., Damas, C., Janus, G. J., Nijhuis, W. H., Panzeri, L., Paveri, S., Mekking, D., Thorstad, K., & Kruse, R. W. (2021). A roadmap to surgery in osteogenesis imperfecta: Results of an international collaboration of patient organizations and interdisciplinary care teams. Acta Orthopaedica, 92(5), 608–614. https://doi.org/10.1080/17453674.2021.1941628 Urits, I., Charipova, K., Gress, K., Li, N., Berger, A. A., Cornett, E. M., Kassem, H., Ngo, A. L., Kaye, A. D., & Viswanath, O. (2021). Adverse Effects of Recreational and Medical Cannabis. Psychopharmacology Bulletin, 51(1), 94. Wei, W., Ulyte, A., Gruebner, O., von Wyl, V., Dressel, H., Brüngger, B., Blozik, E., Bähler, C., Braun, J., & Schwenkglenks, M. (2020). Degree of regional variation and effects of health insurance-related factors on the utilization of 24 diverse healthcare services—A cross-sectional study. BMC Health Services Research, 20(1), 1091. https://doi.org/10.1186/s12913-020-05930-y Weiss, M. E., Lerret, S. M., Sawin, K. J., & Schiffman, R. F. (2020). Parent Readiness for Hospital Discharge Scale: Psychometrics and Association With Postdischarge Outcomes. Journal of Pediatric Health Care, 34(1), 30–37. https://doi.org/10.1016/j.pedhc.2019.06.011 Xu, B., Anderson, D. B., Park, E.-S., Chen, L., & Lee, J. H. (2021). The influence of smoking and alcohol on bone healing: Systematic review and meta-analysis of non-pathological fractures. EClinicalMedicine, 42. https://doi.org/10.1016/j.eclinm.2021.101179
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