Making the Most Out of Case Studies

Questions that You might ask about Case Studies 1. What is a Case Study ? Answers to Your Questions

2. Why do I have to make a Case Study ? 3. How do I choose a client for case study ?

4. How do I make a case study ?

5. How do I document a case study ?

It is an in-depth review of a selected client encountered in the clinical setting It is a teaching-learning tool It is utilized by Clinical Instructors to discuss in detail a selected clients case, utilizing the nursing process and research approach It is an opportunity for students to read and understand better, cases which had been discussed during lectures. It is a written requirement submitted by students for the purpose of evaluation More important than it being a requirement to be submitted during a prescribed time, case studies are made to reinforce what had been learned during lectures. Thus case studies enhance learning. Ask yourself the following questions, What among the cases in the ward .. am I interested to learn about more ? have I encountered for the first ? have I not yet reviewed in my past clnical exposures ? will I have the opportunity to learn most ? is frequently a Nursing Board Examination content ? The case that is an answer to most if not all of the above question is the best case to choose Review literatures (your textbooks, other books, and journals), and find out what important points are discussed about the case you have selected, such as description of the case, foreign, local statistics (pertaining to the Philippines and the specific institution where the case had been chosen), management and treatment. Take down notes and make sure that you list down your references Gather data about the selected client from the following sources : patients chart, patient, family members, and significant others, nurses who have cared for the patient). Compare the data you read from literatures to those that you have personally gathered from the above sources. Make sure that your data are accurate and complete Make a time schedule for conducting your case study bearing in mind the deadline for submission. Your time schedule should include the following activities : choosing a client, reading literatures, gathering and validating data, analyzing and interpreting the data collected, writing up the case study, submitting the case study, practicing for the ward class. Complete the five chapters and their corresponding contents :Chapter I : Introduction Description of the case / disease being tackled.and relevant statistics (foreign, Filipino, and local setting) and information based on related literatures.

Prepared by Nursing 201 Team First Semester, Schoolyear 2005-2006

 Purpose and Objectives Sample : Purpose : This case study aims to present the nursing care of a client who underwent Caesarian Section. Specifically, this study seeks to achieve the following objectives : 1. Identify factors that led to the development of the problem 2. Analyze the relationship of factors leading to the development of the problem 3. Discuss the relevant interventions that were utilized to resolve problems 4. Explain the patients responses toward the interventions Significance and Justification In writing up this section, be guided by the questions : 1. Who will directly benefit from your case study after you have presented them and provided the library a copy of your study ? 2. In what way will the above people or institutions benefit from your study ? Scope and Limitations The scope is a miniature or very brief summary of the conduct of a case study. In writing the scope, be guided by 4 Ws and 1 H What are you studying about (you will state the purpose of your study) When did you conduct the case study ? (inclusive dates from the time that you handle the patient until you have collected your data) Where did you select your client (specify the hospitals / agencys name only and the unit, there is no need to write the address of the institution) Who is the client ? (write only the initials of the client). If you had other key informants other than the client (like relatives or significant others), explain in this section. How did you collect your data ? (briefly describe the procedure employed for ensuring accuracy and completeness of the data. There is also need to specify what difficulties were encountered during the case study.

Background of the Study. Describe in more details the site of the study (the name and the type of the institution) and the specific unit in the hospital. Describe services and facilities which are relevant to the case on hand. In the last paragraph, describe the reason why you chose the client for the case presentation. Expound on the bullets related to question # 3 above. Chapter II : Presentation of the Client This section is written in narrative form specifying dates and time. This section should any reader of your case study, a clear picture what transpired to the client immediately before admission, on admission, in the ward, until the student endorses him/her to another health caregiver
Prepared by Nursing 201 Team First Semester, Schoolyear 2005-2006

This section starts with an introduction of the patient, using his / her demographic data , which includes initials, age, gender, residence (town/province only, no need to put house number), occupation, and other data such as gender issues. (refer to the information under demographics in the RTRMS History Form) The next paragraph will be the history of present condition, and to end indicate the chief complaint upon admission or the reason for seeking health service. The succeeding paragraphs present the course in the ward, which are the day to day occurrences, including the patients problems, diagnostic, laboratories and their results and significance, and/or therapeutic procedures done on the patient. The last paragraph is the condition of the patient when the student last saw him / her. To whom was the patient endorsed ? After chapter II and before chapter III, the Concept Map is presented. Chapter III :Analysis and Interpretation The nursing diagnoses are explained one by one. The physiological or pathophysiological bases of the diagnosis are presented in narrative form This section shows the interrelationship among factors identified through P.E., History taking, diagnostic procedures. Chapter IV : Summary of Findings This section shows the fulfillment of the objectives stated in chapter I. (Example, the objective #1 is to identify factors that led to the development of the condition. The students enumerate these factors) Chapter V : Conclusions and Recommendations Conclusions are statements which are arrived at after the patients needs have been met or not met and problems have been resolved or not resolved To write good conclusions, answer the following questions. 1. What are client-related factors that promoted meeting of needs, early recovery, and prevented the setting in of complications or caused exactly the opposite ?. 2. What competencies of nurses promoted meeting of needs, early recovery, and prevented the setting in of complications or caused exactly the opposite ? Students cannot conclude unless there are findings that lead to conclusions. Recommendations present what actions that nurses should take to ensure that clients responses to interventions shall be positive. Students should recommend based on conclusions drawn from the findings. Appendices A. Pathophysiology or Physiology in Schematic
Prepared by Nursing 201 Team First Semester, Schoolyear 2005-2006

Diagram This should show the usual disease progress as indicated in related literatures. Signs and symptoms specifically identified in the selected clients case should be in all capital letters. B. Drug Study This section should include the brand and generic names of the drug, dosage, route of administration, and frequency of administration, the mechanism of action, adverse drug effects, and nursing responsibilities C. Care Plan (Part II) The following are the contents : Nursing Diagnoses Goal Outcome indicators Tabulated form First column entitled Nursing Intervention are the intended nursing actions to meet clients needs or to solve problems, based from literature reviews Second column entitled Performance Indicators / Evaluation, patient responses or outcomes specific of the interventions if possible. Ex. If the intervention is measure intake and output, evaluation is the amount of intake and output. If the intervention was not performed due to clientrelated reasons (limitation on the part of caregivers are unacceptable), then performance indicators are shown. Example, a prn medication is to be given for fever, it will read : PRN medication not given fever resolved by Tepid Sponge Bath. To create a venue for discussing the client and the case, improving the case study contents, and evaluate how much the students have learned from the case study. The students are given freedom to choose a presentation strategy for as long as it meets the following criteria : a. Clarity and completeness of presentation b. Adherence to the time limit of 20 minutes c. Audiovisual aids in acceptable form are used These criteria ensure the successful meeting of the objectives of a Case Study. A Case Study Evaluation tool should be attached to your manuscript in order that you may understand how your case study was quantified to come up with a grade. Correct, refine the case study before it is submitted back to the Clinical Instructor. The revised form is stored in the designated place where other students or researchers may benefit from them maximally. (ideally kept in the RTRMS library) Never look at it as a burden Cosncientiously prepare for Case Studies Believe that case Studies will help you take care better of clients with similar cases Believe that you might just encounter board examination items pertaining to the Case Study you have done. Be committed and dedicated in preparing for case Studies.

6. Why are we required to present our case study ? 7.How do we present a case study ?

8. How are we graded in a case study ? 9. What do we do after a case study had been presented ? 10. What should my attitudes be toward case studies ? 11. How will I

Prepared by Nursing 201 Team First Semester, Schoolyear 2005-2006

best benefit from a case study ? After all, God must have allowed us to invent case studies for a very special reason, that is to contribute in the formation of competent and God-loving individuals who shall look after the needs of clients.

Prepared by Nursing 201 Team First Semester, Schoolyear 2005-2006