Clinical Example Assignment

Suggestions for writing a clinical example:

  1. Introduce the patient (sex, age (if younger than 90), reason for admission/appointment, comorbidities, etc.)
  2. Describe the situation and what prompted you to apply information learned in class. Identify the relevant class lecture.
  3. Discuss your thoughts briefly.
  4. Describe the corrective, evidence-based action(s) you took and/or the learning you experienced (the "ah-ha!" moment).
  5. Describe how your actions made a difference and/or will influence your practice in the future.
  6. Were your actions different from what you might have done prior to this class?


Sample Clinical Example

The other day, we had an admission from a skilled nursing facility to our floor. The person was an elderly patient diagnosed with generalized weakness and pneumonia. She arrived on night shift. Her co-morbidities were CHF and diabetes. 

During shift change, I overheard the attending nurse tell an oncoming RN that the patient didn’t need a specialty bed, only turning, as she didn’t have any pressure ulcers, just red areas on her coccyx. 

Thinking back to the wound care module, I remembered that if the redness did not blanch, it was a stage 1. I asked the off-going nurse if the area blanched. She said she did not check as she assumed that it was just mild pressure redness from being on the stretcher for hours in the ED. 

After report was over, I followed the attending nurse to the room. We turned the patient and looked at the reddened area. First of all, the patient was wet and the reddened area was on the coccyx as noted. I gently pushed on the reddened area and noted that it did not blanch. I informed the nurse that this was a stage 1 and, with the wetness of the patient, the patient was at risk for a stage 2 or beyond. We discussed ordering a specialty bed, but decided to cleanse the area, use protective barrier cream and keep her clean and dry, while turning her side to side frequently. By keeping her coccyx off-loaded, increasing her nutritional intake with the help of dietary, and closely following and treating her diabetes, her coccyx area resolved prior to discharge. We prevented deeper damage. 

The wound care module helped me identify early risk factors and stop something so preventable. The bonus was educating fellow nurses on what a stage 1 really is.


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