The deteriorating patient

The deteriorating patient

The deteriorating patient

NSB236

Integrated Nursing Practice 3: On campus

ASSESSMENT TASK 1: The deteriorating patient

This document contains:

 Assessment
requirements.

 Detailed instructions for
completing the task.

 Criterion Reference
Assessment (CRA) Rubric
that markers use to grade
the assessment task.

NSB236: Integrated Nursing Practice 3

NSB236 – Assessment Task 1 Page 2 of 19

Assessment Task 1

Assessment name: Case Study: The Deteriorating Patient

Task description:
For this essay you are required to select ONE (1) case scenario related
to the clinical deterioration of a patient:

Option 1: Hypovolemic shock
Option 2: Septic Shock

The assessment tasks requires you to:

1. From the chosen case study identify and discuss two (2)
signs or symptoms of clinical deterioration associated
with the pathophysiology of the patients’ presenting
problem.

2. Following on from your discussion, and related to the patients
deterioration, identify one (1) priority problem associated
with the patient’s clinical presentation, and through the
application of contemporary research provide a justification as
to why the problem is a clinical priority within the case.

3. Discuss two (2) nursing interventions to address the
priority problem and how to evaluate the efficacy of these
interventions.

4. Identify one psychosocial issue derived from the
information provided within the case study, and applying a
patient centred approach, discuss the care needs and
considerations related to the patient and their family.

References: A minimum of 15 contemporary references no older
than 7 years. The reference list is to be presented in accordance to
QUT APA requirements and identify eight (8) papers that are considered
by the author (you) to be of high importance. These eight (8) papers are
to include a three (3) sentence annotation that outlines their significance
(please refer to the example provided within this resource). Indicate
these in your list using ** (see example provided below).

What you need to do:
In order to undertake this essay you will need to research the topic using
current and relevant peer reviewed literature, in conjunction with
reviewing:

 The lecture and tutorial materials associated with the
relevant topic.The deteriorating patient

 Your knowledge and understanding related to:

1. The physiology and pathophysiology of the primary
diagnosis and associated clinical data identified within
the chosen case study;

2. The physiological assessments relevant to the
features within the case study.

This assessment task is an individual assessment item and should be
reflective of your own independent work.

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Length: 1700 words +/-10% (word length includes in-text referencing and
excludes your reference list and annotations).

Estimated time to
complete task:

Approximately 30 hours

Weighting: 50%

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

Due date: Week 9: Friday September 20th, 2019 submitted via Turnitin in your
NSB236 Blackboard site by 23:59 hours. More information about
Turnitin is available on the FAQs about Turnitin page.

Presentation
requirements:

This assessment task must:

 Be a formal written academic essay containing an introduction,

body and conclusion, addressing the task, its specified

requirements and adhering to the prescribed word limit.

 Use QUT CiteWrite APA referencing for citing academic literature

(see http://www.citewrite.qut.edu.au/).

 Assignment cover sheet must be included as the first page of

your document with the assessment title, your name, student

number, tutor name and word count included. Template is

accessible via the NSB236 Blackboard site

 Be submitted in electronic form via Turnitin as a word document

only.

 A minimum of 15 relevant references to be cited from valid,

contemporary journal articles only, no older than 7 years.

 Include a footer on each page with your name, student number,

unit code and page number.

 3 cm margins on all sides, double-spaced text

 Use font, such as Times New Roman, Arial or Calibri; font size 12

 CiteWrite APA style referencing

(see http://www.citewrite.qut.edu.au/)

Please note:

 The use of websites as references is NOT permitted.

 The citation of textbooks are NOT included in the minimum

referencing requirements (for example if you cite two (2)

textbooks, you will still need 15 references to be cited from valid,

contemporary journal articles, no older than 7 years).

 The submitted essay should NOT contain tables, figures or

appendices.

 The use of dot points are NOT permitted.

 Subheadings are NOT permitted in this essay
https://qutvirtual4.qut.edu.au/group/student/it-and-printing/qut-blackboard/assessment-on-qut-blackboard/submitting-assignments/turnitinhttps://qutvirtual4.qut.edu.au/group/staff/teaching/teaching-with-technology/supported-technologies/online-assessment/turnitin/frequently-asked-questionshttp://www.citewrite.qut.edu.au/http://www.citewrite.qut.edu.au/

NSB236: Integrated Nursing Practice 3 The deteriorating patient

NSB236 – Assessment Task 1 Page 4 of 19

Learning outcomes
assessed:

1. Consolidate knowledge of key NMBA Registered Nurse
Standards for Practice, National Safety and Quality Health
Services Standards, and National Health Priorities to enable
effective decision planning and action in a range of complex
clinical situations across the lifespan.

2. Apply knowledge of anatomy, physiology and pathophysiology to

support evidence-based decision making associated with
planning and action.

3. Demonstrate structured decision making and clinical reasoning to
review a range of health situations, synthesise evidence and
data, determine priorities and formulate plans of care and
interventions in line with timeframes and agreed goals

What you need to
submit:

One word document that contains the following items:

1. Assignment Cover Sheet that completed in its entirety and written
assessment addressing the tasks as per the assessment outline.

Must be submitted in electronic form via Turnitin by the assigned
date.

Resources needed to
complete task:

 Case studies and clinical documents available within this
document.

 Documents such as additional readings available on your
blackboard site.

 Access to the prescribed texts for this unit as outlined in the unit
details

 Cite|Write APA guide.

 Turnitin Tip Sheets.

Academic Integrity

The School of Nursing takes academic integrity very seriously. All work
submitted must be your own work and work not previously submitted
for other study. The work of others needs to be correctly
acknowledged and referenced according to the CiteWrite APA
guidelines.

There are serious consequences that will be imposed should you be
found to breach academic integrity. Make sure you are familiar with the
MOPP C/5.3 Academic Integrity and view the Academic Integrity video
and explore the Academic Case Studies available on your Blackboard
site.

Maintaining academic integrity is your responsibility. If in doubt,
check it carefully.

Assignment Hints http://www.citewrite.qut.edu.au/cite/qutcite.jsp#apahttps://qutvirtual4.qut.edu.au/group/student/it-and-printing/qut-blackboard/assessment-on-qut-blackboard/viewing-marks-and-feedback-in-turnitinhttp://www.citewrite.qut.edu.au/cite/qutcite.jsphttp://www.citewrite.qut.edu.au/cite/qutcite.jsphttp://www.mopp.qut.edu.au/C/C_05_03.jsp

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This assignment requires you to critically consider the signs and symptoms
associated with clinical deterioration in relation to the patient’s primary clinical
diagnosis, with consideration to:

 The change in health status associated with the primary clinical diagnosis;

 Consider how the patients clinical history may impact on assessment data
and core interventions;

 The identified clinical priority which should clearly emerge from your
discussion of the patients health history.

 The application of clinical data and research to identify two (2) core
interventions and assessments that address the stated clinical priority.

 Demonstrating your clinical reasoning with in the selected case study.

 Demonstrating your understanding and application of evidence based care
i.e. the research you have selected to support your discussion and key points
regarding clinical interventions and assessment outcomes.

Additional information:

 There MUST be two (2) nursing interventions discussed to address the
priority problem.

 Of the two interventions, a MAXIMUM of one (1) intervention can be solely
related to a pharmacological agent and/or a collaborative intervention.

 All interventions should consider the nursing role within the provision of the
intervention.The deteriorating patient

Example of an annotated reference list:

N.B this is an example of an annotated reference list. Please ensure that you are
familiar with the APA requirements for this assessment item. (**: papers of
importance).

**Besedovsky, L., Ngo, H.V., Dimitrov, S., Gassenmaier, C., Lehmann, R. &

Born, J. (2017). Auditory closed-loop stimulation of EEG slow

oscillations strengthens sleep and signs of its immune-supportive

function. Nature Communications. 8(1):1984.

The study investigated the electroencephalographic slow oscillations and the

effect of auditory stimulus and their physiological implications on sleep

amongst healthy individuals.

Freedman, N.S., Gazendam, J., Levan, L., Pack, A.I. & Schwab, R.J.

(2001). Abnormal sleep/wake cycles and the effect of environmental

noise on sleep disruption in the intensive care unit. American Journal

of Respiratory and Critical Care Medicine.163(2):451-7.

**Horsten, S., Reinke, L., Absalom, A.R. & Tulleken, J.E. (2018).

Systematic review of the effects of intensive-care-unit noise on sleep

of healthy subjects and the critically ill. British Journal of

Anaesthesia.120(3):443-52.

The systematic review evaluated the impact of environmental noise as a
sleep disturbing factor. The meta-analysis identified considerable variability

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between studies and risks of bias. Noise reduction has a positive impact on
healthy individuals.

Muzet A. (2007). Environmental noise, sleep and health. Sleep Medicine

Review.11(2):135-42;

**Trivedi, M.S., Holger, D., Bui, A.T., Craddock, T.J. & Tartar, J.L. (2017).

Short-term sleep deprivation leads to decreased systemic redox

metabolites and altered epigenetic status. PloS one.12(7):e0181978.

Researchers demonstrated the presence of oxidative stress and ATP deletion
in healthy individuals who are subjected to sleep deprivation.

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Case Option 1: Hypovolemic shock

History of presenting complaint

Kenneth Bradman is a 67 year old man who has been admitted to the surgical high

dependency unit post a large per rectum (PR) bleed, which required an emergency

gastroscopy for an upper gastrointestinal bleed and the injunction of two (2) bleeding

ulcers in the context of non-steroidal anti-inflammatory drug (NSAID) use and

previous ethanol misuse.

Whilst in the emergency department he required a large blood transfusion which

included:

 4 units of packed red blood cells (PRBC),

 4 litres of NaCl 0.9%,

 4 units of fresh frozen plasma (FFP) and,

 5 units of cryoprecipitate.

He has been transferred for further monitoring to the Surgical High Dependency Unit

secondary to underlying hypovolemic shock, new onset of atrial fibrillation and

concerns regarding the potential of an acute kidney injury.

The surgical team has requested hourly monitoring for this patient, and his progress

will be reviewed tomorrow.The deteriorating patient

Past medical history:

Type 2 diabetes mellitus, chronic kidney disease, hypertension, coronary artery

disease, colon cancer and underwent a right sided hemicolectomy in December

2018, ethanol misuse (consumed 10+ standard drinks of alcohol per day prior to

imprisonment , has undergone alcohol withdraw during sentencing).

Normal medications:

Mr. Bradman’s normal medications include:

Allopurinol, aspirin, candesartan, frusemide, metformin, metoprolol, rosuvastatin,

magnesium, warfarin

Night Duty Registered Nurse documentation indicates:

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Neurological: Patient orientated to place and time intermittently, disorientated at

times and requires reorientation, pupils equal and reactive light. Equal arm and leg

strength bilaterally.

Cardiovascular: 12 lead ECG performed on admission indicating Atrial Fibrillation,

ischemic ECG changes noted in the Emergency Department resolved. Continues to

be monitored in Atrial Fibrillation with a rate between 80-100 beats per minute.

Peripherally cool to touch, dorsal pedis palatable bilaterally. Systolic blood pressure

between 105 -120mmHg post transfusions. Patient has been afebrile overnight. IV

plasma-Lyte 148 is running via peripherally inserted venous catheter at 80ml/Hr.

Respiratory: SpO2 greater than 95% on 6L via a Hudson mask, decreased air entry

bilaterally to the bases, mildly elevated respiratory rate between 15-20 breaths/min.

Gastrointestinal: Patient currently nil by mouth for the next 6 hours, distended

abdomen with decreased bowel sounds on auscultation in all four quadrants, one

episode of melena overnight. Salem Sump nasogastric tube in situ measuring 65cm

at the tip of nose – position confirmed via chest radiograph with minimal output.

Blood glucose levels ranging between 8-12mmol/L overnight.

Renal: Indwelling urinary catheter in situ and patent, urinary output has been less

than 30mls/hr for the past two hours.

Integument: Spider naevi noted on abdomen, and a midline incision scar related to

his right hemicolectomy surgery. Peripheral edema noted to feet and ankles.

Psychosocial: Patient is a prisoner with prison officer escort. Nil inquiries overnight

Vitals

Time Admitted to
ward
04:35hrs

05:00hrs 06:00 hrs 07:00hrs

Temp (°C) 36.3 36.6 36.5 37.2

Respirations
(breaths/min)

18 22 20 23

Non-invasive
blood pressure
and Mean
Arterial
Pressure
(MAP) (mmHg)

128/92 (98) 115/72 112/68 108/58

Heart rate
(beats/min)

108 112 110 118

SpO2 (Fio2) 96%- 6L via 95% – 6L via 95% – 6L via 93 – 6L via HM

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HM HM HM

BGL 8.3mmol 10.2mmol 12.1mmol

Actrapid
infusion
commenced
at 2 units/hr

9.6mmol

Actrapid infusion
at 2 units/hr

You note on your assessment at 08:25 hours that Mr Bradman appears pale, and

disorientated. You palpate his radial pulse and note that is hand is cool to touch, and

the radial pulse is thready and irregular at 116 beats/min, his blood pressure is

reported as being 94/48mmHg via the automated blood pressure machine and on a

manual assessment you note it is 100/50mmHg. His breathing is more labored, his

SpO2 is 91% on 6L of oxygen/minute via a Hudson Mask and on auscultation there

are bilateral coarse crackles. You note that there is an increased amount of coffee

colored fluid coming up via his salem sump nasogastric tube, his feet are mottled,

cool to touch but the doralis pedis is able to be manually palpated. His urinary output

is 16mls since 0700hrs. You notified the surgical registrar who checks the morning

pathology results and is concerned that the patient is having further bleeding and is

in hypovolemic shock.The deteriorating patient

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This morning’s pathology results (07:45hrs):

Investigation Results Reference range

Hemoglobin (Hb) ↓ 69 130 – 180 g/L

White cell count ↑ 13.5 4.3-10.8 x 109/L

Urea 13 2.5 to 7.1 mmol/L

Creatinine ↑ 112

(patients baseline
function 97)

45 to 90 mmol/L

Estimated
Glomerular
Filtration rate
(eGFR)

48
mL/min/1.73m2

(patients baseline
eGFR 63
mL/min/1.73m2

90 to 120 mL/min/1.73 m2

Glucose (Gluc) 6.1 3.0-9.6mmol/L

Coagulation
profile:

APPT

INR

PT

30

1.2

15

30-40 seconds

0.8-1.2 seconds

9.5-13.5 seconds

Sodium 137mmol 135-145 mmol

Potassium 4.7 mmol 3.5-4.5 mmol

Magnesium 0.8mmol 0.7-1.0mmol

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Case Option 2: Septic shock

History of presenting complaint

Elodie Greer is 14 year old girl with a previous diagnosis of Acute Lymphoblastic

Leukaemia (ALL) which was treated with chemotherapy. She has received a

subsequent allogenic stem cell transplant 7 weeks ago.

She presents with a three-day history of feeling generally unwell and malaise. Her

mother (Christine) has brought Elodie into to the Emergency Department at 14:00

hours as she had become increasingly concerned about Elodie, as she has become

quite and withdrawn. She reports that Elodie has been doing well post her transplant

and has been active and happy. Christine states that Elodie is not a whinny kid and

would do almost anything to avoid further time in hospital.

Elodie was assessed in the Emergency Department has been transferred to the

Pediatric hematology/oncology ward as a priority admission with suspected sepsis

secondary to an infected Hickman’s line.

Past medical history:

ALL

Bone marrow translate – June 2019

Body morphology

Height 157cm

Weight 51kg

Current medications:

Eloide’s current medications include:

Sodium bicarbonate mouthwash, loperamide, ondansetron, cyclosporine, potassium

and magnesium supplements

On assessment:

Elodie is admitted to the pediatric hematology/oncology unit at 20:45hrs.

On admission:

 She appears lethargic and diaphoretic,

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 Temperature on assessment 38.4 (orally), her heart rate is elevated (103

beats/min) and blood pressure is 102/67mmHg ,

 Respiratory rate is increased (21 breaths/minute) with noted increased work

of breathing, and SpO2 is 91% on 2 L via NP.

 She has not voided for since this morning in the Emergency Department

(ED) (at approximately 6:30hrs) and reported that it was dark yellow in

colour.

 She reports her mouth is dry and she feels thirsty but does not feel like

drinking or eating reporting that she is too tired and “feels a bit sick”.

The medical round is currently reviewing Elodie and note that blood cultures (for

microscopy culture and sensitivities) were taken from the Hickman’s catheter in ED

which has not grown any organisms to date. On review they determine that the

patient is experiencing sepsis, her blood pathology results reveal the following:

Investigation Results Reference range

Hemoglobin (Hb) 120 120 – 160 g/L.

White cell count ↑ 12.5 4.3-10.8 x 109/L

Platelets 101 150-400 x 109

Psychosocial

Resides with mother and step father

Has 1 biological sibling

2 step siblings

Good relationship with biological father

Good family dynamics between couples.

Mum has been in to visit this evening and appears stressed and anxious.

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.

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NSB236 Assessment Task 1 Rubric

Name:

Learning outcomes assessed: 1,2,& 3 Weighting: 50%

Criteria 7 6 5 4 3 2 – 1

1. Applied
knowledge of
pathophysiology:
Critically discusses
the signs and
symptoms of
clinical
deterioration in the
context of the
primary diagnosis.

Weighting: 25%

Demonstrates a
critical explanation
that reflects a
comprehensive
interpretation and
explanation of the
assessment data;

AND

Comprehensive
understanding of
the central issues
of the case – all
key
pathophysiological
concepts and
physical
assessment data
addressed to
determine
sign/symptoms of
deterioration;

AND

Demonstrated a
comprehensive
depth of reasoning
and logical and
analytical thinking.

Demonstrates a high
level of critical
explanation that
reflects a significant
interpretation and
explanation of the
assessment data;

AND

High level
understanding of the
central issues of the
case – almost all key
pathophysiological
concepts and
assessment data
addressed to
determine
sign/symptoms of
deterioration;

AND

Demonstrates a high
level of reasoning
and logical and
analytical thinking.

Demonstrates a good
explanation and
reflects sound
interpretation with
some critical
explanation of the
assessment data; The deteriorating patient

AND

Sound understanding
of the central issues of
the case – most key
pathophysiological
concepts and
assessment data
addressed to determine
sign/symptoms of
deterioration

AND

Demonstrates a good
depth of reasoning and
logical and analytical
thinking.

Demonstrates a
satisfactory explanation
and reflects a basic
interpretation and some
critical explanation of
the assessment data –
content not overly
discerning;

AND/OR

Satisfactory
understanding of the
central issues of the
case – some key
pathophysiological
concepts and
assessment issues
addressed to determine
sign/symptoms of
deterioration;

AND

Adequately
demonstrated depth of
reasoning and logical
and analytical thinking.

Demonstrated
limited critical
explanation and
reflects a
basic/limited
interpretation and
limited critical
explanation of the
assessment data –
rudimentary
understanding and
is descriptive.

AND/OR

Demonstrates
limited
understanding of
the central issues of
the case – not all
key
pathophysiological
concepts and
assessment issues
addressed to
determine
sign/symptoms of
deterioration;

AND/OR

You have not
adequately
demonstrated depth

Demonstrates
little/no critical
explanation that
reflects
rudimentary/little
interpretation and
little/no critical
explanation of the
assessment data –
content not discerning
and primarily
descriptive.

AND/OR

Little/no
understanding of the
central issues of the
case – demonstrates
rudimentary/limited/no
understanding of
pathophysiological
concepts and
assessment issues to
determine
sign/symptoms of
deterioration;

AND/OR

Has not met the
assessment/academic
requirements as

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of reasoning and
logical and
analytical thinking.

outlined in the task
document.

2. Critical thinking

and knowledge:
Demonstrates an
understanding of
the chosen
scenario priority
problem, linking to
the scenario
assessment data,
pathophysiology/
interventions and
evaluation of the
interventions to
address the priority
problem. The deteriorating patient

Weighting: 25%

Comprehensive
and compelling
application of
pathophysiological
and physiological
concepts which
demonstrated an
understanding of
links between the
patient condition,
and the priority
problem.

AND

Provides a
compelling,
consistent and
highly accurate
argument
supporting the
relevance and
appropriateness of
the two nursing
interventions using
contemporary
research and
physiological
justification.

AND

Outcome
measures

A high quality
application of
pathophysiological
and physiological
concepts which
demonstrated an
understanding of
links between the
patient condition,
assessments and the
priority problem.

AND

The discussion is
based on a highly
articulate and
compelling
application of
research to justify
the interventions that
directly address the
problem statement.

AND

Demonstrates a high
standard of clinical
knowledge to
accurately identify
evaluation criteria to
indicate the success
of both nursing
interventions.

AND

A good and convincing
application of
pathophysiological and
physiological concepts
which demonstrated an
understanding of links
between the patient
condition, assessments
and the priority problem
identified.

AND

A well-developed
discussion presented to
justify the relevance
and appropriateness of
the two nursing
interventions.

AND

Provided a strong
application of clinical
knowledge to identify
evaluation criteria to
indicate the success of
both nursing
Interventions.

AND

The approaches are
supported to a good
level by contemporary
evidence and makes

A satisfactory
application of
pathophysiological and
physiological concepts
which demonstrated a
satisfactory
understanding of links
between the patient
condition, assessments
and the priority problem.

AND

Attempted to provide an
argument/justification
supporting the
relevance and
appropriateness of the
two nursing
interventions.

AND

Applied some clinical
knowledge to identify
evaluation criteria to
indicate the success of
both nursing
intervention.

AND/OR

The approaches are
supported to a
satisfactory level by
contemporary evidence

Limited application
of
pathophysiological
and physiological
concepts which
demonstrated
limited
understanding of
links between the
patient condition,
assessments and
the problem
statement.

AND/OR

Interventions
identified are
discussed at a
superficial level with
limited clinical
reasoning. The deteriorating patient

AND/OR

There is
limited/superficial
evidence of a critical
discussion to justify
the interventions
and evaluation
criteria.

AND/OR

There is evidence of

Little /no application
of pathophysiological
and physiological
concepts which
demonstrated no
understanding of links
between the patient
condition,
assessments and the
priority problem.

AND/OR

Little/no justification
for the problem
statement and
interventions and
physiological
assessments for
outcomes

AND/OR

Evidence or
misconception/poor
conceptual
understanding of
content contributing to
flawed clinical
reasoning.

AND/OR

Unable to apply
clinical
knowledge/reasoning

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discussed are
comprehensively
supported by
contemporary
evidence and
makes association
with physiological
concepts.

The approaches are
supported to a high
level by
contemporary
evidence and makes
association with
physiological

concepts.

association with
physiological concepts.

and makes association
with physiological
concepts.

misconceptions or
lacks insight and
understanding of
the association with
physiological
concepts.

.

as to how the
interventions relate to
the management of
the chosen priority
problem.

AND/OR

The content
presented places the
patient at a significant
risk of an adverse
and/or sentinel event

AND/OR

Failed to meet the
minimum
requirements of the
assessment.

3. Patient centred
care and
engagement:
Applies
contemporary
approaches that
address, support
and empower the
patient and/or
family in the
context of an acute
admission

Comprehensive
and compelling
application of
contemporary
research that
articulates an
compelling
discussion of
patient centred
care approaches to
support the patient
and/or family
during an acute
admission.

A high quality
application of
contemporary
research that
articulates an
compelling
discussion of patient
centred care
approaches to
support the patient
and/or family during
an acute admission

A good and convincing
application of
contemporary research
that articulates an
compelling discussion
of patient centred care
approaches to support
the patient and/or
family during an acute
admission

A satisfactory
application of
contemporary research
that articulates an
compelling discussion of
patient centred care
approaches to support
the patient and/or family
during an acute
admission.

AND/OR

An emphasis on
referring to allied
healthcare services to
meet identified needs.

Limited application
of contemporary
research that
articulates an
compelling
discussion of patient
centred care
approaches to
support the patient
and/or family during
an acute admission.

AND/OR

Rudimentary
discussion of
interventions and

Little/no application of
contemporary
research that
articulates an
compelling discussion
of patient centred
care approaches to
support the patient
and/or family during
an acute admission

AND/OR The deteriorating patient

Misconceptions
present between
paternalistic
approaches and

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Weighting: 15%

referrals to allied
healthcare services.

patient centred care.
AND/OR

Has not met the
requirements of the
assessment

4. Application of
evidence

Weighting: 15%

Demonstrates
skilful and insightful
use of high quality,
credible and
relevant sources to
develop ideas,
rationalise
approaches and
decision making
that are appropriate
to the clinical
scenario.

AND

There is an
excellent
demonstration of
conceptual
understanding of
content.

AND

Content is
paraphrased and
accurately reflects
the ideas/concepts
of the published
works.

AND

Has sourced 15
contemporary
research articles

Demonstrates skilful
use of high quality,
credible and relevant
sources to develop
ideas, rationalise
approaches and
decision making that
are appropriate to
the clinical scenario.

AND

There is a good
demonstration of
conceptual
understanding of
content.

AND

Content is
paraphrased and
accurately reflects
the ideas/concepts of
the published works.

AND

Has sourced 15
contemporary
research articles
(journal only), and
provided an accurate
annotation 8 of the

Demonstrates
consistent use of
credible, relevant
sources to support
ideas and decision
making that are
situated within the
thought question.

AND

There is a well-
grounded
demonstration of
conceptual
understanding of
content.

AND

Content is paraphrased
and accurately reflects
the ideas/concepts of
the published works.

AND

Has sourced 15
contemporary
research articles
(journal only), and
provided an accurate
annotation 8 of the
published research
articles.The deteriorating patient

Demonstrates an
attempt to use credible
and/or relevant sources
to support ideas and
decision making that are
appropriate for the
thought question.

AND

There is a satisfactory
demonstration of
conceptual
understanding of
content.

AND/OR

Content is generally
paraphrased, and may
include 1-2 direct
quotes. The presented
ideas accurately reflect
the ideas/concepts of
the published works.

AND/OR

Has sourced 15
contemporary research
articles (journal only),
and provided an
accurate annotation 8 of
the published research
articles

Demonstrates an
attempt to use
sources to support
ideas and decision
making in the
writing.

AND/OR

May have a number
of 3-4 direct quotes
that could have
been paraphrased
to demonstrate
synthesis and
understanding of
content.

AND/OR

Content is not well
paraphrased and
indicates some
limitations in
conceptual
understanding and
application of ideas.

AND/OR

1-2 citations are not
deemed to be
contemporary.

AND/OR

15 contemporary
research articles

Limited evidence
used to support ideas,
poorly cited and or
paraphrased.

AND/OR

The discussion does
not demonstrate a
strong grasp of
conceptual
understanding to
support decision
making. Frequent use
of direct quotes

AND/OR

Breaches to academic
integrity are present.

AND/OR

Has not met the
assessment
requirements
(research not
contemporary, has
not met minimum
requirements for
references, has not
met requirements for
annotated references,
used websites, and
resources that not of
a scholarly nature)

NSB236

NSB236 – Assessment 1: The deteriorating patient Page 18 of 19

(journal only), and
provided an
accurate
annotation 8 of the
published research
articles

published research
articles.

(journal only), and
provided an
accurate annotation
7 of the published
research articles

Academic writing

Weighting: 20%

Comprehensive,
Clear and logical
presentation;
compelling and
articulate
development of an
argument.

AND

Excellent syntax:
language that
skillfully
communicates
meaning to readers
with clarity and
fluency. Clear,
readable, prose.
Excellent use of
transitions; no
problems with
spelling,
punctuation, or
grammar.
Infrequent and
minor mechanical
problems. Errors
do not impair
readability. The deteriorating patient

AND

Did not use direct
quotes.

Presented a high
level and quality
discussion that is
clear and logical
presentation; very
good development of
an argument.

AND

High level of Syntax
skills: Uses language
that effectively
communicates
meaning to readers
with clarity and
fluency. Clear,
readable, prose.
Some issues with
transitions; no to
minimal (2-4)
problems with
spelling, punctuation,
or grammar.
Infrequent and minor
mechanical
problems. Errors do
not impair
readability.

AND

Did not use direct
quotes;

Presentation is
organized and presents
a clear argument for a
given position.

AND

Uses professional
language that generally
conveys meaning to
readers. Occasional
errors and minor
problems with
mechanics of
language. Occasional
awkward sentences
and poor transitions
reduce readability.

AND/OR

Sometimes used (1-2)
direct quotes ;

AND

Adhered to the
prescribed word limit

AND/OR

Infrequent errors in
APA style; errors
involve only minor
aspects of APA style –

Minor problems of
organization or logic;
Needs work on creating
transitions between
ideas.

AND

Uses language that
generally conveys
meaning to readers with
clarity, although writing
may include some
errors. Occasional
problems with
mechanics of language.

AND/OR

Some awkward
sentence construction.
Transitions may need
further development.
Conceptual
understanding of
content is not lost by the
standard of writing.

AND/OR

Sometimes used direct
(3-4) quotes;

AND/OR

Logical flow and
organisation is
hampered by poor
expression of ideas
and grammatical
errors.

AND/OR

Mechanics of writing
impedes the
discussion of ideas
and the submission
would benefit from
further editing.

AND/OR

Overuse (4+) of
direct quotes,

Not within required
word limit. (15%
over or under
prescribed work
limit).

AND/OR

Attempted to use
APA style but errors
are frequent and
include errors in
citations and

Poor logical order to
the information
provided; sentences
poorly structured and
phrased; ideas are
repeated;
comprehension of
content is impeded.

AND/OR

Uses language that
sometimes impedes
meaning because of
errors in usage.
Problems with the
mechanics of
language serious
enough to interfere
with effective
communication.

Frequent errors in
punctuation, spelling,
sentence structure,
etc.

AND/OR

Overuse of direct
quotes (>5) or inability
to demonstrate ability
to paraphrase
content.

AND/OR

NSB236

NSB236 – Assessment 1: The deteriorating patient Page 19 of 19. The deteriorating patient

AND

All relevant aspects
of APA style are
used correctly. Title
page properly
formatted, use of
intext citations,
format of
references cited.

Adhered to
prescribed word
limit.

AND
All relevant aspects
of APA style are
used correctly. Title
page properly
formatted, use of
intext citations,
format of references
cited.

AND

Adhered to
prescribed word limit.
.

no errors in style for
citations & references.

Attempted to use APA
style but errors are
occasional and include
errors in citations and
references.

AND/OR

Word limit under/over
the 10% allowance.

references.

Did not adhere to the
minimum
requirements outlined
for the assessment
(e.g word limit and is
under or exceed by
>/<15%, multiple
errors in APA, and
assessment task
specifics)

AND/OR

Issues identified associated with breaches to academic integrity.The deteriorating patient