NRS 460 Benchmark – Case Study Assignment: Timothy Smith – Intensive Care Unit

NRS 460 Benchmark – Case Study Assignment: Timothy Smith – Intensive Care Unit

NRS-460 Benchmark – Case Study: Timothy Smith – Intensive Care Unit (ICU)
PART II: Critical Thinking Activity
Use the findings from your evaluation to complete the following:
Power of Attorney
Upon arrival in the ICU, you discover Mr. Smith does not have a power of attorney.
Discuss how you would determine who would make decisions on his behalf. Your response should be a minimum of 150 words. The power of attorney is a healthcare directive about an individual who will make decisions on behalf of another should they not be in a position to do so. I would consider some options if the patient does not have a power of attorney. Firstly, the patient’s spouse would make decisions on behalf of the patient if he were married. Secondly, I would consider his adult children to make decisions on behalf of the patient should he not be married, divorced, or a widower. The patient’s parents would also be considered the key decision-makers if the patient does not have a spouse and adult children to make decisions on his behalf. Should these options fail; the patient’s siblings can also be called to be the decision-makers. Other relatives such as aunts or grandparents might also be relied upon if the patient does not have siblings. Close friends and significant others might also be considered if the above options are unsuccessful. Lastly, the healthcare provider would make decisions with the patient’s best interests should the above options fail.
How can you utilize the chaplain to assist in locating the family? Your response should be a minimum of 150 words. Chaplains can be used to assist in locating the patient’s family. Chaplains can act as contact persons. They are skilled in recognizing communication gaps and their management. Chaplains use this skill to mediate relationships among family members and healthcare providers and act as patient advocates. Chaplains can also use the partnerships they have with communities as a way of locating and helping families. The partnerships can be used to promote social agency-based connections when caring for the patient. Chaplains can also help identify, anticipate, and manage barriers that the patient and his family experience with the healthcare system. They can collaborate with other healthcare providers such as case managers and social workers to address hea

lth system barriers that the patient’s family encounters. Chaplains can also provide family members with the spiritual, social, and psychological support that they need. These forms of support help family members cope with the complex demands they encounter while supporting the patient’s recovery (Teague et al., 2019).

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Quality vs. Quantity of Life
Healthcare professionals often have to have difficult conversations with patients and families in the intensive care unit (ICU) regarding prognosis and outcomes.
What resources are available to have difficult discussion with Timothy’s family on quality versus quantity of life? Your response should be a minimum of 150 words. Nurses can utilize some resources to discuss difficult conversations on quality versus quantity of life in Smith’s case. One of the resources is the hospital’s counseling services. The healthcare providers can collaborate with counselors to educate the family about Timothy’s prognosis and the available alternatives. Counseling will help the family be prepared for any eventuality in Smith’s care. The other resource is support services within a hospital. This includes palliative care teams and chaplains who can assist in discussing quality versus quantity of life with the family. The support services can ease the difficulty that nurses and other healthcare providers involved in Smith’s care encounter in facilitating effective communication and collaboration with the family. Palliative care resources, including websites for organizations that offer palliative care resources, can also benefit the family (Avgeri et al., 2023; Scott et al., 2019). The family can utilize resources from organizations such as the Center to Advance Palliative Care to increase their understanding and make informed decisions on quality versus quantity care in Smith’s case.
Given Mr. Smith’s assessment findings, discuss his quality of life should he receive hematoma evacuation surgery. Your response should be a minimum of 150 words. Mr. Smith is at risk of poor quality of life following hematoma evacuation surgery. Most studies show that patients have poor outcomes at discharge, which worsen during the follow-up period. Factors such as 24-hour post-operative Glasgow Coma Scale (GCS) score, preoperative GCS score, midline shift, and pupillary abnormalities determine the quality of life following the surgery (Akbik et al., 2019). Factors such as smaller acute subdural hematomas, no existing comorbidities, and better neurological status are associated with favorable outcomes following Smith’s surgery (Younsi et al., 2021). Mr. Smith suffered a fractured femur and hairline fracture of 3 left ribs. This implies that his functional status will significantly decrease post-hematoma evacuation surgery. His ability to function optimally in social and occupational roles will significantly decrease, leading to poor quality of life. The risk of mortality is high should Smith be diagnosed with expansive intracranial hematoma. The study by Kamabu et al. (2023) found that mortality risk at 16-month follow-up was 53.4% among patients with expansive intracranial hematomas. Factors such as old age, mean arterial pressure above 95 mmHg, infections, and low GCS predicted mortality risk.
Ethical Considerations
Ethical considerations are an important part of nursing care but become especially vital when dealing with trauma patients considering the potential of poor prognosis.
Discuss the ethical considerations of palliative care, possible outcomes, and limitations with Mr. Smith’s condition taking into account his assessment findings. Your response should be a minimum of 200 words. Ethics will inform the palliative care that Smith receives despite the possibility of poor outcomes. Nurses must respect the principle of autonomy. Smith and his family’s decision to choose or refuse treatment must be respected. Palliative care nurses must also ensure that their decisions and actions are in Smith’s best interests. The decisions made should not subject Smith to any form of harm but promote a common good. Palliative care nurses should also preserve Smith and his family’s right to dignity. They should ensure that they respect their rights and provide humane care to Smith. Palliative care nurses should promote a peaceful death that is free from pain should Smith’s condition deteriorate. Palliative care nurses should also provide Smith and his family with honesty and dignity. They should incorporate values such as respect, honesty, trust, and openness into Smith’s care. Nurses should also ensure shared decision-making in their practice when caring for Smith. They should involve Smith and his family in setting healthcare goals and strategies that can be adopted to achieve them. Smith’s care might involve difficult conversations such as those related to the prognosis of his treatment and preferences for end-of-life care. As a result, palliative care nurses should ensure transparency, honesty, and respect for the patient’s and family member’s autonomy in the care process (Akdeniz et al., 2021). Palliative care nurses should provide accurate information about the care options, benefits, limitations, and disadvantages for Smith and his family to make informed decisions about care options.
Psychosocial and Spiritual Considerations
Providing 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 promote Smith’s psychosocial and spiritual needs. Firstly, the nurse should create a care environment, which makes Smith feel comfortable and safe to share his experiences and needs. The nurse should demonstrate caring behaviors such as respect, empathy, and open communication to help Smith express his needs and be actively involved in addressing them. The nurse should also assess and respond promptly to Smith’s care needs. This includes ensuring regular pain assessment and management and implementing care interventions that address his prioritized needs. The nurse should also provide emotional support to Mr. Smith. This includes ensuring their supportive presence, listening and acknowledging Smith’s concerns and experiences, and reassuring him. The nurse can also promote Smith’s psychosocial needs by providing culturally appropriate care. The care should align with Smith’s cultural values, beliefs, and preferences. Some of the interventions to meet Smith’s spiritual needs include involving spiritual leaders in the care process, offering prayers, supporting his connectedness with the sacred, and performing spiritual pain assessment (Dos Santos et al., 2022).
Economic Issues
BSN-prepared nurses have an understanding of system-based practice including implications of financial and economic considerations related to providing care.
Due to the multi-system injuries, Mr. Smith incurred, discuss the economic issues that the individual and family may encounter. Consider his ability to work, housing needs, supplemental income, temporary disability, insurance, and medical expenses. Your response should be a minimum of 200 words. Mr. Smith and his family might encounter considerable economic challenges. Firstly, Smith’s functional status in social and occupational roles will decrease significantly. The changes will translate into decreased income and increased dependence on his family members. Mr. Smith will also require frequent hospital visits for assessment and treatment. This will increase the costs that Mr. Smith and his family incur in the process. Mr. Smith suffered multiple complications that are likely to result in temporary disability. The family will have to incur considerable costs in meeting Mr. Smith’s activities of daily living since they would need a qualified professional to offer the needed care. In some cases, some family members will have to sacrifice their time and jobs to provide the home that Smith needs. Mr. Smith will also require rehabilitation care for him to regain full functioning after the accident. This will require specialized services of skilled providers such as occupational therapists and speech therapists. Access to such services will imply a considerable economic burden to Mr. Smith and his family (Pley et al., 2020; Sarode et al., 2021). Mr. Smith will also require assistive devices following his discharge from the hospital. This includes crutches and a wheelchair for easy mobility at home. Home changes must also be made to facilitate his mobility with the assistive devices. These demands will act as an economic burden for Smith and his family, hence, the challenge.
Collaboration
What is the purpose of collaborating with the following when providing care for Mr. Smith? Explain the role of each team member’s competency and how they contribute to Mr. Smith’s care.
Occupational Therapists Occupational therapists will provide care services such as modifying Smith’s home environment, providing therapeutic exercises, and determining Smith’s functional abilities.
Physical Therapists Physical therapists will play roles such as providing functional mobility training, gait training, and therapeutic exercises that will improve Smith’s functioning.
Respiratory Therapists The respiratory therapists will ensure Smith’s optimum respiratory functioning and health status. They will provide care such as airway management, oxygen therapy administration, and monitoring equipment used for mechanical ventilation.
Speech Therapists Speech therapists will provide Smith with speech rehabilitation therapy. Hematoma evacuation is likely to affect Smith’s speech and language, hence, the need for speech therapists.
Dieticians Dieticians will collaborate with Smith and other healthcare providers to determine the appropriate diets for Smith. They will also adjust his diet according to his health status and needs.
Physiatrists (Doctor of Rehabilitative Medicine) Smith is at risk of adverse mental health outcomes such as depression and anxiety disorders. The psychiatrist provides services such as psychiatric assessment, treatment, and prevention of mental health problems.
Wound Care Nurse The wound care nurse would provide the required wound cleaning and dressing. The nurse would also refer Smith for specialized care should there be signs of poor wound healing.
Neuropsychologists Neuropsychologists will assess and provide care services such as psychotherapy, cognitive training, and determination of Smith’s ability to make informed decisions about his health needs.
Select two team members and discuss their competencies (skill set) as applicable to Mr. Smith’s care. Your response should be a minimum of 150 words. The wound care nurse should be competent in different aspects of Mr. Smith’s care. Firstly, the nurse should be competent in assessing, planning, implementing, monitoring, and evaluating wound care services. The nurse should perform accurate wound assessment and use the data to develop patient-centered treatments to facilitate recovery. The nurse should also be competent in translating evidence-based practices in wound care into nursing practice. Evidence-based interventions would promote outcomes, including safety, quality, and efficiency. The nurse should also be competent in interprofessional collaboration. He/she should be able to coordinate care being delivered by multidisciplinary teams involved in Smith’s case. The occupational therapist should be competent in patient assessment, planning, implementation, monitoring, and evaluation of care plans. The therapist should also be competent in providing culturally appropriate care to Smith (Yu et al., 2021). The care given should align with Smith’s cultural needs, values, and preferences.
Interdisciplinary Team
Interdisciplinary team collaboration is vital to the successful management of patients with complex conditions.
Part I: Team Dynamics
Explain what principles can be applied to facilitate effective team dynamics in a way that: (1) ensures that the role of each individual/team member is defined by his/her scope of practice; and (2) ensures that the delegation of work to team members based on roles and competencies is assigned without confusion for the team or patient. Your response should be a minimum of 200 words. One of the principles that can be adopted to facilitate effective team dynamics is encouraging open communication. Open communication among the team members would improve the quality and safety of care given to Smith. The communication should be two-way to ensure clarity and timely implementation of care interventions. Open communication also includes ensuring clarity in delegated roles to prevent duplication of roles in the care process. The other principle for effective team dynamics is respect. The team members should respect each other’s views about the care approaches to be adopted for Mr. Smith. The other principle is ensuring the active participation of the team members. Team members should be proactively involved in Smith’s assessment, planning, implementation, monitoring, and evaluation of care. Active participation promotes the empowerment of the team members and ownership of the adopted care interventions. Effective leadership must also be employed to ensure effective team dynamics. The leadership must recognize the need for active team member involvement, open communication, shared-decision making, and respect for diversity among the team members. Team leaders should also lead by example and encourage innovation and the use of evidence-based interventions to improve outcomes in Smith’s care. Lastly, shared vision and goals should guide the team members (Buljac-Samardzic et al., 2020). They should understand and own the goals and vision for the implementation of patient-centered interventions that would improve outcomes.
Part II: Interprofessional Communication
1. Discuss the importance of each member of the interdisciplinary team communicating their information in a professional, accurate, and timely manner when treating Mr. Smith. Your response should be a minimum of 150 words. Interdisciplinary team members should communicate their information in a professional, accurate, and timely manner when treating Mr. Smith. Firstly, communicating in a professional, accurate, and timely manner promotes patient safety. It eliminates the risk of adverse outcomes such as medical and medication errors in Smith’s care. Communicating in a professional, accurate, and timely manner also promotes clarity in Mr. Smith’s care. Clarity eliminates issues such as duplication of roles and interventions. It also ensures efficiency in the delivery of patient care services. Communicating in a professional, accurate, and timely manner also strengthens professionalism. It ensures that each member of the team understands his or her roles and scope of practice in providing the care that Mr. Smith requires. It also facilitates efficient coordination of team-based care. Communicating information promptly also influences decision-making (Burgener, 2020). The team members can make prompt decisions about the patient care needs and approaches to address them when information is communicated in a clear, timely, and professional manner.
2. How does the presence of diversity, equity, and inclusion impact the dynamics of team-based communications? Your response should be a minimum of 150 words. The presence of diversity, equity, and inclusion influences the dynamics of team-based communications. The diversity encourages the adoption of care interventions that incorporate unique experiences, knowledge, and skills of the team members. Diversity also promotes innovation. Team members are encouraged to explore multiple care strategies that can be used to achieve Smith’s health needs. Diversity among the team members also improves problem-solving when addressing Smith’s problems. Healthcare providers with diverse backgrounds bring their skills and expertise to solving Smith’s health problems, which results in the adoption of decisions that would enhance safety, quality, and efficiency in Smith’s care. Diversity, equity, and inclusion also strengthen the adoption of care values that drive care excellence (Hogan et al., 2023). For example, team members recognize the need to respect each other, collaborate in determining and addressing Smith’s care needs, and learn from each other to enrich their practice.
ICU Psychosis/Delirium
There are specific considerations that nurses should be aware of when taking care of patients in the ICU.
Explain ICU psychosis/delirium. Your response should be a minimum of 100 words. ICU delirium refers to the acute confusion state that patients admitted to the ICU develop. A change in awareness and attention over a short period and cognitive deficits characterize ICU delirium. Patients experience symptoms, including perceptual disturbances, disorientation, and memory deficits. ICU delirium can be classified into types that include mixed, hypoactive, and hyperactive delirium. Several factors contribute to ICU delirium. They include metabolic imbalances, medications, trauma, infections, hypoxia, seizures, vitamin deficiencies, vascular conditions, and neurocognitive decline among others. Risk factors associated with ICU delirium include age, cognitive impairment, severe illness, comorbidity, and major surgery (Ali & Cascella, 2024). Routine monitoring should be done to prevent the risk of adverse events such as falls.
What interventions can nurses implement to prevent ICU psychosis/delirium from happening? Your response should be a minimum of 150 words. Nurses can implement some interventions to prevent ICU psychosis from happening. Firstly, nurses can implement interventions that aim at modifiable risk factors for ICU delirium. This includes the implementation of strategies that improve cognitive impairment, and encourage sleep hygiene, and hearing. Nurses should also promote visual stimulation and adopt strategies that prevent constipation, hypoxia, dehydration, and infection. Some medications can also be administered to prevent ICU delirium. For example, the administration of intravenous dexmedetomidine is associated with a decrease in delirium prevalence. Melatonin might also be administered to promote good sleep hygiene. Early mobilization of patients admitted to the ICU also has some benefits of reducing the incidence and risk of ICU delirium. Nurses should assess patients regularly for ICU delirium and implement preventive and management strategies. They can utilize evidence-based bundles such as the ABCDER bundle to assess, prevent, detect, and manage ICU delirium (Ali & Cascella, 2024).
Based on Mr. Smith’s current assessment findings, discuss his risk of developing ICU psychosis/delirium. Your response should be a minimum of 150 words. Mr. Smith is highly at risk of developing ICU psychosis. Mr. Smith has multiple complications that would increase his length of ICU stay. Prolonged ICU stay is associated with an increased risk of ICU delirium. As noted above, early mobility reduces the incidence of ICU psychosis. However, Mr. Smith is likely to remain bedridden for a long time because of his multiple fractures and brain injury. The prolonged hospitalization and being bedridden are likely to increase the risk of Mr. Smith developing ICU delirium. Mr. Smith is also at risk of infections. This included ventilator-associated pneumonia and urinary tract infection due to prolonged mechanical ventilation and catheterization. These infections will elevate the risk of Mr. Smith developing ICU delirium (Ali & Cascella, 2024). Therefore, nurses should implement preventive strategies for optimum health and well-being.
References
Akbik, O. S., Starling, R. V., Gahramanov, S., Zhu, Y., & Lewis, J. (2019). Mortality and Functional Outcome in Surgically Evacuated Acute Subdural Hematoma in Elderly Patients. World Neurosurgery, 126, e1235–e1241. https://doi.org/10.1016/j.wneu.2019.02.234
Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations at the end-of-life care. SAGE Open Medicine, 9, 20503121211000920. https://doi.org/10.1177/20503121211000918
Ali, M., & Cascella, M. (2024). ICU Delirium. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK559280/
Avgeri, K., Zakynthinos, E., Tsolaki, V., Sgantzos, M., Fotakopoulos, G., & Makris, D. (2023). Quality of Life and Family Support in Critically Ill Patients following ICU Discharge. Healthcare, 11(8), 1106. https://doi.org/10.3390/healthcare11081106
Buljac-Samardzic, M., Doekhie, K. D., & van Wijngaarden, J. D. H. (2020). Interventions to improve team effectiveness within health care: A systematic review of the past decade. Human Resources for Health, 18(1), 2. https://doi.org/10.1186/s12960-019-0411-3
Burgener, A. M. (2020). Enhancing Communication to Improve Patient Safety and to Increase Patient Satisfaction. The Health Care Manager, 39(3), 128. https://doi.org/10.1097/HCM.0000000000000298
Dos Santos, F. C., Macieira, T. G. R., Yao, Y., Hunter, S., Madandola, O. O., Cho, H., Bjarnadottir, R. I., Dunn Lopez, K., Wilkie, D. J., & Keenan, G. M. (2022). Spiritual Interventions Delivered by Nurses to Address Patients’ Needs in Hospitals or Long-Term Care Facilities: A Systematic Review. Journal of Palliative Medicine, 25(4), 662–677. https://doi.org/10.1089/jpm.2021.0578
Hogan, T. H., O’Rourke, B. P., Weeks, E., Silvera, G. A., & Choi, S. (2023). Top-level leaders and implementation strategies to support organizational diversity, equity, inclusion, and belonging (DEIB) interventions: A qualitative study of top-level DEIB leaders in healthcare organizations. Implementation Science, 18(1), 59. https://doi.org/10.1186/s13012-023-01319-7
Kamabu, L. K., Bbosa, G. S., Lekuya, H. M., Cho, E. J., Kyaruzi, V. M., Nyalundja, A. D., Deng, D., Sekabunga, J. N., Kataka, L. M., Obiga, D. O. D., Kiryabwire, J., Kaddumukasa, M. N., Kaddumukasa, M., Fuller, A. T., & Galukande, M. (2023). Burden, risk factors, neurosurgical evacuation outcomes, and predictors of mortality among traumatic brain injury patients with expansive intracranial hematomas in Uganda: A mixed methods study design. BMC Surgery, 23, 326. https://doi.org/10.1186/s12893-023-02227-9
Pley, C., Purohit, K., Krkovic, M., & Abdulkarim, A. (2020). A health economic analysis of the management of open lower limb fractures in the elderly. European Journal of Orthopaedic Surgery & Traumatology, 30(8), 1383–1391. https://doi.org/10.1007/s00590-020-02713-3
Sarode, A. L., Ho, V. P., Pieracci, F. M., Moorman, M. L., & Towe, C. W. (2021). The financial burden of rib fractures: National estimates 2007 to 2016. Injury, 52(8), 2180–2187. https://doi.org/10.1016/j.injury.2021.05.027
Scott, P., Thomson, P., & Shepherd, A. (2019). Families of patients in ICU: A Scoping review of their needs and satisfaction with care. Nursing Open, 6(3), 698–712. https://doi.org/10.1002/nop2.287
Teague, P., Kraeuter, S., York, S., Scott, W., Furqan, M. M., & Zakaria, S. (2019). The Role of the Chaplain as a Patient Navigator and Advocate for Patients in the Intensive Care Unit: One Academic Medical Center’s Experience. Journal of Religion and Health, 58(5), 1833–1846. https://doi.org/10.1007/s10943-019-00865-z
Younsi, A., Fischer, J., Habel, C., Riemann, L., Scherer, M., Unterberg, A., & Zweckberger, K. (2021). Mortality and functional outcome after surgical evacuation of traumatic acute subdural hematomas in octa- and nonagenarians. European Journal of Trauma and Emergency Surgery, 47(5), 1499–1510. https://doi.org/10.1007/s00068-020-01419-9
Yu, M.-L., Brown, T., Hewitt, A., Cousland, R., Licciardi, L., & Lyons, C. (2021). Baccalaureate occupational therapy students’ development of social and emotional competencies. Nurse Education Today, 105, 105032. https://doi.org/10.1016/j.nedt.2021.105032

 

 

Assessment Description

Use the “Case Study: Timothy Smith – ICU” template to complete the assignment.

This case study has indirect care experience requirements. The “NRS-460 – Case Studies: Indirect Care Experience Hours” form, found in the Topic 1 Resources, will be used to document the indirect care experience hours completed in the case study. As progress is made on the case study, update this form indicating the date(s) each section is completed. This form will be submitted in Topic 5.

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the past 5 years and appropriate for the assignment criteria and relevant to nursing practice.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies and professional standards:

RN-BSN

6.2: Perform effectively in different team roles, using principles and values of team dynamics.

American Association of Colleges of Nursing Core Competencies for Professional Nursing Education

This assignment aligns to AACN Core Competencies 3.2, 6.1, and 6.2.

Attachments

NRS-460-RS-T2-BenchmarkCaseStudy-TimothySmith-ICU.docx

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Benchmark – Case Study: Timothy Smith – Intensive Care Unit – Rubric

 

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Rubric Criteria

Total160 points

Criterion	1. Unsatisfactory	2. Insufficient	3. Approaching	4. Acceptable	5. Target
Power of Attorney	0 points Discussion of how to determine who would make decisions on the patient’s behalf if he does not have Power of Attorney, as well how to utilize the chaplain to assist in locating family, is not present.	6 points Discussion of how to determine who would make decisions on the patient’s behalf if he does not have Power of Attorney, as well how to utilize the chaplain to assist in locating family, is incomplete or incorrect.	6.32 points Discussion of how to determine who would make decisions on the patient’s behalf if he does not have Power of Attorney, as well how to utilize the chaplain to assist in locating family, is present but lacks detail.	7.12 points Discussion of how to determine who would make decisions on the patient’s behalf if he does not have Power of Attorney, as well how to utilize the chaplain to assist in locating family, is detailed.	8 points Discussion of how to determine who would make decisions on the patient’s behalf if he does not have Power of Attorney, as well how to utilize the chaplain to assist in locating family, is thorough.
Quality vs. Quantity of Life	0 points Discussion of the resources available to have difficult discussions with the patient’s family on quality versus quantity of life, including the patient’s quality of life should he receive hematoma evacuation surgery, is not present.	18 points Discussion of the resources available to have difficult discussions with the patient’s family on quality versus quantity of life, including the patient’s quality of life should he receive hematoma evacuation surgery, is incomplete or incorrect.	18.96 points Discussion of the resources available to have difficult discussions with the patient’s family on quality versus quantity of life, including the patient’s quality of life should he receive hematoma evacuation surgery, is present but lacks detail.	21.36 points Discussion of the resources available to have difficult discussions with the patient’s family on quality versus quantity of life, including the patient’s quality of life should he receive hematoma evacuation surgery, is detailed.	24 points Discussion of the resources available to have difficult discussions with the patient’s family on quality versus quantity of life, including the patient’s quality of life should he receive hematoma evacuation surgery, is thorough.
Ethical Considerations	0 points Discussion of the ethical considerations of palliative care, possible outcomes, and limitations with the patient’s condition is not present.	12 points Discussion of the ethical considerations of palliative care, possible outcomes, and limitations with the patient’s condition is incomplete or incorrect.	12.64 points Discussion of the ethical considerations of palliative care, possible outcomes, and limitations with the patient’s condition is present but lacks detail.	14.24 points Discussion of the ethical considerations of palliative care, possible outcomes, and limitations with the patient’s condition is detailed.	16 points Discussion of the ethical considerations of palliative care, possible outcomes, and limitations with the patient’s condition is thorough.
Psychosocial and Spiritual Considerations	0 points Discussion of ways in which the nurse can address the patient’s psychosocial and spiritual needs is not present.	6 points Discussion of ways in which the nurse can address the patient’s psychosocial and spiritual needs is incomplete or incorrect.	6.32 points Discussion of ways in which the nurse can address the patient’s psychosocial and spiritual needs is present but lacks detail.	7.12 points Discussion of ways in which the nurse can address the patient’s psychosocial and spiritual needs is detailed.	8 points Discussion of ways in which the nurse can address the patient’s psychosocial and spiritual needs is thorough.
Economic Issues	0 points Discussion of the economic issues the individual and family may encounter, including ability to work, housing needs, supplemental income, temporary disability, insurance, and medical expenses, is not present.	12 points Discussion of the economic issues the individual and family may encounter, including ability to work, housing needs, supplemental income, temporary disability, insurance, and medical expenses, is incomplete or incorrect.	12.64 points Discussion of the economic issues the individual and family may encounter, including ability to work, housing needs, supplemental income, temporary disability, insurance, and medical expenses, is present but lacks detail.	14.24 points Discussion of the economic issues the individual and family may encounter, including ability to work, housing needs, supplemental income, temporary disability, insurance, and medical expenses, is detailed.	16 points Discussion of the economic issues the individual and family may encounter, including ability to work, housing needs, supplemental income, temporary disability, insurance, and medical expenses, is thorough.
Collaboration	0 points Explanation of the role of each team member’s competency and how they contribute to the patient’s care is not present.	12 points Explanation of the role of each team member’s competency and how they contribute to the patient’s care is incomplete or incorrect.	12.64 points Explanation of the role of each team member’s competency and how they contribute to the patient’s care is present but lacks detail.	14.24 points Explanation of the role of each team member’s competency and how they contribute to the patient’s care is detailed.	16 points Explanation of the role of each team member’s competency and how they contribute to the patient’s care is thorough.
Interdisciplinary Team Part I: Team Dynamics (B) (C6.2)	0 points Explanation of the principles that can be applied to facilitate effective team dynamics that ensuring the role of each member is define by his/her scope of practice, as well as ensures the delegation of work is based on roles and competencies, is not present.	18 points Explanation of the principles that can be applied to facilitate effective team dynamics that ensuring the role of each member is define by his/her scope of practice, as well as ensures the delegation of work is based on roles and competencies, is incomplete or incorrect.	18.96 points Explanation of the principles that can be applied to facilitate effective team dynamics that ensuring the role of each member is define by his/her scope of practice, as well as ensures the delegation of work is based on roles and competencies, is present but lacks detail.	21.36 points Explanation of the principles that can be applied to facilitate effective team dynamics that ensures the role of each member is defined by his/her scope of practice, as well as ensuring the delegation of work is based on roles and competencies, is detailed.	24 points Explanation of the principles that can be applied to facilitate effective team dynamics that ensures the role of each member is define by his/her scope of practice, as well as ensuring the delegation of work is based on roles and competencies, is thorough.
Interdisciplinary Team Part II: Interprofessional Communication	0 points Discussion of the importance of each member of the interdisciplinary team communicating their information in a professional, accurate and timely manner, as well as how the presence of diversity, equity, and inclusion impact the dynamics of team-based communications, is not present.	12 points Discussion of the importance of each member of the interdisciplinary team communicating their information in a professional, accurate and timely manner, as well as how the presence of diversity, equity, and inclusion impact the dynamics of team-based communications, is incomplete or incorrect.	12.64 points Discussion of the importance of each member of the interdisciplinary team communicating their information in a professional, accurate and timely manner, as well as how the presence of diversity, equity, and inclusion impact the dynamics of team-based communications, is present but lacks detail.	14.24 points Discussion of the importance of each member of the interdisciplinary team communicating their information in a professional, accurate and timely manner, as well as how the presence of diversity, equity, and inclusion impact the dynamics of team-based communications, is detailed.	16 points Discussion of the importance of each member of the interdisciplinary team communicating their information in a professional, accurate and timely manner, as well as how the presence of diversity, equity, and inclusion impact the dynamics of team-based communications, is thorough.
ICU Psychosis	0 points Explanation of ICU psychosis/delirium and the interventions nurses can implement to prevent it from happening, as well as a discussion on the patient’s risk for developing ICU psychosis/delirium, is not present.	12 points Explanation of ICU psychosis/delirium and the interventions nurses can implement to prevent it from happening, as well as a discussion on the patient’s risk for developing ICU psychosis/delirium, is incomplete or incorrect.	12.64 points Explanation of ICU psychosis/delirium and the interventions nurses can implement to prevent it from happening, as well as a discussion on the patient’s risk for developing ICU psychosis/delirium, is present but lacks detail.	14.24 points Explanation of ICU psychosis/delirium and the interventions nurses can implement to prevent it from happening, as well as a discussion on the patient’s risk for developing ICU psychosis/delirium, is detailed.	16 points Explanation of ICU psychosis/delirium and the interventions nurses can implement to prevent it from happening, as well as a discussion on the patient’s risk for developing ICU psychosis/delirium, is thorough.
Mechanics of Writing Includes spelling, punctuation, grammar, and language use.	0 points Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.	6 points Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.	6.32 points Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.	7.12 points Few mechanical errors are present. Suitable language choice and sentence structure are used.	8 points No mechanical errors are present. Appropriate language choice and sentence structure are used throughout.
Documentation of Sources Includes citations, footnotes, references, bibliography, etc., as appropriate to assignment and style.	0 points Sources are not documented.	6 points Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.	6.32 points Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.	7.12 points Sources are documented, as appropriate to assignment and style, and format is mostly correct.	8 points Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of errors.

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