Creating a title for a case study

[stjoa]

Hi everyone,

I was asked to provide a title that decribes a case study and to ensure that the title relfects the content of the case study. I have come up with a couple of titles, but they all do not sound right to me. They all sound like I am summarising the case study. I was wondering what does "title" mean?? Could anyone give me a hand please..

Here is the case study:

Mrs. Smith (widow) is 82 years of age and had been admitted to your ward at 8.00pm. via casualty with shortness of breath. Until her admission, Mrs. Smith had been independently living within the community.

Her past medical history includes: Type II diabetes - medication controlled, ischemic heart disease and Osteoarthritis. Mrs. Smith's mobility is restricted, and she is currently on a waiting list for a right hip replacement. She has poor vision related to retinopathy and peripheral neuropathy. Despite her co-morbities, Mrs. Smith remains independently mobile with the aid of a walking frame.

Because Mrs. Smith had complained of not having slept well for the past week, the doctor has prescribed her sleeping medications. These are administered by the RN on the evening shift. Mrs. Smith informed the nurses on the evening shift that she had poor bladder control and would probably need to go to the toilet during the night. The evening nurse assured Mrs. Smith that someone will assist her and that she must use the call bell.

You are working on the night shift but not caring for Mrs. Smith. You are covering while your colleague is having a 4.00 am. break. While you are attending to a patient at the other end of the ward who is vomiting, you suddenly hear calls for help from the direction of Mrs. Smith's room.

You rush to Mrs. Smith's room to find her lying on the floor holding her right hip and crying in pain. On examination, her hip has externally rotated suggesting that it is fractured. You note that she appears to be confused because she is telling you that the toilet is not where it should be. Apparently, she had woken up needing to go to the toilet and because no-one responded to her calls for assistance, Mrs. Smith decided that she couldn't wait any longer. Her frame was not in its usual place and because she was desperate not to have an 'accident' Mrs. Smith tried to walk unaided to the bathroom. Half way there, she lost her balance and fell to the floor.

You are required to complete an 'Adverse Event' form and cannot locate any documentation to indicate that she had been assessed for her risk of falling.

Any help would be really appreciated. Thanks for your time.

[Daytonite, BSN, RN]

Where are the titles you said you came up with? You never posted them.

[stjoa]

Ooopppssss. Sorry.. I thought I'd posted them at the beginning.

Here are my titles:

1. A case study on how to prevent the incidence of falling in health care facilities.

2. Examining the sources of falling and providing strategies for improvement in a health care facility.

Another problem with my title is, I don't have iany deas how long the title should be.

Thanks..

[Daytonite, BSN, RN]

1. a case study on how to prevent the incidence of falling in health care facilities.

this is no different than care planning. you assess what the problem is and develop goals and interventions for it. what is the problem? patients falling or the staff leaving the environment so that the patients are at a risk to fall? then, your study is going to do what? prevent falling? is that realistic?

2. examining the sources of falling and providing strategies for improvement in a health care facility.

the source, or cause, of falling would be an etiology of the problem, wouldn't it? that has to do with problem identification. providing strategies for improvement would be appropriate except that you do not identify what you are going to improve.

another problem with my title is, i don't have iany deas how long the title should be.

it doesn't matter as long as it identifies the subject of the paper. it can be 3 words or 15 words long. for example,

examination of the cause of patient falls on an acute hospital medical unit and strategies to prevent them from occurring.

[stjoa]

Thank you so much Daytonite, it does help a lot. I have got a couple more questions here, I couldn't get what the following questions are trying to ask, could you help me out?? Thanks in advanced.

"Provide a background to the professional issue associated with with quality and safety"

"Examine what you see as the key quality and safety issue"

What are they trying to say?

Thanks heaps..

[classicdame, MSN, EdD]

I think they are asking you to describe any issue associated with quality %& safety then discuss what a professional nurse can do about it. That could be as simple as a risk assessment to determine if a patient is at high risk for fall

[stjoa]

issue associated with quality and safety??

[Daytonite, BSN, RN]

"provide a background to the professional issue associated with with quality and safety"

this means you have to do some research about quality and safety issues connected with the nursing profession, and probably acute hospital facilities as well. you will need this to back up the position you will take in the paper. there are probably studies and statistics on patient safety you will want to look up.

"examine what you see as the key quality and safety issue"

this is no different than care planning (problem solving) except it is a quality improvement issue with the problem being patient safety. you go through the steps of the nursing process to identify what the problem is. every facility has policies and procedures (rules) that its employees are supposed to follow. many of the nursing staff rules in the nursing policy and procedure manual are based on good nursing principles and some on the hospital policies. for example, in the case,

the evening nurse assured mrs. smith that someone will assist her and that she must use the call bell. . .she had woken up needing to go to the toilet and because no-one responded to her calls for assistance, mrs. smith decided that she couldn't wait any longer. her frame was not in its usual place.

when i first read this i saw the violation of their own promise to the patient. even more, there is a safety issue there. who put the patient's walker where she couldn't get to it? how come no one responded to her "calls for help"? the scenario isn't telling you if she was ringing the call bell or calling out. maybe she didn't have a call bell to ring either! lots of violations of hospital and nursing safety policies to attack here.

what we did when i worked on a quality assurance/quality improvement committee was we would choose one or two nursing policy or procedures each month and then do random checking to see if the nursing staff was complying with them. if we found that the staff was less than 95% compliant with a policy or procedure the committee considered that a problem and procedures were instituted to correct it. this is mandated by jcaho. different things were done. inservicing the staff was done in different ways: groups, individually, posters, having special speakers come in. then, we always re-tested to see how that affected compliance. sometimes the policy or procedure needed to be changed. especially, if, after reading some of the professional literature there was feeling that our current policy and procedure was outdated. that required cooperation with another committee and inserving of the staff.

is this making sense? do you see how the nursing process also applies here? those five steps to problem solve are always going to be put into play one way or another.

[stjoa]

Can lack of staffing be considered as a professional issue associated with quality and safety?

[Daytonite, BSN, RN]

Can lack of staffing be considered as a professional issue associated with quality and safety?

I wouldn't include the words "lack of staffing" in the title. "Lack of staffing" is a judgment that someone has made. The underlying issue, however, is that it is a safety or quality issue. Examine the issue of safety or quality associated with the numbers of nursing staff compared to patient needs.

[stjoa]

OOpsss.. I wasnt thinking to include lack of staffing thingy in my title, I was thinking to include it in my introduction

"Introduction to your case study provides a brief background to the professional issue associated with quality and safety"

Giving the above statement, would it be appropriate using lack of staffing as the professional issue associated with quality and safety? Or would you rather pick something that is relevant to falls?

Thanks..

[Daytonite, BSN, RN]

What should go, or be included, in your Introduction?