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Nursing Case Study Analysis [10 Examples & How-To Guides]

• Wilson Logan
• August 6, 2022
• blog , Nursing Topics and Ideas

What is a case study analysis?

A case study analysis is a detailed examination of a specific real-world situation or event. It is typically used in business or nursing school to help students learn how to analyze complex problems and make decisions based on limited information.

Preparing a good case study analysis is not an easy task and requires a lot of time and effort. This article provides some tips on how to write a case study analysis that will help you get the most out of your research and provide a solid foundation for your writing.(Nursing Case Study Analysis)

Nursing Case Study Analysis

Nurses are constantly faced with decisions that have to be made in a timely and effective manner. Often, these decisions are based on the available information, which may be limited.

In order to make the best possible decisions, nurses need to be able to analyze and interpret data. Nursing case studies are an important tool that can help nurses improve their decision-making skills.

10 Nursing Case Study Analysis Examples

How to write case study analysis in nursing.

A case study analysis requires you to investigate a nursing scenario, examine the alternative solutions, and propose the most effective solution using supporting evidence.(Nursing Case Study Analysis)

Nurses have to constantly make decisions that affect the lives of their patients. In order to ensure that these decisions are made correctly, nurses need to have strong problem-solving and critical-thinking skills. Case studies are an excellent way for nurses to hone these skills.

Writing a nursing case study analysis is not as difficult as it may first seem. Follow these steps and you will be well on your way to writing a successful case study analysis.(Nursing Case Study Analysis)

• Read the case study carefully. As you read, take note of any key facts or information that could be important for your analysis.
• Once you have finished reading the case study, identify the main problem or issue that needs to be addressed.
• Brainstorm possible solutions to the problem or issue . Try to come up with a few different options.
• Choose the best solution based on the information in the case study and your own clinical experience.
• Write up your analysis in a clear and concise manner. Be sure to support your chosen solution with evidence from the case study and your own professional experience .

Here’s How To Write A Nursing Case Study

How do you analyze a case study in nursing?

A nursing case study is an in-depth examination of a single individual. It is usually used to identify new areas of knowledge or to validate existing knowledge.

When analyzing a nursing case study, it is important to consider the following elements:

• The patient’s medical history. This includes any prior illnesses, treatments, and medications.
• The patient’s current condition. This includes symptoms, vital signs, and laboratory results.
• The nurse’s observations. This includes the nurse’s notes on the patient’s condition and behavior.
• The patient’s family and social history. This includes information on the patient’s family, friends, and social support network.(Nursing Case Study Analysis)
• The patient’s response to treatment. This includes any changes in the patient’s condition or symptoms after receiving treatment.

How nursing practitioners can analyze Patient’s Cases

As a nurse practitioner, you will often be asked to provide a case analysis for your patients. This can be a daunting task, but there are some key elements that you should always include in your analysis.

• The first element is the patient history. This should include any relevant medical history, as well as any personal information that may be pertinent to the case.
• The second element is the physical examination. This should include a thorough examination of the patient, including any relevant test results.(Nursing Case Study Analysis)
• The third element is the diagnosis. This is where you will provide your assessment of the patient’s condition and identify any potential problems.
• The fourth element is the treatment plan. This is where you will outline the course of treatment that you recommend for the patient.
• The fifth and final element is the prognosis. This is where you will provide your assessment of the likely outcome of the case, based on the information that you have gathered.

Steps of writing nursing case study analysis

Furthermore; there are different ways to approach writing a nursing case study analysis, but there are generally three main steps that need to be followed.

• First, you will need to perform a thorough analysis of the case study. This means looking at all aspects of the case and trying to identify any key issues or problems.(Nursing Case Study Analysis)
• Once you have done this, you will need to develop a hypothesis or research question that you can test.
• Finally, you will need to write up your findings in a clear and concise manner.

Assuming that you have been given the task of writing a case study analysis, there are a few key steps that you will need to take in order to ensure that your document is well-written and informative.

• Make sure that you understand all of the information presented in the case study , and take note of any key points or details that you think may be important.
• What points do you want to make in your analysis?
• What evidence will you use to support these points?
• Once you have a good idea of what you want to say in your analysis, start organizing your thoughts and putting them into a coherent structure.(Nursing Case Study Analysis)
• Once you have a rough outline of your case study analysis , start filling in the details. Flesh out your arguments and provide evidence to support them. In addition, make sure to address any counterarguments that could be made against your points.
• Finally, conclude your analysis by summarizing your main points and providing any recommendations or suggestions for further action .

Nursing Case study Analysis Format and Structure

When it comes to writing a case study analysis, there is no one-size-fits-all approach. However, there is a general format and structure that you can follow to ensure your analysis is well-organized and flows smoothly. Here are the basics:

A nursing case study is a detailed study of a patient that is encountered by a nurse. The purpose of the case study is to provide a comprehensive view of the patient’s health condition and history. Nurse practitioners use case studies to enhance their ability to care for patients by providing them with a more complete picture of the patient’s health . Nurse practitioners may use different formats for their nursing case studies. However, all case studies should include certain key elements. These key elements include:

• Patient information – This section should include basic demographic information about the patient, such as age, gender, race/ethnicity, and chief complaint
• Medical history – This section should detail the patient’s past medical history, including any chronic conditions, medications, allergies, and surgeries.(Nursing Case Study Analysis)
• Family history – This section should detail the patient’s family medical history, including any chronic conditions or genetic diseases that may be relevant to the patient’s current condition.
• Social history – This section should detail the patient’s social circumstances, such as employment status, living situation, and alcohol/drug use.
• Review of symptoms –A physical examination will help you to identify any physical abnormalities that may be causing or contributing to the patient’s condition.
• Diagnostic testing – Diagnostic testing may be necessary in order to confirm or rule out a diagnosis . Common tests used in case analysis include blood work, imaging tests, and biopsies.
• Treatment options – Once a diagnosis has been made, you will need to consider treatment options. Treatment options will vary depending on the diagnosis and the severity of the condition.(Nursing Case Study Analysis)
• The prognosis (Evaluation and outcomes) – After considering all of the above factors, you will be able to give the patient a prognosis. The prognosis is an educated guess as to how the condition will progress.

When writing a nursing case study, nurse practitioners should use a clear and concise format. The format should be easy to follow and understand. Nurse practitioners should also include all of the key elements in their nursing case studies.

As a nurse practitioner, you will be required to conduct case analyses on patients in order to make treatment decisions. There are key elements that you will need to take into consideration when conducting a case analysis. These elements include the patient’s history, physical examination, laboratory data, and imaging studies.(Nursing Case Study Analysis)

By taking into consideration all of these elements, you will be able to develop a comprehensive picture of the patient’s condition. This will allow you to make an informed decision about the best course of treatment.

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How to Write a Nursing Case Study [Examples, Format, & Tips]

✒️ case study topics for nursing students.

• 🩺️ The Basics
• 💉 Nursing Case Study: Writing Rules

📑 Nursing Case Study Format

📝 nursing case study examples.

• ⏱️ Tips on Quick Writing

🔗 References

A nursing case study is an in-depth analysis of the health situation of an individual patient.

The analysis is based on:

• medical history,
• other relevant criteria.

In most cases, you will be asked to diagnose to suggest the first aid measures. Alternatively, nurses can be asked to describe a patient in their practice and analyze the correctness of their actions. The purpose is to recreate a realistic hospital setting in the classroom and make students reflect on the treatment process from diagnosis to treatment.

• Anaphylactic shock in a teenager with peanut allergy.
• Non-compliant patient with diabetes: ways to improve adherence.
• Telehealth intervention for managing chronic disease.
• Communication strategies to address vaccine hesitancy in a rural community.
• Postpartum hemorrhage in a new mother: risk factors and interventions.
• Ways to improve recognition of dehydration in aging adults.
• The effective ways of maintaining work-life balance for nurses.
• Cultural competency in providing care to migrants and refugees.
• Why should every patient’s medical history remain confidential?
• The use of massage therapy in relieving pain.
• The challenges facing medicine in 2024.
• How does modern technology impact nursing?
• The significance of regular follow-up appointments with the healthcare provider.
• What are the primary treatments for postpartum depression?
• The use of steroids in cancer treatment.

🩺️ Nursing Case Study: What Is It About?

As a nursing student, you should understand that no two patients are the same. Each has a unique clinical record and condition. And although most nursing case study tasks will ask you to suggest a diagnosis or treatment, your focus should rest on the patient.

Busy nurses can sometimes see their patients in the framework of an illness to be treated or a procedure to be fulfilled. But you should do your best to remember that each patient is a living person with a complex set of needs, emotions, and preferences. A ready-made textbook answer is rarely the best solution for them. Moreover, it rarely helps to analyze a condition in isolation from the patient.

In a nursing case study, your task is to analyze a disorder or illness as a part of a specific medical situation. If you don’t do that, your case study becomes an essay (theoretical and generalized). It is the difference between the two assignment types.

Once again:

A case study in nursing emphasizes the particular patient’s condition. Meanwhile, a nursing essay will explore the disease, prevention methods, treatment, or possible consequences of the disease.

Even if the case is hypothetical, it should focus on the suggested reality. On the other hand, essays are usually literature-based. You are expected to do some reading for a case study too, but you should research and present the information within the context of the patient. In simple terms, a case study uses information in the actual application, and an essay uses it for the sake of generalized suggestions.

💉 How to Write a Nursing Case Study: 3 Key Rules

• Do the fieldwork. Before setting your hands to writing, you should collect all of the available materials: clinical notes, results of medical tests, x-rays, sickness records, etc. Use this information to draw a clear picture of the story. It is always helpful to ask yourself, “What is interesting or unusual about this patient’s condition?” In the course of writing, recall your answer from time to time not to get lost in words. It will help you to convey a definite and appropriate message.

• Stick to the facts. A nursing case study should be an accurate description of the actual situation. Restrain from speculating about the inherent mechanisms of the illness or the general treatment methodology. In fact, students are rarely prepared enough to discuss pathology and physiology. Leave this to reputable experts. The best result you can provide in a case study is an honest account of clinical events.
• Concentrate on the patients and their progress. Remember that a nursing case study is a story of a patient’s progress and not a narrative about their nurse. No matter how efficiently the medical specialist acted, it would be incorrect to add any praiseful remarks. The optimal way is to tell the story in its logical and time order and outline the result of treatment. In this case, the outcome will speak for itself.

Introduction

It is where you should tell the reader why this case is interesting . Place your study in a social or historical context. If, during your preliminary research, you found some similar cases, describe them briefly. If you had a hard time diagnosing the patient or your proposed treatment is complicated, mention it here. Don’t forget to cite the references to each of them!

The introduction should not exceed several paragraphs. The purpose is to explain why the reader will benefit from reading about the case.

Case Presentation

• Why did the patient seek medical help? (Describe the symptoms.)
• What is known about the patient? (Mention only the information that influenced your diagnosis. Otherwise, explain why some information is irrelevant to the diagnosis.)
• Stick to the narrative form. (Make it a story!)
• What are the variants for diagnosis? (Make a shortlist of possible disorders that fall under the patient’s symptoms. But make it specific: not just “pneumonia” but “bilateral pneumonia,” for example. Besides, this point is optional.)
• What were the results of your clinical examination? (If you saw the patient in person.)
• Explain the results of lab tests. (The words “positive” or “negative” are not always clear.)

Actions and Their Results

This section describes the care that has been provided and/or is planned. You can answer the following questions in narrative form . If some information is missing, skip the point:

• What preliminary actions have been taken? (Be specific: not just “wound care,” but “wound cleaning and dressing.”)
• How long has the patient been under care?
• Has the previous treatment given any visible result?
• Why was it suspended or finished?
• Why did the patient withdraw from treatment (if applicable)?
• How could you improve the patient’s condition if the result was negative?
• If the disease is incurable (like in the case of diabetes), which activities would stabilize the patient’s condition?
• If possible, include the patient’s reports of their own physical and mental health.

In this section, you should identify your questions about the case. It is impossible to answer all of them in one case study. Likewise, it is unreal to suggest all the relevant hypotheses explaining the patient’s condition. Your purpose is to show your critical thinking and observation skills. Finalize your conclusion by summarizing the lessons you learned from the nursing case study.

Whenever you directly or indirectly cite other sources or use data from them, add these books and documents to the references list. Follow the citation style assigned by your professor. Besides, 15 items are already too much. Try to make a list of up to 10. Using textbooks as references can be viewed as bad manners.

Include all the tables, photographs, x-rays, figures, and the journal of medication usage in this section. Unless required otherwise in the assignment, start each item from a new page, naming them “Appendix A,” “Appendix B…”.

Below you will find case study samples for various topics. Using them as a reference will improve your writing. If you need more ideas, you are welcome to use our free title-generating tool .

• Case study: healing and autonomy.
• Sara’s case study: maternal and child nursing.
• COPD medical diagnostics: case study.
• Care standards in healthcare institutions: case study.
• Acute bacterial prostatitis: case study analysis.
• Alzheimer disease: the patient case study.
• The treatment of foot ulcers in diabetic patients: case study.
• Hypertension: C.D’s case study.
• Myocardial infarction: cardiovascular case study.
• Major depressive disorder case.
• Case study of the patient with metabolic syndrome .
• Pulmonary analysis case study .
• Older adults isolation: Case study .
• The holistic care: Case study .
• Medical ethics: Case study .
• Patient diagnoses and treatment: Case study .
• Obesity case study: Mr. C .
• Nurse Joserine: Case study problems .
• Chronic stable angina: Case study .
• Fetal abnormality: Case study .
• Researching SOAP: Case study .
• Case study for a patient with hormonal disorders .
• Obesity in the elderly: The case study .
• “Walking the Tightrope”: A case study analysis .
• ARNP approach: Case study analysis .
• Case study on biomedical ethics in the Christian narrative .
• Thermal injury: Case study .
• Ethical dilemma in nursing: Case study .
• Asthma: A case study of the patient .
• Asthma discharge plan: Mini case study .
• Case study: An ethics of euthanasia .
• Case study: Head-to-toe assessment steps .
• Pain management strategies: Case study .
• Case study: Inflammatory bowel disease .
• Sleep deprivation and insomnia: The case study .
• The case study of a heart failure .
• Porphyria cutanea tarda: Disease case study .
• Case study: Hardy Hospital case summary .
• Obesity and its complications: Case study .
• Angina disease case study .
• Nursing ethics case study .
• Case study of a patient: Assessment and treatment plan .
• Cecile case study: Mrs. J .
• Nursing power in the emergency department: Case study .
• Heart failure case study: Mrs. J .
• Application of ethics in nursing: Case study .
• Sudden visual impairment: Case study .
• Epidemiology case study: Outbreak at Watersedge — Public health discovery game .
• Wellness of senior citizens: Case study .
• Healthcare organization evaluation: Case study of Banner Health .

⏱️ Bonus: Tips on Writing a Case Study in Record Time

Need to prepare a case study on nursing or in another field? Below you’ll find a collection fo tips that will help you do it as quickly as possible!

3 Shortcuts for a Quick Start

If you’re about to start writing a case study, you should check yourself if you’re not doing any of the following:

• spending too much time on selecting a topic;
• reading too much before selecting a topic;
• making conclusions too early – creating bias.

Instead of killing time doing the three useless things discussed above, consider these:

• Choose approach. Note that there are 2 major approaches to case studies: the analytical approach (investigating possible reasons without making any conclusions) and problem-oriented approach (focusing on a particular problem and investigating it).
• Skim some sources (DON’T READ THEM). Select several sources. Simply skim abstracts and conclusions.
• Start making notes early. Simply reading is ineffective unless you’re lucky to have a phenomenal memory. Always make notes of any useful arguments.

4 Shortcuts Not to Get Stuck in the Middle

Even if you kick started your case study, it’s too early to celebrate it. Consider the following traps in the middle of the project:

• Watch the structure. The classic logical structure is your formula of success. It will help you move from one point to another without the unnecessary procrastination:
• Respect the logic. Make your case study flow – make logical transitions between the different parts and make it consistent. Avoid changing your position throughout the paper.
• Be detail-oriented. Any trifle deserves attention when you write a case study.
• Avoid bias. Be sure that all your opinions are based on the specific arguments form the case study. Avoid pouring your biased views into the project.

3 Shortcuts for a Happy Ending

• Offer a realistic solution. College case study is a rehearsal of real-life situations. Take the responsibility for your suggestions.
• Keep your conclusion short. Avoid repeating the details and don’t include any new information.
• Consider creating a Power Point. If your task is not only writing a case study, but also presenting it – why not create PowerPoint slides to help you?

As the last step on your way to a perfect nursing case study, prepare the title page. Its format usually depends on the professor’s requirements. But if you know the citation style, our Title Page Maker is a perfect tool to apply the right formatting and accelerate the process. And if you have any know-how on how to write a medical case study, you are very welcome to share it with other students in the comments below.

❓ Nursing Case Study: FAQ

What is a case study in nursing.

A nursing case study explores the condition of a patient. It is based on previous clinical records, lab reports, and other medical and personal information. A case study focuses on the patient and describes the treatment that was (or should be) applied and its (expected) outcome.

How to Write a Nursing Case Study?

• Collect the bulk of data available about the patient.
• Read literature about the diagnosed condition.
• Focus on the individual patient and their symptoms.
• Describe the situation and outline its development in time.
• Analyze the actions of the medical personnel that have been done.
• Plan further treatment of the patient.

Why Are Case Studies Good for Nursing Students?

Nursing case studies offer you a priceless opportunity to gain experience of different patient conditions and cure methods without visiting the clinic. You can think about whether the proposed treatment was appropriate or wrong and suggest a better solution. And the best thing, your teacher will indicate your mistakes (and no patient will be hurt in the process).

Why Are Case Studies Important in Nursing?

• You learn to distinguish the relevant data and analyze it.
• You learn to ask the right questions.
• You learn to evaluate the severity of symptoms.
• You learn to make better diagnoses.
• You train your critical thinking in terms of treatment methods
• Case studies are in-class simulators of authentic atmosphere in a clinical ward.
• What is a case study? | Evidence-Based Nursing
• Case Studies – Johns Hopkins Medicine
• Case Study Research Design in Nursing
• Case study report for Nursing | Learning Lab – RMIT University
• Case Study or Nursing Care Study? – jstor

Research Paper Analysis: How to Analyze a Research Article + Example

Film analysis: example, format, and outline + topics & prompts.

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Main Tips On How To Write a Case Study Analysis

A nursing case study analysis is like an in-depth exploration. It acts as the lifeline connecting theoretical knowledge to its real-world implications, bridging the gap between understanding symptoms and improving the quality of patient care.

Why is a case study analysis so significant? Case studies are types of essays that breathe life into nursing principles, making them more than abstract concepts. They provide context, create connections, and highlight the real-world impact of nursing decisions. Furthermore, they foster empathy, allowing nursing professionals to perceive each patient as unique with distinctive healthcare needs. This comprehensive guide will serve as your roadmap for how to write a nursing case study analysis.

What is a Case Study Analysis in Nursing?

In the 5th century BC, the philosopher Lao-Tse (also Lao-tzu) wrote, “If you tell me, I will listen. If you show me, I will see. But if you let me experience, I will learn.” And so began one of the first active learning philosophies.

A nursing case study analysis is an immersive journey into a patient’s health scenario. It’s like a detective story, where the nurse or nursing student acts as the investigator, and the patient’s condition is the mystery waiting to be solved. Each patient’s story is unique and requires a thorough examination to extract useful insights. But what exactly does this process involve?

A nursing case study analysis begins with a comprehensive exploration of a patient’s health situation. This includes their health history, current symptoms, and previous treatments. This exploration phase involves collecting data from patient interviews, physical examinations, and diagnostic tests. Each data point could be the key to better understanding the patient’s condition.

The next step is to diagnose the issues. This involves understanding the complexities of the patient’s condition—the root causes, contributing factors, and potential risks. The nurse then moves on to planning and implementing interventions. This might involve developing a care plan, suggesting lifestyle modifications, or coordinating with other healthcare professionals for specialized care. These interventions aim to address the diagnosed issues and improve the patient’s health outcomes.

The nurse then moves on to planning and implementing interventions. This might involve developing a care plan, suggesting lifestyle modifications, or coordinating with other healthcare professionals for specialized care. These interventions aim to address the diagnosed issues and improve the patient’s health outcomes.

What is the Purpose of a Case Analysis?

Why do nurses engage in the elaborate process of a case study analysis? What purposes does it serve, and how does it contribute to the broader nursing field?

• Enhancing Patient Care: A nursing case study analysis aims to improve patient care. When a nurse begins analyzing a patient’s case, they are honing their ability to provide effective, personalized care.
• Refining Critical Thinking Skills: A case analysis requires active engagement, thoughtful consideration, and deliberate analysis. Nurses must interpret data, make diagnoses, and plan interventions, all of which demand a high degree of cognitive ability.
• Bridging Theory and Practice: A case study allows nurses to apply theoretical concepts to real-world contexts, demonstrating the practical implications of nursing principles. This deepens their understanding of these concepts and reinforces their learning.
• Fostering Reflective Learning: As nurses evaluate their interventions’ outcomes, they reflect, assessing their actions and learning from their experiences. This cultivates an attitude of continuous learning and promotes personal and professional growth.

Difference Between a Nursing Research Paper and a Case Study

Here are the differences between these two important facets of nursing literature:

Research Paper

A nursing research paper explores a particular topic or concept in depth. Its purpose is to contribute new insights or validate or challenge existing theories. It seeks to add to the collective understanding of a topic and often aims to solve a larger problem or answer a complex question.

A research paper often employs a systematic and structured approach. This might involve a literature review, an experimental study, a survey, or a qualitative investigation, depending on the nature of the research topic. The methodology is often rigorous and has strict guidelines to ensure the validity and reliability of the results.

A research paper generally follows the IMRaD format—Introduction, Methods, Results, and Discussion. Each section has a specific role, contributing to the overall narrative of the paper.

A case study takes a single patient situation or a unique medical scenario and delves into it with microscopic attention. The primary aim is to apply theoretical knowledge to practical, real-life scenarios, enhancing understanding and application.

The case study method employs a more focused approach. It concentrates on a single instance or scenario, using interviews, observations, and medical records review to gain insights. Its strength lies in its detail and specificity.

A case study begins with an introduction of the patient or the situation, followed by a detailed account of the patient’s history, diagnosis, treatment, and the nurse’s role. The focus is on presenting a chronological and detailed narrative of the patient’s journey.

Types of Nursing Case Studies

Here are the five primary types of case studies:

• Problem-Oriented Case Studies: These studies focus on a specific problem encountered in nursing practice. Whether it’s a challenging patient condition, a complex care scenario, or an organizational issue, problem-oriented case studies zero in on the problem. They detail the problem’s context, dissect its causes, and evaluate the solutions implemented.
• Critical Case Studies: They delve into cases with significant implications for nursing practice. These could be landmark cases, rare medical conditions, or novel nursing interventions. A critical analysis case study aims to illuminate the unique aspects and derive valuable lessons. They often lead to advancements in nursing knowledge, influencing nursing practices and policies.
• Historical Case Studies: As the name suggests, historical case studies delve into past nursing scenarios. They offer a retrospective analysis of a patient case, nursing intervention, or healthcare event. They allow for reflecting on past actions, evaluating their outcomes, and extracting lessons for future practice.
• Illustrative Case Studies: Descriptive or illustrative case studies are designed to ‘illustrate’ or ‘describe’ a particular nursing situation or condition. These case studies provide a detailed narrative of the case, painting a vivid picture for the reader. They serve to familiarize the readers with the case’s intricacies, enhancing their understanding and empathy. They are useful for educating patients or the general public about specific health conditions or nursing procedures.
• Collective Case Studies: Multiple case studies involve the analysis of more than one case. The goal is to derive insights from a collective analysis, recognizing patterns, differences, and similarities across the cases. This type of case study is especially useful for comparing different nursing approaches, understanding the variability in patient responses, or evaluating the impact of a particular nursing intervention across multiple scenarios.

6 Steps for Writing a Case Study Analysis

Writing a nursing case study analysis requires a systematic approach to ensure all necessary details are covered and accurately presented. The case study approach allows in-depth, multi-faceted explorations of complex issues in real-life settings. Here is a step-by-step guide to facilitate this process:

Preparation

Preparation means collecting, collating, and comprehending all available patient case information. First, take the patient’s medical history to understand the current health situation. It may include details about previous diagnoses, treatments, hospitalizations, allergies, and family history of diseases.

Check nursing assessments that were conducted. These assessments serve as a foundation for nursing care, offering vital clues about the patient’s health status at different times. Information about the patient’s vital signs, physical examination findings, lab results, and psychosocial assessments can help unravel the case’s complexity.

Review the treatment plans initiated to have insights into the healthcare team’s approach to managing the patient’s condition. Lastly, include the outcomes. What was the response to the treatments initiated? How did the patient’s condition evolve over time? Outcomes, both expected and unexpected, offer a reality check. They help understand the interventions’ effectiveness and provide opportunities for reflection and learning.

Introduction

Introducing your case study analysis is a gateway to the patient’s story, providing crucial initial details and laying the groundwork for in-depth exploration. Present a snapshot of the patient’s background that involves sharing key details, such as the patient’s age and gender, which can influence disease prevalence, presentation, and response to treatment.

Next, share why the patient sought medical care for a first clue to their health status. Was it a routine check-up that led to an unexpected discovery? Or perhaps the patient presented with specific symptoms, causing them concern? Then, outline the primary health concerns. What were the initial diagnoses or suspicions based on the assessments done? Were there any significant risks identified?

Finally, mention the challenges encountered during care, the strategies to address them, or the valuable lessons gleaned from the case. However, don’t give away too much – just enough to pique their interest and keep them reading.

Background Information

A key element of the background information is the patient’s medical history which sheds light on the patient’s health journey. Past medical diagnoses, treatments, lifestyle habits, and familial health patterns can explain the current health problem and guide future healthcare decisions.

The initial nursing assessments form an integral part of the background information. They include observations about the patient’s symptoms and vital signs and depict their health status at the point of care. Key details such as the patient’s blood pressure, heart rate, respiratory rate, temperature, pain level, and overall physical and mental state provide crucial baseline data against which progress can be measured.

Diagnostic tests, such as blood tests, imaging studies, or biopsies, offer objective insights into the patient’s condition. The results of these tests can confirm or rule out diagnoses, guide the choice of interventions, and help assess the effectiveness of treatments.

Lastly, highlight significant observations made during the care process. Did the patient’s condition improve or worsen over time? Were there any unexpected reactions or complications? How did the healthcare team respond? These observations offer a real-world view of the patient’s journey, providing an opportunity to reflect on the decisions made and the outcomes achieved.

Proposed Solutions

First, present the nursing interventions proposed to address the patient’s health concerns. Nursing interventions refer to nurses’ actions to improve patient outcomes, such as administering medication, providing health education, or coordinating care with other healthcare professionals.

Then, discuss the rationale behind each intervention. The rationale is the ‘why’ that justifies the ‘what.’ It explains why a particular intervention was chosen over others and how it is expected to contribute to the patient’s recovery or well-being.

Lastly, determine how each intervention was incorporated into the patient’s care plan. How was the medication administered? What teaching strategies were used for health education? How was care coordination achieved? These details help bring the care process to life, giving readers a peek into the realities of nursing practice.

Recommendations

Recommendations derive from carefully evaluating the patient’s journey, considering the outcomes observed, the challenges encountered, and the lessons learned. These recommendations aim to refine and optimize care processes, ensuring that nursing practice evolves and improves continually.

One common type of recommendation involves suggesting alternative interventions. Despite the best efforts, not all interventions yield the desired outcomes. In such cases, it’s beneficial to explore other potential solutions. These alternatives, informed by the latest evidence and expert opinion, can provide fresh approaches to the problem, opening up new avenues for patient recovery.

Another type of recommendation focuses on enhancing the implementation of interventions. Sometimes, the choice of intervention is sound, but the execution may fall short. Here, the recommendations may address areas such as improving the timing or technique of intervention delivery, enhancing patient education and engagement, or strengthening coordination among the healthcare team.

The review begins with a concise summary of the case. It revisits the patient’s background, the identified health concerns, the nursing interventions implemented, the outcomes observed, and the recommendations proposed. This brief recounting of the case helps anchor the detailed analysis in the reader’s mind.

Following the summary, it’s time for reflection. Reflective essay writing encourages practitioners to learn from their experiences and continuously improve their practice. Discuss the lessons learned from the case, the insights gained, and the challenges faced. This reflective dialogue enriches the case study analysis, transforming it from a simple narrative to a springboard for professional development and growth.

Lastly, the review addresses the case’s broader implications for nursing practice. How does this case contribute to our understanding of patient care? What does it reveal about the application of nursing theory in real-world scenarios? How can the insights from this case inform future nursing practice? By exploring these questions, the review extends the relevance of the case beyond its specific context, connecting it to the larger discourse on nursing care.

Nursing Case Study Analysis Example

This fictitious case involves a patient named “John,” who presents with Type 2 Diabetes and related complications.

Introduction John, a 63-year-old male, presented to the clinic complaining of persistent fatigue, frequent urination, and unexplained weight loss. As a nurse practitioner, I evaluated John’s condition and formulated a care plan. This case study analysis will explore John’s health journey, his health issues, the interventions undertaken, and the lessons gleaned from his case. Background Information John was diagnosed with Type 2 Diabetes five years ago. His medical history reveals that he has struggled to maintain his blood glucose levels within the recommended range. Despite being prescribed oral hypoglycemic agents and advised lifestyle modifications, he found adhering to the recommended regimen challenging. A recent HbA1c test showed a level of 9.5%, indicating poorly controlled diabetes. Proposed Solutions Given John’s condition, the mainstay of his management involved rigorous blood glucose control. His existing medication regimen was reviewed and adjusted to improve glycemic control. Simultaneously, a comprehensive diabetes self-management education (DSME) program was designed to enhance John’s understanding of diabetes and empower him to manage his condition effectively. The DSME covered essential topics such as the nature of diabetes, the importance of regular monitoring and medication adherence, diet and exercise guidelines, and coping strategies for managing stress and preventing complications. Recommendations Despite best efforts, John’s struggle with diabetes control highlights the need for individualized and holistic care approaches in managing chronic conditions like diabetes. In retrospect, introducing a more intensive support system early on, including regular follow-ups and mental health support, might have helped John better manage his condition. This case underlines the importance of comprehensive patient education and the need for healthcare professionals to recognize and address the psychosocial factors that can impact chronic disease management. Review John’s case provides valuable insights into the challenges of managing chronic conditions like diabetes. It underscores the need for a holistic and personalized approach to patient care beyond medical interventions. The lessons from this case highlight the importance of ongoing patient education, the need for mental health support in chronic disease management, and the value of early and proactive interventions. I hope that the experiences and reflections from this case will inform and enrich nursing practice, especially in chronic disease management.

Final Thoughts on Case Study Analysis

Writing a nursing case study analysis demands a keen understanding of nursing concepts, critical thinking skills, and the ability to apply theory to practice. But, with a structured approach and thorough preparation, it is a rewarding and educational process that enhances nursing practice, contributes to better patient outcomes, and facilitates lifelong learning.

If you’re a nursing student or professional seeking assistance with your own case study analysis, research summary, argumentative essay, or academic writing, look no further. Our dedicated professional writers are well-versed in nursing principles, theories, and practices, making them perfectly equipped to craft high-quality, insightful, and personalized nursing case study analyses.

Ready to experience the difference? Place your order today, and let us support your journey to academic excellence and professional development. Let’s craft a nursing case study analysis that earns you high grades and enriches your nursing practice.

FAQs on How To Write a Case Study Analysis

What is a case study analysis.

A case study analysis critically evaluates a specific instance or event, often focused on a person or a small group. It helps in applying theoretical knowledge to practical situations.

How do you structure a case study assignment?

A case study format has an introduction, background information, proposed solutions, recommendations, and a review.

What is an example of case analysis?

Case analysis examples could involve examining a patient’s journey through a specific health condition. It would involve analyzing the patient’s health history, symptoms, treatment, and response to the care provided. An in-depth review of all these elements helps to understand the situation better, gain insights, and improve future patient care.

What is the difference between a case study and a case analysis?

A case study is an in-depth investigation of a single individual, group, or event to explore causation and find underlying principles. On the other hand, a case analysis often refers to examining and interpreting the data from the case study to formulate solutions or extract insights.

What are the stages of a case study?

A case study generally involves five stages: preparation, data collection, analysis, formulation of solutions, and essay conclusions or recommendations.

What is the purpose of a case study?

A case study aims to investigate a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not evident.

What are the qualities of a good case study?

A good case study is relevant, detailed, focused, provides a learning opportunity, and can generate useful results or insights contributing to the broader field of study.

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Writing Tips

A comprehensive nursing case study writing guide.

Aug. 4, 2023 • 7 min read

Nursing Case Study Writing Step-By-Step Guide

Nursing case studies play a vital role in the education and training of aspiring nurses in the USA, UK, UAE, and Canada. These real-life scenarios provide students with a unique opportunity to apply theoretical knowledge to practical situations, enhancing their critical thinking, clinical reasoning, and decision-making skills. In this guide, we'll walk you through the essential steps to creating effective and insightful nursing case studies that meet the academic standards of these countries.

1. Choosing a Relevant Case

The foundation of a successful nursing case study is the selection of an appropriate case. Look for scenarios that align with your course's learning objectives and reflect the wide range of healthcare challenges that nurses may face. Select cases involving ethical quandaries, complex patient interactions, or situations requiring interdisciplinary collaboration.

2. Gathering Information

Thorough research is key to crafting a detailed and accurate nursing case study. Collect data from reputable sources such as medical journals, textbooks, and evidence-based practice guidelines. Ensure that the patient's medical history, current condition, and relevant clinical data are well-documented. Protect patient confidentiality by de-identifying information.

3. Setting the Stage

Introduce the case by providing basic details on the patient, the healthcare setting, and any other relevant information. Describe the patient's demographics, medical history, current symptoms, and reason for seeking medical help. This establishes the context for readers to comprehend the situation and its significance.

4. Clinical Assessment

Detail the nursing assessment process, including physical examinations, diagnostic tests, and the collection of subjective and objective data. Highlight the nurse's role in observing, interviewing, and evaluating the patient's condition. Discuss the data collected and its implications for the patient's care.

5. Diagnosis and Planning

Based on the assessment, outline the nursing diagnoses and collaborative problems. Clearly explain the rationale behind each diagnosis and present a well-reasoned plan of care. Discuss short-term and long-term goals, potential interventions, and the expected outcomes of nursing interventions.

6. Implementation and Evaluation

Describe how the nursing care plan was executed and the interventions that were implemented. Include details about the nurse's interactions with the patient, families, and other healthcare team members. Evaluate the effectiveness of the interventions, discussing any changes in the patient's condition, responses to treatment, and unexpected challenges.

7. Reflection and Learning

Encourage critical thinking by incorporating a reflection section. Invite students to analyze the case, consider alternative approaches, and reflect on what they have learned from the experience. Discuss the ethical, cultural, and emotional aspects of the case, promoting a holistic understanding of patient care.

8. References and Citations

Maintain academic integrity by properly citing all sources used in your case study. Follow the appropriate citation style (such as APA, MLA, or Chicago) as required by your institution.

Writing nursing case studies is an essential skill for nursing students in the USA, UK, and Canada. Through these case studies, students can bridge the gap between theory and practice, preparing them for the complex and dynamic healthcare environments they will encounter in their careers. By carefully selecting cases, conducting thorough research, and presenting well-structured and reflective analyses, nursing students can create case studies that not only meet academic standards but also contribute to their growth as competent and compassionate healthcare professionals.

Our platform has been giving quality services to our students from the very beginning, all thanks to our highly-trained and professional Nursing case study helpers, who complete every task with utmost sincerity and dedication by applying all their knowledge to your projects so that you can raise your head confidently while presenting in front of your class. TutorGenix has always been ranked as the Best Nursing Case Study help in the USA, the UK, Canada, and the UAE. Our Nursing project writers will complete your academic reports, essays, homework, and whatnot, so just order us and we will help with everything we’ve got. You will get instant solutions for nursing homeworks or any other subject homework you need help with, as we have 24/7 available tutors.

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Case Study Research Methodology in Nursing Research

Diane G. Cope

Through data collection methods using a holistic approach that focuses on variables in a natural setting, qualitative research methods seek to understand participants’ perceptions and interpretations. Common qualitative research methods include ethnography, phenomenology, grounded theory, and historic research. Another type of methodology that has a similar qualitative approach is case study research, which seeks to understand a phenomenon or case from multiple perspectives within a given real-world context.

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Systematic reviews, preferred reporting items for systematic reviews and meta-analyses, nursing intervention research.

What Is a Case Study in Nursing?

Unique Characteristics of Nursing Students

A case study gives an in-depth look at an individual patient. In the realm of nursing, case studies focus on specific patients and provide information about their symptoms, their medical history and their diagnoses.

Uses of Case Studies

Nursing students may be given case studies and asked to diagnose patients based on information about the patients' symptoms, medical histories and other relevant details.

Alternatively, nursing students may be asked to write their own case studies. The students illustrate a case they have dealt with, explaining about the patient, the symptoms, the diagnosis, the treatments and information from a physical assessment.

Reading a case study and coming up with a diagnosis is a good way for nursing students to test the knowledge they've acquired in the classroom in a more realistic, clinical way. Writing case studies is also a useful learning tool; it forces students to reflect on the entire course of treatment for a patient, ranging from obtaining important information to diagnosis to treating the medical condition.

Completing a successful case study requires paying attention to and obtaining important relevant information. One of the best ways to do this is to ask the right questions. Think about the characteristics of the patient: the age, the sex, occupation, where they live. Students should pay attention to vitals, such as temperature and blood pressure. They should also consider the symptoms: How severe are they? When did they start? By asking a lot of questions and getting a lot of information, students who are writing and reading case studies can have enough information to make a better diagnosis.

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Lauren Griffin began writing professionally in 2010. Her articles appear on various websites, specializing in academics, food and other lifestyle topics. Griffin attended Columbia University and holds a Bachelor of Arts in psychology.

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How to write a Nursing Case Study Analysis Paper

Writing a nursing case study is not something most nursing students look forward to. This is because it is a somewhat difficult process that is often overwhelming for nursing students. Nevertheless, by reading this guide prepared by our best nursing students, you should be able to easily and quickly write a nursing case study that can get you an excellent grade.

How different is this guide from similar guides all over the internet? Very different!

This guide provides all the pieces of information that one would need to write an A-grade nursing case study. These include the format for a nursing case study, a step-by-step guide on how to write a nursing case study, and all the important tips to follow when writing a nursing case study.

This comprehensive guide was developed by the top nursing essay writers at NurseMyGrade, so you can trust that the information herein is a gem that will catapult your grades to the next level. Expect updates as we unravel further information about writing a nursing case study.

Now that you know you’ve discovered a gold mine, let’s get right into it.

What Is a Nursing Case Study?

A nursing case study is a real or imagined patient scenario designed to test the knowledge and skills of student nurses. Nursing case study assignments usually focus on testing knowledge and skills in areas of nursing study related to daily nursing practice.

As a nursing student, you must expect a nursing case study assignment at some point in college. The fact that you are reading this post means that point is now.

While there is no standard structure for writing a nursing case study assignment, there are some things or elements that must be present in your nursing assignment for your professor to consider it complete.

In the next section, you will discover these things that your instructor n expects in your nursing case study analysis.

The Nursing Case Study Template

• • Title page
• • Introduction
• • Case presentation (Patient info, history and medical condition)
• • Diagnosis/Nursing assessment
• • Intervention/Nursing care plan
• • Discussion and recommendations
• • Conclusion
• • References

The Structure of a Nursing Case Study Analysis

You now know what nursing professors expect in a nursing case study analysis. In this section, we will explain what exactly to include in each section of your nursing case study analysis to make it an excellent one.

1. Title page

The title page is important in all types of academic writing. You must include it when writing your nursing case study analysis or any other type of essay or paper. And you must include it in the format recommended by your college.

If your college has no specific title page format, use the title page format of the style requested in the assignment prompt. In nursing college, virtually all assignments are supposed to be written either in Harvard or APA format.

So, check your assignment prompt and create your title page correctly. The typical title page should include the topic of your paper, your name, the name of your professor, the course name, the date you are submitting the paper, and the name of your college.

2. Abstract

Most nursing professors require you to include an abstract in your nursing case study analysis. And even when you are not specifically required to write one, it is good to do so. Of course, you should consult with your professor before doing so.

When writing an abstract for your paper, make sure it is about 200 words long. The abstract should include a brief summary of the case study including all the important information in the patient presentation such as the history, the age, and the current diagnosis.

The summary should also include the nursing assessment, the current interventions, and recommendations.

3. Introduction

After writing the title page and the abstract, start writing the introduction. The introduction of a nursing case study analysis must briefly include the patient presentation, the patient’s current diagnosis and medication, and the recommendations. It must also include a strong thesis statement that shows what the paper is all about.

You shouldn’t just write an introduction for the sake of it. If you do so, your introduction will be bland. You need to put in good effort when writing your introduction. The best way to do this is to use your introduction to show you understand the case study perfectly and that you are going to analyze it right.

You can always write your introduction last. Many students do this because they believe writing an introduction last makes it more precise and accurate.

4. Case presentation

After introducing your nursing case study analysis, you should present the case. It is usually very easy to present a case. You simply need to paraphrase the patient scenario. When doing this, do not forget to include all the important details in the patient scenario including the description of the patient, patient history, complaints, medical history, family history, and so on.

In short, everything important in the patient scenario should be in your case presentation. The only thing you need to avoid when writing your case presentation is copying the patient scenario or case study word-for-word.

5. Diagnosis

After case presentation, you should explain the diagnosis. In other words, you should explain the condition, disease, or medical situation highlighted in the case presentation. For example, if the patient is a heavy smoker and he has COPD, it is at this point that you explain how COPD is linked to heavy smoking.

And when explaining the condition, go deep into the pathophysiology. Focus specifically on the patient’s risk factors. Make sure you get your explanation from recent nursing literature. And do not forget to cite all the literature you get your facts from.

In short, this section should explain the patient’s condition or suffering.

6. Intervention

After the diagnosis section, your nursing case study analysis should have an intervention section. This section is also known as the nursing care plan section. What you are supposed to do in this section is to present a nursing care plan for the patient presented in the patient scenario.

A good nursing care plan is one that details the patient’s chief complaints or critical problems. It then describes the causes for these problems using evidence from recent medical or nursing literature. It then details the potential intervention for each problem. Lastly, it includes goals and evaluation strategies for the measures.

Some nursing professors regard the intervention section (or nursing care plan section) as the most important part of a nursing case study. This is because this part details exactly how the student nurse will react to the patient scenario (which is exactly what the nursing professors want to know). So make sure you put in good effort when developing this section to get an excellent grade in this section.

7. Discussion and recommendations

The intervention section in a nursing case study is followed by a discussion and recommendations section. In this section, you are supposed to expound on the patient scenario, the diagnosis, and the nursing care plan. You are also supposed to expound on the potential outcomes if the care plan is followed properly. The rationale for the care plan or its important bits should also be explained in the discussion.

The discussion should be followed by recommendations. Recommendations usually everything important that can be done or changed to manage patient condition or prevent its reoccurrence. Basically, anything that enhances the patient’s well-being can be a recommendation. Just make sure your key recommendations are supported by evidence.

8. Conclusion

This is the second last section of a typical nursing case study. What you need here is to summarize the entire case study. Make sure your summary has at least the case presentation, the nursing assessment/diagnosis, the intervention, and the key recommendations.

At the very end of your conclusion, add a closing statement. The statement should wrap up the whole thing nicely. Try to make it as impressive as possible.

9. References

This is the last section of a nursing case study. No nursing case study is complete without a references section. You should make sure your case study has both in-text citations and a references page.

And you should make sure both are written as recommended in the assignment. The style section is usually Harvard or APA. Follow the recommended style to get a good grade in your essay.

Step-By-Step Guide to Writing a Nursing Case Study

You now know all the key sections you need to include in a nursing case study. You also know what exactly you need to do in each section. It is now time to know how exactly to write a nursing case study. The process detailed below should be easy to follow because you now know the typical structure of nursing case studies.

When given a nursing case study assignment, the first thing you need to do is to read. You need to read two pieces of information slowly and carefully.

First, you need to read the prompt itself slowly and carefully. This is important because the prompt will have important bits of information that you need to know, including the style, the format, the word count, and the number of references needed. All these bits of information are important to know to ensure what you are writing is the right thing.

Second, you need to read the patient scenario slowly and carefully. You should do this to understand it clearly so that you do not make any mistakes in your analysis.

• Create a rough outline

Failure to plan is a plan to fail. So do not fail to plan. In other words, do not fail to create an outline for your case study analysis. Use the template provided in this essay to create a rough outline for your nursing case study analysis.

Make sure your outline is as detailed as it can be at this stage. You can do light research to achieve this aim. However, this is not exactly necessary because this is just a rough outline.

• Conduct thorough research

After creating a rough outline, you should conduct thorough research. Your research should especially focus on providing a credible and evidence-based nursing assessment on the patient problem(s). The evidence you should use should only be from recent nursing or medical literature.

You will also need to conduct thorough research to come up with an effective intervention or nursing care plan. So when researching the patient’s problem and its diagnosis, you should also research the most suitable intervention or you should do it right after.

When conducting research, you should always note down your sources. So for every piece of information you find and what to use, you should have its reference.

After conducting thorough research, you should enhance your rough outline using the new pieces of information you have discovered. Make sure it is as comprehensive as possible.

• Write your nursing case study

At this stage, you simply need to follow your comprehensive outline to write your case study analysis. If you created a good outline, you should find it very easy to write your nursing case study analysis.

If you did not, you will find it difficult to write your nursing case study. Whenever you are stuck when writing your case study analysis paper, you should re-read the part of this article where we explain what to include in every section of your analysis. Doing so will help you know what exactly to write to continue with your essay. Writing a nursing case study analysis usually takes only a few hours.

• Reference your case study

After writing your case study, make sure you add all in-text citations if you had not added them already. And when adding them, you should make sure you follow the style/format recommended in the assignment prompt (usually APA or Harvard style).

After adding in-text citations exactly where they need to be and in the right format, add all the references you have used in a references page. And you should add them correctly as per the rules of the style you were asked to use.

Do not forget to organize your references alphabetically after you are done creating your references page.

• Thoroughly edit your case study

After STEP 5 above, you need to edit your case study. You should edit it slowly and carefully. Do this by proofreading it twice. Proofread it slowly each time to discover all the grammar, style, and punctuation errors. Remove all the errors you find.

After proofreading your essay twice, check it one more time to make sure every sentence is very easy to understand. This is what will transform your ordinary case study into an A-grade case study. Of course, it must also have all the standard sections expected in a case study.

Just to make sure your case study is absolutely perfect, check it one more time using a grammarly.com or a similar computer grammar checker. Doing this will help you catch and eliminate all the remaining errors in your work.

• Submit your case study analysis

After you are done proofreading and editing your case study analysis, it will be 100% ready for submission. Just convert it into the format it is required in and submit it.

Nursing Case Study Tips and Tricks

The guide above and other pieces of information in this article should help you to develop a good nursing case study analysis. The tips and tricks in this section should help you to ensure that your nursing case study analysis you create is an excellent one.

• Begin early

The moment you see a nursing case study assignment prompt, identify a date to start writing it and create your own deadline to beat before the deadline stated in the prompt.

If you do this and then start writing your case study analysis early before your deadline, you will have plenty of time to do excellent research, to develop an excellent paper, and to edit your final paper as thoroughly as you want to.

Most student nurses combine work and study. So if you decide to leave a nursing case study assignment until late to complete it, something could come up and you could end up failing to submit it or submitting a rushed case study analysis.

• Use the right terminology

When writing an essay or any other academic paper, you are always encouraged to use the simplest language possible to make your work easy to understand. However, this is not the case when writing a nursing case study analysis. While your work should certainly be easy to understand, you are required to use the right nursing terminology at every point where it is necessary. Failure to do this could water down your work or make it look less professional or convincing.

• Avoid copying and pasting

If you are a serious nursing student, you obviously know that copying and pasting is not allowed or tolerated in assignments. However, sometimes copying and pasting can seem okay in nursing case study. For example, it can seem okay to copy-paste the patient presentation. However, this is not okay. You are supposed to paraphrase the verbatim when presenting the patient presentation in your essay. You should also avoid copy pasting information or texts directly. Every fact or evidence you research and find should be paraphrased to appear in your work. And it should be cited correctly.

• Always ask for help if stuck

This is very important. Students are usually overwhelmed with academic work, especially a month or two to the end of the semester. If you are overwhelmed and you think you will not have the time to complete your nursing case study analysis or to submit a quality one, ask for help. Ask for help from an assignment help business like ours and you will soon have a paper ready that you can use as you please. If you choose to get help from us, you will get a well-researched, well-planned, well-developed, and fully edited nursing case study.

• Format your paper correctly

Many students forget to do proper formatting after they are done writing their nursing case study analyses. Before you submit your paper, make sure you format it correctly. If you do not format your paper correctly, you will lose marks because of poor formatting. If you feel you are not very confident with your APA or Harvard formatting skills, send your paper to us to get it correctly formatted and ready for submission.

Last words - where to get help if overwhelmed

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Methodology

• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyze the case, other interesting articles.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

Unlike quantitative or experimental research , a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

However, you can also choose a more common or representative case to exemplify a particular category, experience or phenomenon.

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews , observations , and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

The aim is to gain as thorough an understanding as possible of the case and its context.

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In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis , with separate sections or chapters for the methods , results and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyze its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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How to Write a Thorough Nursing Case Study

Table of Contents

Case studies are common requirements for nursing schools and healthcare institutions. But learning how to write a nursing case study can be challenging. If you’re stuck on how to get started, we’ve got your back! In this article, we’ll be guiding you through all the necessary elements you should include ensuring your study is clear and thorough. We’ll also share some key tips to make your work more professional. When done right, a case study can enhance your knowledge base and help identify better healthcare practices. And this can greatly improve overall healthcare standards.

What is a Nursing Case Study?

A nursing case study is a detailed assessment of a patient’s medical history, diagnosis, and treatment .   It seeks to identify the causes of an illness or injury and analyze how they have been addressed. This helps assess the overall quality of care given. These case studies aim to understand the cause of certain illnesses, how to prevent them, and how to best treat them. The data gathered from these studies can inform policy changes and develop effective strategies for improving patient outcomes.

How to Write a Nursing Case Study

Writing a nursing case study requires thoughtful consideration of relevant information and resources. You must select a single subject, conduct research on it, interview experts, analyze the data collected, and present your findings. That may seem like a lot, but let us break it down for you. Here’s a look at the key elements that your case study structure should cover:

A title page should be concise yet informative, helping readers understand what the focus of the study is. It includes the following elements:

• Title of the case study
• Author’s name
• Any collaborators or contributors to the work
• An abstract summarizing the contents

An abstract is a summary of the content of the case study, which outlines its purpose, methods used, results, and conclusions. It aims to provide readers with a clear overview of the studied topic without reading through the entire document.

Introduction

The introduction sets the stage for the case study by introducing the main subject and providing background information. It should include the research question(s) or hypothesis that will guide the investigation.

Case Presentation

Your case presentation needs to include as much relevant detail as possible while maintaining clarity and brevity. It details the following:

• Patient’s history
• Physical exam findings
• Laboratory values
• Imaging studies
• Treatments received
• Clinical course

Pathophysiology

Pathophysiology discusses how diseases affect normal body processes and functions. Try to explain the pathology behind the observed symptoms to understand how they can be managed. This may involve discussing anatomy, physiology, biochemistry, genetics, pharmacology, immunology, and pathogenesis.

Nursing Care Plan

A nursing care plan should provide an overview of the patient’s current condition, including any pre-existing medical conditions. It should also outline the desired goals for the patient’s health, such as stabilizing vital signs or reducing pain levels. The plan will usually include a list of interventions to be carried out by nurses. It can also outline monitoring steps to evaluate whether these interventions are effective in achieving the desired outcomes.

Discussion and Recommendations

This section provides an opportunity to discuss any issues or suggestions related to the patient’s case study. Experienced professionals can provide valuable input regarding the best strategies to improve the treatment outcome.

The conclusion is where you can summarize all the findings from the study and provide your final thoughts regarding the results. It should draw attention to any successes achieved during the investigation and identify areas for improvement. Your conclusion should also make clear how the results relate to the overall objective of providing quality care for the patient.

The references section is where sources used throughout the case study are listed. These may include textbooks, reports, journal entries, and other forms of documentation that were consulted for the project. All entries must adhere to proper citation standards (e.g., APA style) and appear alphabetically according to the author’s name.

Final Words

Learning how to write a nursing case study has far more applications than just fulfilling a course requirement. These case studies can be invaluable tools in advocating for improved healthcare for individuals and communities. Hopefully, this quick guide has helped you better understand how to write a more comprehensive and clearer work. Good luck!

Abir Ghenaiet

Abir is a data analyst and researcher. Among her interests are artificial intelligence, machine learning, and natural language processing. As a humanitarian and educator, she actively supports women in tech and promotes diversity.

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What is a case study?

Affiliations.

• 1 School of Nursing, Laurentian University, Sudbury, Ontario, Canada.
• 2 School of Health and Social Care, London South Bank University, London, UK.
• PMID: 29146764
• DOI: 10.1136/eb-2017-102845

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Henry and Ertha Williams

Julia morales and lucy grey, millie larsen.

• Developing Interprofessional Education and Practice in Oral Health
• Importance of Oral-Systemic Health in Older Adults
• Performing Oral Health Assessments on Aging Patients
• Oral Health for the Older Adult Living in the Community
• Elder Abuse in the United States
• Geriatric Syndromes
• Mental Health Needs of Older Adults
• Student-Led Geriatric Nursing Conference: Evidence in Practice
• Teaching Oral Health Care for Older Adults
• Using Case Study Betsy to Understand Down's Syndrome & Dementia
• Using Cinema to Enhance Teaching Issues Related to Older Adults
• Using the Monologue of Doris Smith to Understand Situational Decision-Making
• Caring for the Caregiver
• Caring for the Older Adult at Risk for Falling
• Coordinating and Managing Care During Transitions Among Care Settings
• End-of-Life Decision Making for Older Adults: Competent and Compassionate Care
• Myths of Aging
• Using Continuing Care Retirement Communities to Enhance a Better Understanding of Older Adults
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ACE.S Unfolding Cases

An unfolding case is one that evolves over time in a manner that is unpredictable to the learner. New situations develop and are revealed with each encounter. Every ACE unfolding case uses the highly regarded unfolding case model developed for Advancing Care Excellence for Seniors (ACE.S) . Each case includes the following:

• A first-person monologue that introduces the family and the complex problems they are facing.
• Simulation scenarios designed to help students practice assessing function and expectations of their patient(s), with links to appropriate evidence-based assessment tools. Suggestions for debriefing are included.
• An innovative final assignment that asks students to finish the story .
• Instructor toolkits with suggestions on how to use the various components of the unfolding cases and incorporate them into the curriculum.

These unfolding cases combine the power of storytelling with the experiential nature of simulation scenarios. They are intended to create a robust, meaningful experience for students, one that provides a simulated experience of continuity of care and that will help them integrate the Essential Knowledge Domains and Nursing Actions into their practice of nursing. We hope you will give them a try! Standardized/Simulated patients are recommended for all ACE simulations. If you are not already familiar with the Association for Standardized Patient Educators Standards of Best Practice, we encourage you to review them.

Learn more about unfolding cases by visiting the  How to Use an Unfolding Case  page.

Sherman "Red" Yoder

Nln leadership development program for simulation educators project mapping the ace.s unfolding cases to the aacn essentials.

Project Disclaimer: Simulation leadership projects are a requirement for the Leadership Development Program for Simulation Educators. All projects are then placed within SIRC for the benefit of the nursing education community. Inclusion of this specific project does not constitute an endorsement by the NLN of the AACN Essentials.

Unfolding Cases with Older Adults from Other ACE Programs

Butch sampson (ace.v), eugene shaw (ace.v), ertha williams (ace.z), george palo (ace.z), judy and karen jones (ace.z), mike walker (ace+).

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Next Generation NCLEX Case Study Sample Questions

One of the big changes on the Next Generation NCLEX exam is a shift toward case studies. Case studies often require a deeper level of critical thinking, and understanding diseases on a more in-depth level (especially the pathophysiology) will make these types of questions easier to answer.

In this article, you’ll be able to watch a free video to help you prepare for the new Next Generation NCLEX case study format. Nurse Sarah will walk you step-by-step through each scenario and help you understand how to use critical thinking and nursing knowledge to answer these types of questions.

Next Generation NCLEX Case Study Review Questions Video

NGN Case Study Sample Questions and Answers

First, let’s take a look at our case study summary below:

Case Study Summary:

A 68-year-old male is admitted with shortness of breath. He reports difficulty breathing with activity, lying down, or while sleeping. He states that in order to “breathe easier,” he has had to sleep in a recliner for the past week. The patient has a history of hypertension, myocardial infarction (2 years ago), and cholecystectomy (10 years ago). The patient is being transferred to a cardiac progressive care unit for further evaluation and treatment.

Question 1 of 6: The nurse receives the patient admitted with shortness of breath. What findings are significant and require follow-up? The options are listed below. Select all that apply.

To answer this first question in the NGN case study, let’s look at the information provided in the nursing notes and vital signs tabs provided:

This question is asking us to identify findings that are significant and require the nurse to follow-up. In other words, what is presenting that we can’t ignore but need to investigate further.

Therefore, let’s comb through the nursing notes and vital signs to see what is abnormal and requires follow-up.

First, the patient arrived to the room via stretcher. That’s fine and doesn’t necessarily require follow-up.

Next, the patient is alert and oriented x 4 (person, place, time, event). This tells us that the patient’s neuro status is intact so far. Therefore, the shortness of breath isn’t affecting the patient’s mental function yet (we have enough oxygen on board right now for brain activity).

However, the nurse has noticed the shortness of breath with activity and talking, which should not normally happen. This tells us something is wrong and is significant enough to require follow-up. We want to know why is this happening, is it going to get worse, etc.

The patient’s weight and vital signs were collected (this is good). Weight is 155 lbs. and BMI is within a healthy range (doesn’t tell us too much but may be useful later). The patient is also connected to a bedside monitor, so they need to be monitored constantly like on a progressive care unit.

The monitor shows sinus tachycardia . This is significant because it seems the patient’s shortness of breath is causing the heart to compensate by increasing the heart rate to provide more oxygen (hence the lungs may be compromised).

Then we find out that the lungs are indeed compromised because crackles are heard in both lungs , and this may be why our patient is short of breath. This is significant (could the patient have pulmonary edema?)

Then we find out the nurse has noted an S3. This is an extra heart sound noted after S2. And what jumps out to me about this is that it is usually associated with volume overload in the heart like in cases of heart failure . However, S3 may be normal in some people under 40 or during pregnancy, but that’s not the case with our patient based on what we read in the case summary.

Therefore, based on everything I’m reading in this case study, I’m thinking this patient may have heart failure, but we need those test results back (especially the echo and chest x-ray, and hopefully a BNP will be in there too).

We are also told that the patient has an 18 gauge IV inserted (which is good thing to have so we can give medications if required), orders have been received, labs drawn, and testing results are pending.

Now let’s look at the “Vital Signs” tab above, and ask yourself what is normal vs. abnormal for this patient (adult male).

• The heart rate is high at 112 (tachycardia), and should normally be 60-100 bpm (see heart rhythms ).
• Blood pressure is higher than normal (normal is 120/80), which indicates hypertension.
• Oxygen saturation is 94% (this is on the low side as we’d normally want around 95% or higher, and the patient is on 4 L nasal cannula, which tells us the lungs are not okay).
• Respiratory rate is increased (26 breaths per minute)…normal is 12-20 breaths per minute.

Based on the information we were provided, I’ve selected the answers below. These findings are significant and definitely require follow-up by the nurse.

When answering these NGN case study questions, it’s helpful to think of the ABCDE (airway, breathing, circulation, etc.) as all of these fall into that category. If we don’t follow-up on the shortness of breath, crackles, respiratory rate, o2 saturation (94% on 4 L nasal cannula), the respiratory system can further decline.

In addition, the sinus tachycardia, S3 gallop, and hypertension could indicate fluid overload in the heart. This may cause the heart to tire out and lead the lethal rhythm. On the other hand, temperature, pain, weight, and BMI are not abnormal and do not require follow-up.

See the Complete Next Generation NCLEX Case Study Review

Each question in the case study builds on the previous question. To see how these questions evolve based on the patient’s condition and labs, watch the entire Next Generation NCLEX Case Study Review video on our YouTube Channel (RegisteredNurseRN).

NCLEX Practice Quizzes

We’ve developed many free NCLEX review quizzes to test your knowledge on nursing topics and to help you prepare for the Next Generation NCLEX exam.

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You can get an eBook version here or a physical copy of the book here.

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The case study approach

Sarah crowe.

1 Division of Primary Care, The University of Nottingham, Nottingham, UK

Kathrin Cresswell

2 Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK

Ann Robertson

3 School of Health in Social Science, The University of Edinburgh, Edinburgh, UK

Anthony Avery

Aziz sheikh.

The case study approach allows in-depth, multi-faceted explorations of complex issues in their real-life settings. The value of the case study approach is well recognised in the fields of business, law and policy, but somewhat less so in health services research. Based on our experiences of conducting several health-related case studies, we reflect on the different types of case study design, the specific research questions this approach can help answer, the data sources that tend to be used, and the particular advantages and disadvantages of employing this methodological approach. The paper concludes with key pointers to aid those designing and appraising proposals for conducting case study research, and a checklist to help readers assess the quality of case study reports.

Introduction

The case study approach is particularly useful to employ when there is a need to obtain an in-depth appreciation of an issue, event or phenomenon of interest, in its natural real-life context. Our aim in writing this piece is to provide insights into when to consider employing this approach and an overview of key methodological considerations in relation to the design, planning, analysis, interpretation and reporting of case studies.

The illustrative 'grand round', 'case report' and 'case series' have a long tradition in clinical practice and research. Presenting detailed critiques, typically of one or more patients, aims to provide insights into aspects of the clinical case and, in doing so, illustrate broader lessons that may be learnt. In research, the conceptually-related case study approach can be used, for example, to describe in detail a patient's episode of care, explore professional attitudes to and experiences of a new policy initiative or service development or more generally to 'investigate contemporary phenomena within its real-life context' [ 1 ]. Based on our experiences of conducting a range of case studies, we reflect on when to consider using this approach, discuss the key steps involved and illustrate, with examples, some of the practical challenges of attaining an in-depth understanding of a 'case' as an integrated whole. In keeping with previously published work, we acknowledge the importance of theory to underpin the design, selection, conduct and interpretation of case studies[ 2 ]. In so doing, we make passing reference to the different epistemological approaches used in case study research by key theoreticians and methodologists in this field of enquiry.

This paper is structured around the following main questions: What is a case study? What are case studies used for? How are case studies conducted? What are the potential pitfalls and how can these be avoided? We draw in particular on four of our own recently published examples of case studies (see Tables ​ Tables1, 1 , ​ ,2, 2 , ​ ,3 3 and ​ and4) 4 ) and those of others to illustrate our discussion[ 3 - 7 ].

Example of a case study investigating the reasons for differences in recruitment rates of minority ethnic people in asthma research[ 3 ]

Example of a case study investigating the process of planning and implementing a service in Primary Care Organisations[ 4 ]

Example of a case study investigating the introduction of the electronic health records[ 5 ]

Example of a case study investigating the formal and informal ways students learn about patient safety[ 6 ]

What is a case study?

A case study is a research approach that is used to generate an in-depth, multi-faceted understanding of a complex issue in its real-life context. It is an established research design that is used extensively in a wide variety of disciplines, particularly in the social sciences. A case study can be defined in a variety of ways (Table ​ (Table5), 5 ), the central tenet being the need to explore an event or phenomenon in depth and in its natural context. It is for this reason sometimes referred to as a "naturalistic" design; this is in contrast to an "experimental" design (such as a randomised controlled trial) in which the investigator seeks to exert control over and manipulate the variable(s) of interest.

Definitions of a case study

Stake's work has been particularly influential in defining the case study approach to scientific enquiry. He has helpfully characterised three main types of case study: intrinsic , instrumental and collective [ 8 ]. An intrinsic case study is typically undertaken to learn about a unique phenomenon. The researcher should define the uniqueness of the phenomenon, which distinguishes it from all others. In contrast, the instrumental case study uses a particular case (some of which may be better than others) to gain a broader appreciation of an issue or phenomenon. The collective case study involves studying multiple cases simultaneously or sequentially in an attempt to generate a still broader appreciation of a particular issue.

These are however not necessarily mutually exclusive categories. In the first of our examples (Table ​ (Table1), 1 ), we undertook an intrinsic case study to investigate the issue of recruitment of minority ethnic people into the specific context of asthma research studies, but it developed into a instrumental case study through seeking to understand the issue of recruitment of these marginalised populations more generally, generating a number of the findings that are potentially transferable to other disease contexts[ 3 ]. In contrast, the other three examples (see Tables ​ Tables2, 2 , ​ ,3 3 and ​ and4) 4 ) employed collective case study designs to study the introduction of workforce reconfiguration in primary care, the implementation of electronic health records into hospitals, and to understand the ways in which healthcare students learn about patient safety considerations[ 4 - 6 ]. Although our study focusing on the introduction of General Practitioners with Specialist Interests (Table ​ (Table2) 2 ) was explicitly collective in design (four contrasting primary care organisations were studied), is was also instrumental in that this particular professional group was studied as an exemplar of the more general phenomenon of workforce redesign[ 4 ].

What are case studies used for?

According to Yin, case studies can be used to explain, describe or explore events or phenomena in the everyday contexts in which they occur[ 1 ]. These can, for example, help to understand and explain causal links and pathways resulting from a new policy initiative or service development (see Tables ​ Tables2 2 and ​ and3, 3 , for example)[ 1 ]. In contrast to experimental designs, which seek to test a specific hypothesis through deliberately manipulating the environment (like, for example, in a randomised controlled trial giving a new drug to randomly selected individuals and then comparing outcomes with controls),[ 9 ] the case study approach lends itself well to capturing information on more explanatory ' how ', 'what' and ' why ' questions, such as ' how is the intervention being implemented and received on the ground?'. The case study approach can offer additional insights into what gaps exist in its delivery or why one implementation strategy might be chosen over another. This in turn can help develop or refine theory, as shown in our study of the teaching of patient safety in undergraduate curricula (Table ​ (Table4 4 )[ 6 , 10 ]. Key questions to consider when selecting the most appropriate study design are whether it is desirable or indeed possible to undertake a formal experimental investigation in which individuals and/or organisations are allocated to an intervention or control arm? Or whether the wish is to obtain a more naturalistic understanding of an issue? The former is ideally studied using a controlled experimental design, whereas the latter is more appropriately studied using a case study design.

Case studies may be approached in different ways depending on the epistemological standpoint of the researcher, that is, whether they take a critical (questioning one's own and others' assumptions), interpretivist (trying to understand individual and shared social meanings) or positivist approach (orientating towards the criteria of natural sciences, such as focusing on generalisability considerations) (Table ​ (Table6). 6 ). Whilst such a schema can be conceptually helpful, it may be appropriate to draw on more than one approach in any case study, particularly in the context of conducting health services research. Doolin has, for example, noted that in the context of undertaking interpretative case studies, researchers can usefully draw on a critical, reflective perspective which seeks to take into account the wider social and political environment that has shaped the case[ 11 ].

Example of epistemological approaches that may be used in case study research

How are case studies conducted?

Here, we focus on the main stages of research activity when planning and undertaking a case study; the crucial stages are: defining the case; selecting the case(s); collecting and analysing the data; interpreting data; and reporting the findings.

Defining the case

Carefully formulated research question(s), informed by the existing literature and a prior appreciation of the theoretical issues and setting(s), are all important in appropriately and succinctly defining the case[ 8 , 12 ]. Crucially, each case should have a pre-defined boundary which clarifies the nature and time period covered by the case study (i.e. its scope, beginning and end), the relevant social group, organisation or geographical area of interest to the investigator, the types of evidence to be collected, and the priorities for data collection and analysis (see Table ​ Table7 7 )[ 1 ]. A theory driven approach to defining the case may help generate knowledge that is potentially transferable to a range of clinical contexts and behaviours; using theory is also likely to result in a more informed appreciation of, for example, how and why interventions have succeeded or failed[ 13 ].

Example of a checklist for rating a case study proposal[ 8 ]

For example, in our evaluation of the introduction of electronic health records in English hospitals (Table ​ (Table3), 3 ), we defined our cases as the NHS Trusts that were receiving the new technology[ 5 ]. Our focus was on how the technology was being implemented. However, if the primary research interest had been on the social and organisational dimensions of implementation, we might have defined our case differently as a grouping of healthcare professionals (e.g. doctors and/or nurses). The precise beginning and end of the case may however prove difficult to define. Pursuing this same example, when does the process of implementation and adoption of an electronic health record system really begin or end? Such judgements will inevitably be influenced by a range of factors, including the research question, theory of interest, the scope and richness of the gathered data and the resources available to the research team.

Selecting the case(s)

The decision on how to select the case(s) to study is a very important one that merits some reflection. In an intrinsic case study, the case is selected on its own merits[ 8 ]. The case is selected not because it is representative of other cases, but because of its uniqueness, which is of genuine interest to the researchers. This was, for example, the case in our study of the recruitment of minority ethnic participants into asthma research (Table ​ (Table1) 1 ) as our earlier work had demonstrated the marginalisation of minority ethnic people with asthma, despite evidence of disproportionate asthma morbidity[ 14 , 15 ]. In another example of an intrinsic case study, Hellstrom et al.[ 16 ] studied an elderly married couple living with dementia to explore how dementia had impacted on their understanding of home, their everyday life and their relationships.

For an instrumental case study, selecting a "typical" case can work well[ 8 ]. In contrast to the intrinsic case study, the particular case which is chosen is of less importance than selecting a case that allows the researcher to investigate an issue or phenomenon. For example, in order to gain an understanding of doctors' responses to health policy initiatives, Som undertook an instrumental case study interviewing clinicians who had a range of responsibilities for clinical governance in one NHS acute hospital trust[ 17 ]. Sampling a "deviant" or "atypical" case may however prove even more informative, potentially enabling the researcher to identify causal processes, generate hypotheses and develop theory.

In collective or multiple case studies, a number of cases are carefully selected. This offers the advantage of allowing comparisons to be made across several cases and/or replication. Choosing a "typical" case may enable the findings to be generalised to theory (i.e. analytical generalisation) or to test theory by replicating the findings in a second or even a third case (i.e. replication logic)[ 1 ]. Yin suggests two or three literal replications (i.e. predicting similar results) if the theory is straightforward and five or more if the theory is more subtle. However, critics might argue that selecting 'cases' in this way is insufficiently reflexive and ill-suited to the complexities of contemporary healthcare organisations.

The selected case study site(s) should allow the research team access to the group of individuals, the organisation, the processes or whatever else constitutes the chosen unit of analysis for the study. Access is therefore a central consideration; the researcher needs to come to know the case study site(s) well and to work cooperatively with them. Selected cases need to be not only interesting but also hospitable to the inquiry [ 8 ] if they are to be informative and answer the research question(s). Case study sites may also be pre-selected for the researcher, with decisions being influenced by key stakeholders. For example, our selection of case study sites in the evaluation of the implementation and adoption of electronic health record systems (see Table ​ Table3) 3 ) was heavily influenced by NHS Connecting for Health, the government agency that was responsible for overseeing the National Programme for Information Technology (NPfIT)[ 5 ]. This prominent stakeholder had already selected the NHS sites (through a competitive bidding process) to be early adopters of the electronic health record systems and had negotiated contracts that detailed the deployment timelines.

It is also important to consider in advance the likely burden and risks associated with participation for those who (or the site(s) which) comprise the case study. Of particular importance is the obligation for the researcher to think through the ethical implications of the study (e.g. the risk of inadvertently breaching anonymity or confidentiality) and to ensure that potential participants/participating sites are provided with sufficient information to make an informed choice about joining the study. The outcome of providing this information might be that the emotive burden associated with participation, or the organisational disruption associated with supporting the fieldwork, is considered so high that the individuals or sites decide against participation.

In our example of evaluating implementations of electronic health record systems, given the restricted number of early adopter sites available to us, we sought purposively to select a diverse range of implementation cases among those that were available[ 5 ]. We chose a mixture of teaching, non-teaching and Foundation Trust hospitals, and examples of each of the three electronic health record systems procured centrally by the NPfIT. At one recruited site, it quickly became apparent that access was problematic because of competing demands on that organisation. Recognising the importance of full access and co-operative working for generating rich data, the research team decided not to pursue work at that site and instead to focus on other recruited sites.

Collecting the data

In order to develop a thorough understanding of the case, the case study approach usually involves the collection of multiple sources of evidence, using a range of quantitative (e.g. questionnaires, audits and analysis of routinely collected healthcare data) and more commonly qualitative techniques (e.g. interviews, focus groups and observations). The use of multiple sources of data (data triangulation) has been advocated as a way of increasing the internal validity of a study (i.e. the extent to which the method is appropriate to answer the research question)[ 8 , 18 - 21 ]. An underlying assumption is that data collected in different ways should lead to similar conclusions, and approaching the same issue from different angles can help develop a holistic picture of the phenomenon (Table ​ (Table2 2 )[ 4 ].

Brazier and colleagues used a mixed-methods case study approach to investigate the impact of a cancer care programme[ 22 ]. Here, quantitative measures were collected with questionnaires before, and five months after, the start of the intervention which did not yield any statistically significant results. Qualitative interviews with patients however helped provide an insight into potentially beneficial process-related aspects of the programme, such as greater, perceived patient involvement in care. The authors reported how this case study approach provided a number of contextual factors likely to influence the effectiveness of the intervention and which were not likely to have been obtained from quantitative methods alone.

In collective or multiple case studies, data collection needs to be flexible enough to allow a detailed description of each individual case to be developed (e.g. the nature of different cancer care programmes), before considering the emerging similarities and differences in cross-case comparisons (e.g. to explore why one programme is more effective than another). It is important that data sources from different cases are, where possible, broadly comparable for this purpose even though they may vary in nature and depth.

Analysing, interpreting and reporting case studies

Making sense and offering a coherent interpretation of the typically disparate sources of data (whether qualitative alone or together with quantitative) is far from straightforward. Repeated reviewing and sorting of the voluminous and detail-rich data are integral to the process of analysis. In collective case studies, it is helpful to analyse data relating to the individual component cases first, before making comparisons across cases. Attention needs to be paid to variations within each case and, where relevant, the relationship between different causes, effects and outcomes[ 23 ]. Data will need to be organised and coded to allow the key issues, both derived from the literature and emerging from the dataset, to be easily retrieved at a later stage. An initial coding frame can help capture these issues and can be applied systematically to the whole dataset with the aid of a qualitative data analysis software package.

The Framework approach is a practical approach, comprising of five stages (familiarisation; identifying a thematic framework; indexing; charting; mapping and interpretation) , to managing and analysing large datasets particularly if time is limited, as was the case in our study of recruitment of South Asians into asthma research (Table ​ (Table1 1 )[ 3 , 24 ]. Theoretical frameworks may also play an important role in integrating different sources of data and examining emerging themes. For example, we drew on a socio-technical framework to help explain the connections between different elements - technology; people; and the organisational settings within which they worked - in our study of the introduction of electronic health record systems (Table ​ (Table3 3 )[ 5 ]. Our study of patient safety in undergraduate curricula drew on an evaluation-based approach to design and analysis, which emphasised the importance of the academic, organisational and practice contexts through which students learn (Table ​ (Table4 4 )[ 6 ].

Case study findings can have implications both for theory development and theory testing. They may establish, strengthen or weaken historical explanations of a case and, in certain circumstances, allow theoretical (as opposed to statistical) generalisation beyond the particular cases studied[ 12 ]. These theoretical lenses should not, however, constitute a strait-jacket and the cases should not be "forced to fit" the particular theoretical framework that is being employed.

When reporting findings, it is important to provide the reader with enough contextual information to understand the processes that were followed and how the conclusions were reached. In a collective case study, researchers may choose to present the findings from individual cases separately before amalgamating across cases. Care must be taken to ensure the anonymity of both case sites and individual participants (if agreed in advance) by allocating appropriate codes or withholding descriptors. In the example given in Table ​ Table3, 3 , we decided against providing detailed information on the NHS sites and individual participants in order to avoid the risk of inadvertent disclosure of identities[ 5 , 25 ].

What are the potential pitfalls and how can these be avoided?

The case study approach is, as with all research, not without its limitations. When investigating the formal and informal ways undergraduate students learn about patient safety (Table ​ (Table4), 4 ), for example, we rapidly accumulated a large quantity of data. The volume of data, together with the time restrictions in place, impacted on the depth of analysis that was possible within the available resources. This highlights a more general point of the importance of avoiding the temptation to collect as much data as possible; adequate time also needs to be set aside for data analysis and interpretation of what are often highly complex datasets.

Case study research has sometimes been criticised for lacking scientific rigour and providing little basis for generalisation (i.e. producing findings that may be transferable to other settings)[ 1 ]. There are several ways to address these concerns, including: the use of theoretical sampling (i.e. drawing on a particular conceptual framework); respondent validation (i.e. participants checking emerging findings and the researcher's interpretation, and providing an opinion as to whether they feel these are accurate); and transparency throughout the research process (see Table ​ Table8 8 )[ 8 , 18 - 21 , 23 , 26 ]. Transparency can be achieved by describing in detail the steps involved in case selection, data collection, the reasons for the particular methods chosen, and the researcher's background and level of involvement (i.e. being explicit about how the researcher has influenced data collection and interpretation). Seeking potential, alternative explanations, and being explicit about how interpretations and conclusions were reached, help readers to judge the trustworthiness of the case study report. Stake provides a critique checklist for a case study report (Table ​ (Table9 9 )[ 8 ].

Potential pitfalls and mitigating actions when undertaking case study research

Stake's checklist for assessing the quality of a case study report[ 8 ]

Conclusions

The case study approach allows, amongst other things, critical events, interventions, policy developments and programme-based service reforms to be studied in detail in a real-life context. It should therefore be considered when an experimental design is either inappropriate to answer the research questions posed or impossible to undertake. Considering the frequency with which implementations of innovations are now taking place in healthcare settings and how well the case study approach lends itself to in-depth, complex health service research, we believe this approach should be more widely considered by researchers. Though inherently challenging, the research case study can, if carefully conceptualised and thoughtfully undertaken and reported, yield powerful insights into many important aspects of health and healthcare delivery.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

AS conceived this article. SC, KC and AR wrote this paper with GH, AA and AS all commenting on various drafts. SC and AS are guarantors.

Pre-publication history

The pre-publication history for this paper can be accessed here:

http://www.biomedcentral.com/1471-2288/11/100/prepub

Acknowledgements

We are grateful to the participants and colleagues who contributed to the individual case studies that we have drawn on. This work received no direct funding, but it has been informed by projects funded by Asthma UK, the NHS Service Delivery Organisation, NHS Connecting for Health Evaluation Programme, and Patient Safety Research Portfolio. We would also like to thank the expert reviewers for their insightful and constructive feedback. Our thanks are also due to Dr. Allison Worth who commented on an earlier draft of this manuscript.

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Nursing Case Study

ScienceDirect posted a nursing ethics case study where an end-stage prostate cancer patient, Mr. Green, confided to nursing staff about his plan to commit suicide. The patient asked the nurse to keep it a secret. The ethical problem is whether the nurse should tell the health care team members about the patient’s thought without his permission. The best ethical decision for this nursing case study was to share this critical information with other health care professionals, which was the action the nurse took. The team adhered to the proper self-harm and suicide protocol. The appropriate team performed a palliative therapy. As a result, the patient didn’t harm himself and died peacefully a few months after he was discharged.

What Is a Nursing Case Study? A nursing case study is a detailed study of an individual patient. Through this type of research, you can gain more information about the symptoms and the medical history of a patient. It will also allow you to provide the proper diagnoses of the patient’s illness based on the symptoms he or she experienced and other affecting factors. Nursing students usually perform this study as part of their practicum, making it an essential experience because, through this research methodology , they can apply the lessons they have learned from school. The situation mentioned above was an excellent example of a nursing case study.

Nursing Case Study Format

1. introduction.

Purpose: Briefly introduces the case study, including the main health issue or condition being explored. Background: Provides context for the patient scenario, outlining the significance of the case in nursing practice. Objectives: Lists the learning objectives or goals that the case study aims to achieve.

2. Patient Information

Demographics: Age, gender, ethnicity, and relevant personal information. Medical History: Past medical history, including any chronic conditions, surgeries, or significant health events. Current Health Assessment: Presents the patient’s current health status, including symptoms, vital signs, and results from initial examinations.

3. Case Description

Clinical Presentation: Detailed description of the patient’s presentation, including physical examination findings and patient-reported symptoms. Diagnostic Findings: Summarizes diagnostic tests that were performed, including lab tests, imaging studies, and other diagnostic procedures, along with their results. Treatment Plan: Outlines the initial treatment provided to the patient, including medications, therapies, surgeries, or other interventions.

4. Nursing Care Plan

Nursing Diagnoses: Identifies the nursing diagnoses based on the assessment data. Goals and Outcomes: Establishes short-term and long-term goals for the patient’s care, including expected outcomes. Interventions: Describes specific nursing interventions planned or implemented to address each nursing diagnosis and achieve the stated goals. Evaluation: Discusses the effectiveness of the nursing interventions, including patient progress and any adjustments made to the care plan.

5. Analysis

Critical Analysis: Analyzes the case in depth, considering different aspects of patient care, decision-making processes, and the application of nursing theories and principles. Reflection: Reflects on the nursing practice, lessons learned, and how the case study has impacted the understanding and application of nursing knowledge.

6. Conclusion

Summary: Provides a concise summary of the key points from the case study, including the patient outcome and the nursing care impact. Implications for Practice: Discusses the implications of the case for nursing practice, including any changes to practice or policy that could improve patient care. Recommendations: Offers recommendations for future care or areas for further study based on the case study findings.

Examples of Nursing Case Study

Management of Acute Myocardial Infarction (AMI) Introduction: A 58-year-old male with a history of hypertension and smoking presents to the emergency department with chest pain. This case study explores the nursing management for patients with AMI.   Patient Information: Demographics: 58-year-old male, smoker. Medical History: Hypertension, no previous diagnosis of heart disease. Current Health Assessment: Reports severe chest pain radiating to his left arm, sweating, and nausea.   Case Description: Clinical Presentation: Patient appeared in distress, clutching his chest. Diagnostic Findings: ECG showed ST-elevation in anterior leads. Troponin levels were elevated. Treatment Plan: Immediate administration of aspirin, nitroglycerin, and morphine for pain. Referred for emergency coronary angiography.   Nursing Care Plan: Nursing Diagnoses: Acute pain related to myocardial ischemia. Goals: Relieve pain and prevent further myocardial damage. Interventions: Monitoring vital signs, administering prescribed medications, and providing emotional support. Evaluation: Pain was managed effectively, and the patient was stabilized for angiography.   Analysis: The timely nursing interventions contributed to stabilizing the patient’s condition, showcasing the critical role nurses play in acute care settings.   Conclusion: This case highlights the importance of quick assessment and intervention in patients with AMI, emphasizing the nurse’s role in pain management and support.

Managing Type 1 Diabetes in a Pediatric Patient Introduction: A 10-year-old female diagnosed with type 1 diabetes presents for a routine check-up. This case study focuses on the nursing care plan for managing diabetes in pediatric patients.   Patient Information: Demographics: 10-year-old female. Medical History: Diagnosed with type 1 diabetes six months ago. Current Health Assessment: Well-controlled blood glucose levels, but expresses difficulty with frequent insulin injections.   Case Description: Clinical Presentation: Patient is active, engaging in school activities but struggles with diabetes management. Diagnostic Findings: HbA1c is 7.2%, indicating good control. Treatment Plan: Insulin therapy, carbohydrate counting, and regular blood glucose monitoring.   Nursing Care Plan: Nursing Diagnoses: Risk for unstable blood glucose levels. Goals: Maintain blood glucose within target range and increase patient comfort with diabetes management. Interventions: Education on insulin pump use, dietary advice, and coping strategies. Evaluation: Patient showed interest in using an insulin pump and understood dietary recommendations.   Analysis: This case emphasizes the importance of education and emotional support in managing chronic conditions in pediatric patients.   Conclusion: Effective management of type 1 diabetes in children requires a comprehensive approach that includes education, technological aids, and psychological support.

Elderly Care for Alzheimer’s Disease Introduction: An 82-year-old female with Alzheimer’s disease presents with increased confusion and agitation. This case study examines the complexities of caring for elderly patients with Alzheimer’s.   Patient Information: Demographics: 82-year-old female. Medical History: Alzheimer’s disease, osteoarthritis. Current Health Assessment: Increased confusion, agitation, and occasional aggression.   Case Description: Clinical Presentation: Patient exhibits signs of advanced Alzheimer’s with memory loss and disorientation. Diagnostic Findings: Cognitive tests confirm the progression of Alzheimer’s. Treatment Plan: Non-pharmacological interventions for agitation, memory aids, and safety measures in the home.   Nursing Care Plan: Nursing Diagnoses: Impaired memory related to Alzheimer’s disease. Goals: Reduce agitation and prevent harm. Interventions: Use of calming techniques, establishing a routine, and environmental modifications. Evaluation: Agitation was reduced, and the patient’s safety was improved through environmental adjustments.   Analysis: The case underscores the need for tailored interventions to manage Alzheimer’s symptoms and improve the quality of life for the elderly.   Conclusion: Nursing care for Alzheimer’s patients requires a multifaceted approach focusing on safety, symptom management, and patient dignity.

Nursing Case Study Topics with Samples to Edit & Download

• Telehealth Nursing
• Mental Health and Psychiatric Nursing
• Geriatric Nursing Care
• Palliative and End-of-Life Care
• Pediatric Nursing
• Emergency and Critical Care Nursing
• Chronic Disease Management
• Nursing Ethics and Patient Rights
• Infection Control and Prevention
• Oncology Nursing
• Nursing Leadership and Management
• Cultural Competence in Nursing
• Substance Abuse and Addiction Nursing
• Technological Innovations in Nursing
• Nursing Education and Training

Nursing Case Study Examples & Templates

1. nursing case study template.

2. Free Nursing Student Care Plan Template

3. Nursing Action Case Study Example

4. Hospital Nursing Care Case Study Example

5. Printable Nursing Health Case Study Example

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6. Fundamentals of Nursing Case Study Example

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7. Sample Nursing Case Study Example

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8. Nursing Research Case Study Example

9. Standard Nursing Case Study Example

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10. Nursing Disability Case Study Example

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11. Nursing care Patients Case Study Example

12. School of Nursing Case Study Example

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13. Evaluation of Nursing Care Case Study Example

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Nursing Case Study Segments

Typically, a nursing case study contains three main categories, such as the items below.

1. The Status of a Patient

In this section, you will provide the patient’s information, such as medical history, and give the current patient’s diagnosis, condition, and treatment. Always remember to write down all the relevant information about the patient. Other items that you can collect in this stage are the reasons for the patient to seek medical care and the initial symptoms that he or she is experiencing. After that, based on the gathered information, you will explain the nature and cause of the illness of the patient.

2. The Nursing Assessment of the Patient

In this stage, you will need to prepare your evaluation of the patient’s condition. You should explain each observation that you have collected based on the vital signs and test results. You will also explain each nursing diagnosis that you have identified and determine the proper nursing care plan for the patient.

3. The Current Care Plan and Recommendations

Describe the appropriate care plan that you can recommend to the patient based on the diagnosis, current status, and prognosis in detail, including how the care plan will affect his or her life quality. If needed, you can also evaluate the patient’s existing care plan and give recommendations to enhance it. It is also crucial to cite relevant authoritative sources that will support your recommendations .

Objectives of Nursing Case Study

Nursing case studies are integral educational tools that bridge theoretical knowledge with practical application in patient care. They serve several key objectives essential for the development of nursing students and professionals. Here are the primary objectives of nursing case studies:

1. Enhance Critical Thinking and Clinical Reasoning

Case studies encourage nurses to analyze complex patient scenarios, make informed decisions, and apply critical thinking skills to solve problems. They simulate real-life situations, requiring nurses to evaluate data, consider multiple outcomes, and choose the best course of action.

2. Improve Diagnostic Skills

Through the detailed analysis of patient information, symptoms, and diagnostic results, nursing case studies help improve diagnostic skills. They allow nurses to practice interpreting clinical data to identify patient conditions and understand the underlying causes of symptoms.

3. Facilitate Application of Theoretical Knowledge

Nursing case studies provide a direct bridge between classroom learning and clinical practice. They offer a practical venue for applying theoretical knowledge about anatomy, physiology, pharmacology, and nursing theories to real-world patient care situations.

4. Promote Understanding of Comprehensive Patient Care

These studies emphasize the importance of holistic care, considering the physical, emotional, social, and psychological aspects of patient well-being. Nurses learn to develop comprehensive care plans that address all facets of a patient’s health.

5. Encourage Reflective Practice and Self-Assessment

Reflecting on case study outcomes enables nurses to evaluate their own decision-making processes, clinical judgments, and actions. This self-assessment promotes continuous learning and professional growth by identifying areas for improvement.

6. Foster Interdisciplinary Collaboration

Case studies often involve scenarios that require collaboration among healthcare professionals from various disciplines. They teach nurses the value of teamwork, communication, and the integration of different expertise to achieve optimal patient outcomes.

7. Enhance Patient Education and Advocacy Skills

By working through case studies, nurses improve their ability to educate patients and families about health conditions, treatment plans, and preventive measures. They also learn to advocate for their patients’ needs and preferences within the healthcare system.

8. Prepare for Real-Life Challenges

Nursing case studies prepare students and new nurses for the unpredictability and challenges of real-life clinical settings. They provide safe, controlled environments to practice responses to emergencies, ethical dilemmas, and complex patient needs without the risk of actual harm.

Steps in Nursing Process

Whether you are handling a patient with schizophrenia, pneumonia, diabetes, appendicitis, hypertension, COPD, etc, you will need to follow specific steps to ensure that you are executing the critical nursing process.

1. Assess the Patient

The first step of the nursing process requires critical thinking skills as it involves gathering both subjective and objective data. Subjective data includes verbal statements that you can collect from the patient or caregiver. In contrast, objective information refers to measurable and tangible data, such as vital signs, height, weight, etc. You can also use other sources of information, such as electronic health records, and friends that are in direct contact with the patient.

2. Diagnose the Patient

This critical step will help you in the next steps, such as planning and implementation of patient care. In this step, you will formulate a nursing diagnosis by applying clinical judgment. As a nurse, the North American Nursing Diagnosis Association (NANDA) will give you an up-to-date nursing diagnosis list, which will allow you to form a diagnosis based on the actual health problem.

3. Plan for a Proper Patient Care Plan

This part is where you will plan out the appropriate care plan for the patient. You will set this goal following the evidence-based practice (EDP) guidelines. The goal you will set should be specific, measurable, attainable, realistic, and timely ( SMART ).

4. Implement the Plan

In this stage, you can execute the plan that you have developed in the previous step. The implementation may need interventions such as a cardiac monitor, medication administration, etc.

5. Evaluate the Results

It is crucial to remember that every time the team does an intervention, you must do a reassessment to ensure that the process will lead to a positive result. You may need to reassess the patient depending on his progress, and the care plan may be modified based on the reassessment result.

Where to find nursing case studies?

Nursing case studies can be found in a variety of academic, professional, and medical resources. Here are some key places to look for nursing case studies:

• Academic Journals : Many academic journals focus on nursing and healthcare and publish case studies regularly. Examples include the “Journal of Clinical Nursing,” “Nursing Case Studies,” and “American Journal of Nursing.”
• University and College Libraries : Many academic institutions provide access to databases and journals that contain nursing case studies. Libraries often have subscriptions to these resources.
• Online Medical Libraries : Websites like PubMed, ScienceDirect, and Wiley Online Library offer a vast collection of nursing and medical case studies.
• Professional Nursing Organizations : Organizations such as the American Nurses Association (ANA) and the National League for Nursing (NLN) often provide resources, including case studies, for their members.
• Nursing Education Websites : Websites dedicated to nursing education, such as Lippincott NursingCenter and Nurse.com, often feature case studies for educational purposes.
• Government Health Websites : The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) sometimes publish case studies related to public health nursing and disease outbreaks.
• Nursing Textbooks and eBooks : Many nursing textbooks and eBooks include case studies to illustrate key concepts and scenarios encountered in practice.
• Online Nursing Forums and Communities : Forums and online communities for nursing professionals may share or discuss case studies as part of their content.
• Conference Proceedings : Nursing and healthcare conferences often include presentations of case studies. Many of these are published in the conference proceedings, which may be accessible online.

Carrying out a nursing case study can be a delicate task since it puts the life of a person at stake. Thus, it requires a thorough investigation. With that said, it is essential to gain intensive knowledge about this type of study. Today, we have discussed an overview of how to conduct a nursing case study. However, if you think that you are having problems with your writing skills , we recommend you to consider looking for an essay writing service from the experts in the nursing department to ensure that the output follows the appropriate writing style and terminology.

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Akhtar N, Lee L Utilization and complications of central venous access devices in oncology patients. Current Oncology.. 2021; 28:(1)367-377 https://doi.org/10.3390/curroncol28010039

BD ChloraPrep: summary of product characteristics.. 2021; https://www.bd.com/en-uk/products/infection-prevention/chloraprep-patient-preoperative-skin-preparation/chloraprep-smpc-pil-msds

Chloraprep 10.5ml applicator.. 2022a; https://www.bd.com/en-uk/products/infection-prevention/chloraprep-patient-preoperative-skin-preparation/chloraprep-patient-preoperative-skin-preparation-product-line/chloraprep-105-ml-applicator

Chloraprep 3ml applicator.. 2022b; https://www.bd.com/en-uk/products/infection-prevention/chloraprep-patient-preoperative-skin-preparation/chloraprep-patient-preoperative-skin-preparation-product-line/chloraprep-3-ml-applicator

Website.. 2021; https://www.cdc.gov/cancer/preventinfections/providers.htm

Ceylan G, Topal S, Turgut N, Ozdamar N, Oruc Y, Agin H, Devrim I Assessment of potential differences between pre-filled and manually prepared syringe use during vascular access device management in a pediatric intensive care unit. https://doi.org/10.1177/11297298211015500

Clare S, Rowley S Best practice skin antisepsis for insertion of peripheral catheters. Br J Nurs.. 2021; 30:(1)8-14 https://doi.org/10.12968/bjon.2021.30.1.8

Caguioa J, Pilpil F, Greensitt C, Carnan D HANDS: standardised intravascular practice based on evidence. Br J Nurs.. 2012; 21:(14)S4-S11 https://doi.org/10.12968/bjon.2012.21.Sup14.S4

Easterlow D, Hoddinott P, Harrison S Implementing and standardising the use of peripheral vascular access devices. J Clin Nurs.. 2010; 19:(5-6)721-727 https://doi.org/10.1111/j.1365-2702.2009.03098.x

Florman S, Nichols RL Current approaches for the prevention of surgical site infections. Am J Infect Dis.. 2007; 3:(1)51-61 https://doi.org/10.3844/ajidsp.2007.51.61

Gorski LA, Hadaway L, Hagle M Infusion therapy standards of practice. J Infus Nurs.. 2021; 44:(S1)S1-S224 https://doi.org/10.1097/NAN.0000000000000396

Guenezan J, Marjanovic N, Drugeon B Chlorhexidine plus alcohol versus povidone iodine plus alcohol, combined or not with innovative devices, for prevention of short-term peripheral venous catheter infection and failure (CLEAN 3 study): an investigator-initiated, openlabel, single centre, randomised-controlled, two-by-two factorial trial [published correction appears in Lancet Infect Dis. 2021 Apr 6]. Lancet Infect Dis.. 2021; 21:(7)1038-1048 https://doi.org/10.1016/S1473-3099(20)30738-6

Gunka V, Soltani P, Astrakianakis G, Martinez M, Albert A, Taylor J, Kavanagh T Determination of ChloraPrep® drying time before neuraxial anesthesia in elective cesarean delivery: a prospective observational study. Int J Obstet Anesth.. 2019; 38:19-24 https://doi.org/10.1016/j.ijoa.2018.10.012

Ishikawa K, Furukawa K Staphylococcus aureus bacteraemia due to central venous catheter infection: a clinical comparison of infections caused by methicillin-resistant and methicillin-susceptible strains. Cureus.. 2021; 13:(7) https://doi.org/10.7759/cureus.16607

Loveday HP, Wilson JA, Pratt RJ Epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect.. 2014; 86:(S1)S1-70 https://doi.org/10.1016/S0195-6701(13)60012-2

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Standards for infusion therapy. 4th edn.. 2016; https://www.rcn.org.uk/clinical-topics/Infection-prevention-and-control/Standards-for-infusion-therapy

Taxbro K, Chopra V Appropriate vascular access for patients with cancer. Lancet.. 2021; 398:(10298)367-368 https://doi.org/10.1016/S0140-6736(21)00920-X

Case Studies

Gema munoz-mozas.

Vascular Access Advanced Nurse Practitioner—Lead Vascular Access Nurse, The Royal Marsden NHS Foundation Trust

View articles · Email Gema

Colin Fairhurst

Vascular Access Advanced Clinical Practitioner, University Hospitals Plymouth NHS Trust

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Simon Clare

Research and Practice Development Director, The Association for Safe Aseptic Practice

View articles · Email Simon

Intravenous (IV) access, both peripheral and central, is an integral part of the patient care pathways for diagnosing and treating cancer. Patients receiving systemic anticancer treatment (SACT) are at risk for developing infections, which may lead to hospitalisation, disruptions in treatment schedules and even death ( Centers for Disease Control and Prevention, 2021 ). However, infection rates can be reduced and general patient outcomes improved with the evidence-based standardisation of IV practice, and the adoption of the appropriate equipment, such as peripheral IV cannulas, flushing solutions and sterile IV dressings ( Easterlow et al, 2010 ).

Cancer treatment frequently involves the use of central venous catheters (CVCs)-also referred to as central venous access devices (CVADs)—which can represent a lifeline for patients when used to administer all kinds of IV medications, including chemotherapy, blood products and parenteral nutrition. They can also be used to obtain blood samples, which can improve the patient’s quality of life by reducing the need for peripheral stabs from regular venepunctures ( Taxbro and Chopra, 2021 ). CVCs are relatively easy to insert and care for; however, they are associated with potential complications throughout their insertion and maintenance.

One serious complication of CVC use is catheter-related bloodstream infections (CRBSIs), which can increase morbidity, leading to prolonged hospitalisation and critical use of hospital resources ( Akhtar and Lee, 2021 ). Early-onset CRBSIs are commonly caused by skin pathogens, and so a cornerstone of a CRBSI prevention is skin antisepsis at the time of CVC insertion. Appropriate antisepsis (decontamination/preparation) of the site for CVC insertion can prevent the transmission of such skin pathogens during insertion, while reducing the burden of bacteria on the CVC exit site ( Loveday et al, 2014 ).

Evidence-based practice for the prevention of a CRBSIs and other healthcare-associated infections recommends skin antisepsis prior to insertion of a vascular-access device (VAD) using a 2% chlorhexidine gluconate and 70% isopropyl alcohol solution. This is recommended in guidelines such as epic3 ( Loveday et al, 2014 ), the Standards for Infusion Therapy ( Royal College of Nursing, 2016 ) and the Infusion Therapy Standards of Practice ( Gorski et al, 2021 ). A strong evidenced-backed product such as BD ChloraPrep™ ( Figure 1 ) has a combination of 2% chlorhexidine gluconate in 70% isopropyl alcohol that provides broad-spectrum rapid-action antisepsis, while the applicators facilitate a sterile, single-use application that eliminates direct hand-to-patient contact, helping to reduce cross-contamination and maintaining sterile conditions ( BD, 2021 ). The BD ChloraPrep™ applicator’s circular head allows precise antisepsis of the required area, and the sponge head helps to apply gentle friction in back-and-forth motion to penetrate the skin layers ( BD, 2021 ). BD ChloraPrep’s rapidacting, persistent and broad-spectrum characteristics and proven applicator system ( Florman and Nichols, 2007 ) make it a vital part of the policy and protocol for insertion, care and maintenance of CVCs in specialist cancer centres such as the Royal Marsden. Meanwhile, the use of BD PosiFlush™ Prefilled Saline Syringe ( Figure 2 ), a prefilled normal saline (0.9% sodium choride) syringe, is established practice for the flushing regime of VADs in many NHS Trusts.

The following five case studies present examples from personal experience of clinical practice that illustrate how and why clinicians in oncology and other disciplines use BD ChloraPrep ™ and BD PosiFlush ™ Prefilled Saline Syringe in both adult and paediatric patients.

Case study 1 (Andy)

Andy was a 65-year-old man being treated for metastatic colorectal cancer at the Royal Marsden NHS Foundation Trust specialist cancer service, which provides state-of-the-art treatment to over 60 000 patients each year.

Andy had a peripherally inserted central catheter (PICC) placed at the onset of his chemotherapy treatment to facilitate IV treatment. While in situ, PICCs require regular maintenance to minimise associated risks. This consists of a weekly dressing change to minimise infection and a weekly flush to maintain patency, if not in constant use. For ambulatory patients, weekly PICC maintenance can be carried out either in the hospital outpatient department or at home by a district nurse or family member trained to do so. Patients, relatives, carers and less-experienced nurses involved in PICC care (flushing and dressing) can watch a video on the Royal Marsden website as an aide memoir.

Initially, Andy decided to have his weekly PICC maintenance at the hospital’s nurse-led clinic for the maintenance of CVCs. At the clinic, Andy’s PICC dressing change and catheter flushing procedures were performed by a nursing associate (NA), who, having completed the relevant competences and undergone supervised practise, could carry out weekly catheter maintenance and access PICC for blood sampling.

In line with hospital policy, the PICC dressing change was performed under aseptic non-touch technique (ANTT) using a dressing pack and sterile gloves. After removal of the old dressing, the skin around the entry site and the PICC was cleaned with a 3 ml BD ChloraPrep™ applicator, using back-andforth strokes for 30 seconds and allowing the area to air dry completely before applying the new dressing. As clarified in a recent article on skin antisepsis (Clare and Rowley, 2020), BD ChloraPrep™ applicator facilitated a sterile, single-use application that eliminates direct hand-to-patient contact, which help reduce cross-contamination and maintaining ANTT. Its circular head allowed precise antisepsis around the catheter, and the sponge head helped to apply gentle friction in back-and-forth strokes to penetrate the skin layers.

Once the new dressing was applied, the NA continued to clean the catheter hub and change the needle-free connector. Finally, the catheter lumen was flushed with 10 ml of normal saline (0.9% sodium chloride) with a pre-filled saline syringe (BD PosiFlush™ Prefilled Saline Syringe). This involved flushing 1 ml at a time, following a push-pause technique, with positive pressure disconnection to ensure catheter patency. The classification of these syringes as medical devices enables NAs and other nonregistered members of the clinical team to support nursing staff with the care and maintenance of PICCs and other CVCs, within local policies and procedures. Using pre-filled syringes can save time and minimise the risk of contamination of the solution ( Ceylan et al, 2021 ).

The use of pre-filled 0.9% sodium chloride syringes facilitates home maintenance of PICCs for patients. When Andy did not need to attend hospital, his PICC maintenance could be performed by a family member. Patients and relatives could access the necessary equipment and training from the day-case unit or outpatient department. Home PICC maintenance is extremely beneficial, not just to providers, but also to patients, who may avoid unnecessary hospital attendance and so benefit from more quality time at home and a reduced risk of hospital-acquired infections. Many patients and relatives have commented on the convenience of having their PICC maintenance at home and how easy they found using the ChloraPrep™ and BD PosiFlush™ Prefilled Saline Syringe ‘sticks’.

Case study 2 (Gail)

Gail was as a 48-year-old woman being treated for bladder cancer with folinic acid, fluorouracil and oxaliplatin (FOLOX). She was admitted for a replacement PICC, primarily for continuous cytotoxic intravenous medication via infusion pump in the homecare setting. Her first PICC developed a reaction thought to be related to a sutureless securement device (SSD) anchoring the PICC. The device was removed, but this resulted in displacement of the PICC and incorrect positioning in the vessel (superior vena cava). Now unsafe, the PICC was removed, awaiting replacement, which resulted in a delayed start for the chemotherapy.

A second PICC placement was attempted by a nurse-led CVC placement team, and a line attempt was made in Gail’s left arm. Skin antisepsis was undertaken using a 2% chlorhexidine gluconate and 70% isopropyl alcohol solution (ChloraPrep™). A BD ChloraPrep ™ 10 ml applicator was selected, using manufacturer’s recommendations, as per best practice guidance for CVC placement ( Loveday et al, 2014 ) and to comply with local policy for the use of ANTT. The BD ChloraPrep™ applicator allowed improved non-touch technique and helped facilitate good key-part and key-site protection, in line with ANTT ( Clare and Rowley, 2021 ).

The inserting clinician failed to successfully position the PICC in Gail’s left arm and moved to try on the right. On the second attempt, Gail noted the use of BD ChloraPrep™ and stated that she was allergic to the product, reporting a severe skin rash and local discomfort. The line placer informed the Gail that she had used BD ChloraPrep™ on the failed first attempt without issue, and she gave her consent to continue the procedure. No skin reaction was noted during or after insertion of the PICC.

BD ChloraPrep™ has a rapid-acting broad-spectrum antiseptic range and ability to keep fighting bacteria for at least 48 hours ( BD, 2021 ). These were tangible benefits during maintenance of the CVC insertion site, in the protection of key sites following dressing change and until subsequent dressing changes. There are reported observations of clinicians not allowing the skin to fully dry and applying a new dressing onto wet skin after removing old dressings and disinfecting the exit site with BD ChloraPrep™. This has been reported to cause skin irritation, which can be mistaken for an allergic reaction and lead the patient to think that they have an allergy to chlorhexidine. In our centre’s general experience, very few true allergic reactions have ever been reported by the insertion team. Improved surveillance might better differentiate between later reported reactions, possibly associated with a delayed response to exposure to BD ChloraPrep ™ at insertion, and local skin irritation caused by incorrect management at some later point during hospitalisation.

Staff training is an important consideration in the safe and correct use of BD ChloraPrep™ products and the correct use of adhesive dressings to avoid irritant contact dermatitis (ICD). It is worth noting that it can be difficult to differentiate between ICD and allergic contact dermatitis (ACD). Education and training should be multifaceted (such as with training videos and study days), allowing for different ways of learning, and monitored with audit. Local training in the benefits of using BD ChloraPrep™ correctly have been reinforced by adding simple instructions to ANTT procedure guidelines for CVC insertion and maintenance. Education on its own is often limited to a single episode of training, the benefit of using ANTT procedure guidelines is that they are embedded in a programme of audits and periodic competency reassessment. This makes sure that, as an integral part of good practice, skin antisepsis with BD ChloraPrep ™ is consistently and accurately retrained and assessed.

Gail’s case illustrates the importance of correct application of BD ChloraPrep ™ and how good documentation and surveillance are vital in monitoring skin health during the repeated use skindisinfection products. Care should be taken when recording ICD and ACD reactions, and staff should take steps to confirm true allergy versus temporary skin irritation.

Case study 3 (Beata)

Beata was a 13-year-old teenage girl being treated for acute myeloid leukaemia. Although Beata had a dual-lumen skin-tunnelled catheter in situ, a peripheral intravenous cannula (PIVC) was required for the administration of contrast media for computed tomography (CT) scanning. However, Beata had needlephobia, and so the lead vascular access nurse was contacted to insert the cannula, following ultrasound guidance and the ANTT. After Beata and her mother gave their consent to the procedure, the nurse gathered and prepared all the equipment, including a cannulation pack, single-use tourniquet, skin-antisepsis product, appropriate cannula, PIVC dressing, 0.9% sodium chloride BD PosiFlush ™ Prefilled Saline Syringe, sterile gel, sterile dressing to cover ultrasound probe and personal protective equipment.

Prior to PIVC insertion, a 4x5 cm area of skin underwent antisepsis with a 1.5 ml BD ChloraPrep ™ Frepp applicator, with back-and-forth strokes for 30 seconds, and was allowed to air-dry. The vascular access team prefer to use BD ChloraPrep ™ Frepp over single-use wipes, as the former is faster acting and provides the right volume to decontaminate the indicated area using ANTT ( Clare and Rowley, 2021 ).

Following insertion, the PIVC was flushed with a 10 ml BD PosiFlush ™ Prefilled Saline Syringe syringe, using a pushpause pulsatile technique, with positive pressure disconnection. Local policy recommends the use of pre-filled saline syringes, as they save time and minimise infection risk compared with manually drawn saline flushes ( Ceylan et al, 2021 ). The Trust also permits competent non-registered members of staff to perform PIVC insertion, which is more cost-effective than depending on registered nurses.

In Beata’s case, the team considered the use of BD ChloraPrep™ and BD PosiFlush™ Prefilled Saline Syringe to be essential for the prevention of VAD-associated infections, as well as increasing the quality of nursing care by saving time in the day-case and inpatient settings alike.

Case study 4 (Emma)

Emma, a 43-year-old woman diagnosed with acute lymphoblastic leukaemia, was scheduled for an allogenic stem-cell transplant and associated chemotherapy. To facilitate this, she attended the vascular access service at University Hospitals Plymouth NHS Trust for the insertion of a triple-lumen skin-tunnelled catheter. This was identified as the best VAD for her needs, because of its longevity, multiple points of access and decreased infection risk compared with other devices, such as PICCs.

This was Emma’s second advanced VAD insertion, having previously received an apheresis line due to poor peripheral venous access, to facilitate the prior stem-cell harvest. She was yet to receive any treatment, and, therefore, no immunodeficiency had been identified prior to the insertion procedure.

Trust policy for skin disinfection prior to the insertion or removal of PICC lines is a 2% chlorhexidine gluconate and 70% isopropyl alcohol solution, BD ChloraPrep™. There is an exception for patient history of allergy or sensitivity to BD ChloraPrep™, where 10% povidone iodine is used instead. Emma had received BD ChloraPrep™ before, with no sign allergy or sensitivity, and so the vascular access team decided to use this product again for insertion. BD Chloraprep™ was used, in preference of other skin antisepsis options, due to the applicator’s ability to effectively penetrate the layers of the epidermis, as well as the ability to eliminate direct hand-to-skin contact between the operator and patient ( Clare and Rowley, 2021 ).

Insertion of a skin-tunnelled catheter first requires disinfection of a large area, including the neck and upper chest. Following the manufacturer’s coverage recommendations, a 10.5 ml BD ChloraPrep™ applicator was selected as most suitable to cover an area of 25x30 cm ( BD, 2022 a).

The applicator was activated by pinching the wings to allow the antiseptic solution to properly load onto the sponge. To ensure proper release of the solution, the applicator was held on the skin against the anticipated site of insertion until the sponge pad became saturated. Then, a back-and-forth rubbing motion was undertaken for a minimum of 30 seconds, ensuring that the full area to be used was covered. The solution was then left to dry completely, prior to full-body draping, leaving the procedural area exposed for the procedure. Generally, drying time takes from 30 to 60 seconds, but local policy is not restrictive, as allowing the solution to fully dry is of paramount importance ( Gunka et al, 2019 ). BD Chloraprep™ is effective against a wide variety of microorganisms and has a rapid onset of action ( Florman and Nichols, 2007 ). Therefore, it was felt to be the best option for procedural and ongoing care skin asepsis in a patient anticipated to be immunocompromised during treatment.

It is the normal policy of the Trust’s vascular access service to flush VADs using BD PosiFlush™ Prefilled Saline Syringes with 0.9% sodium chloride. Likewise, BD PosiFlush™ Prefilled Saline Syringes Sterile Pathway (SP) are used to prime all VADs prior to insertion and to check for correct patency once inserted. BD PosiFlush ™ Prefilled Saline Syringe were used in preference of other options, such as vials or bags, due to the absence of requirement for a prescription in the local organisation. They are treated as a medical device and, therefore, can be used without prescription. The advantage of this is that flushes can be administered in a nurse-led clinic, where prescribers are not always available. Aside from the logistical advantages, the use of pre-filled syringes reduces the risk of microbial contamination through preparation error and administration error through correct labelling ( National Patient Safety Agency, 2007 ) In Emma’s case, three BD PosiFlush™ SP Prefilled Saline Syringes were used to check patency and/or ascertain venous location following the insertion of the skin-tunnelled catheter.

In this case, both BD ChloraPrep ™ and BD PosiFlush ™ Prefilled Saline Syringe proved simple to use and helped achieve a successful procedural outcome for the patient.

Case study 5 (Frank)

Frank was a 47-year-old man who had been diagnosed with infective endocarditis following a trans-oesophageal echo. A few days later, to facilitate his planned treatment of 6 weeks of intravenous antibiotics to be administered 4-hourly every day, he was referred to the vascular access service for insertion of longterm IV access. To facilitate this administration, the decision was made to place a PICC.

Frank’s referral included a history of illegal intravenous drug use and details of the consequent difficulty the ward-based team had in finding suitable veins to obtain vascular access. His medical history also included infected abscesses in the left groin and methicillin-resistant Staphylococcus aureus (MRSA) colonisation.

First, Frank was administered suppression therapy for MRSA decolonisation. Following this and prior to PICC insertion, the skin antisepsis procedure was undertaken using a 2% chlorhexidine gluconate and 70% isopropyl alcohol solution, BD ChloraPrep™, in adherence to Trust policy ( Loveday et al, 2014 ). Specifically, BD ChloraPrep™ applicators are selected for their single-use application. They have been demonstrated to reduce the risk of infectious complications (catheter colonisation and local infection) by 92% compared with 5% povidone iodine (PVI) 69% ethanol ( Guenezan et al, 2021 ). A 3 ml BD ChloraPrep™ applicator was considered suitable to decontaminate an area sufficient for the intended PICC insertion procedure, as recommended by the manufacturer ( BD, 2022 b). It was applied using a back-and-forth motion for a minimum of 30 seconds and left to fully dry ( Loveday et al, 2014 ). Staphylococcus aureus bacteraemia’s have a mortality rate of 20-40% and are predominantly caused by VAD insertion ( Ishikawa and Furukawa, 2021 ), and, therefore, the need to reduce this risk was of particular importance for this patient due to the history of MRSA colonisation.

In Frank’s case, the use of BD ChloraPrep™ during the insertion procedure and for each subsequent dressing change episode participated in an uneventful period of treatment. The clinical challenges posed by the patients’ presentation of MRSA colonisation meant the risk of infection was increased but, through correct antisepsis, no adverse events were noted, and the full course of treatment was successfully administered through the PICC.