Assignment Prompt & Instructions
– ## RUBRIC.docx
**## RUBRIC.docx**
**Case Study Rubric**
| | | |
| — | — | — |
| Case Study Rubric |
| **Criteria** | **Ratings** | **Points** |
| **Chief Complaint (Reason for seeking health care) – S** | Includes a direct quote from patient about presenting problem | /4 pts |
| **Demographics – S** | Begins with patient initials, age, race, ethnicity and gender <br>(5 demographics) | /2 pts |
| **History of the Present Illness (HPI) – S** | Includes the presenting problem and the 8 dimensions of the problem<br>(OLD CARTS – Onset, Location, Duration, Character, <br>Aggravating factors, Relieving factors, Timing and Severity) | /4 pts |
| **Allergies – S** | Includes NKA (including = Drug, Environemental, <br>Food, Herbal, and/or Latex or if allergies are present <br>(reports for each severity of allergy AND description of allergy) | /2 pts |
| **Review of Systems (ROS) – S** | Includes a minimum of 3 assessments for <br>each body system and assesses at least 9 body <br>systems directed to chief complaint AND uses <br>the words “admits” and “denies” | /9 pts |
| **Vital Signs – O** | Includes all 8 vital signs, (BP (with patient position), HR,<br>RR, temperature (with Fahrenheit or Celsius and route <br>of temperature collection), weight, height, BMI<br>(or percentiles for pediatric population) and pain.) | /2 pts |
| **Labs – O** | Includes a list of the labs reviewed at the visit, <br>values of lab results and highlights abnormal values <br>OR acknowledges no labs/diagnostic tests were reviewed. | /3 pts |
| **Medications – O** | Includes a list of all of the patient reported medications and the medical <br>diagnosis for the medication (including name, dose, route, frequency) | /4 pts |
| **Screenings – O** | Includes an assessment of at least 5 screening tests | /3 pts |
| **Past Medical History – O** | Includes, for each medical diagnosis, year of diagnosis and whether the <br>diagnosis is active or current AND there is a medical diagnosis for each <br>medication listed under medications | /3 pts |
| **Past Surgical History – O** | Includes, for each surgical procedure, the year of procedure and the indication for the procedure | /3 pts |
| **Family History – O** | Includes an assessment of at least 4 family members regarding, <br>at a minimum, genetic disorders, diabetes, heart disease and cancer. | /3 pts |
| **Social History – O** | Includes all 11 of the following: tobacco use, drug use, alcohol use, marital status, <br>employment status, current and previous occupation, sexual orientation, sexually active, <br>contraceptive use, and living situation. | /3 pts |
| **Physical Examination – O** | Includes a minimum of 4 assessments for each body system and assesses <br>at least 5 body systems directed to chief complaint | /9 pts |
| **Diagnosis – A** | Includes a clear outline of the accurate principal diagnosis AND lists <br>the remaining diagnoses addressed at the visit (in descending priority) | /5 pts |
| **Differential Diagnosis – A** | Includes at least 3 differential diagnoses for the principal diagnosis | /5 pts |
| **Pharmacologic treatment plan – P** | Includes a detailed pharmacologic treatment plan for each of the diagnoses<br>listed under “assessment”. The plan includes ALL of the following: drug name,<br>dose, route, frequency, duration and cost as well as education related to pharmacologic<br>agent. If the diagnosis is a chronic problem, student includes instructions on currently <br>prescribed medications as above. | /4 pts |
| **Diagnostic/Lab Testing – P** | Includes appropriate diagnostic/lab testing 100% of the time OR acknowledges<br>“no diagnostic testing clinically required at this time” | /5 pts |
| **Education – P** | Includes at least 3 strategies to promote and develop skills for managing their illness and at least 3 self-management methods on how to incorporate healthy behaviors into their lives. | /5 pts |
| **Anticipatory Guidance – P** | Includes at least 3 primary prevention strategies (related to age/condition<br>(i.e. immunizations, pediatric and pre-natal milestone anticipatory guidance)) <br>and at least 2 secondary prevention strategies (related to age/condition (i.e. screening)) | /4 pts |
| **Follow up plan – P** | Includes recommendation for follow up, including time frame (i.e. x # of days/weeks/months) | /4 pts |
| **References** | High level of APA precision | /3 pts |
| **Grammar** | Free of grammar and spelling errors | /3 pts |
| **Incorporation of Current Practice Guidelines** | Includes recommendations from at least 1 professional set of practice<br>guidelines (although not the current version) | /4 pts |
| **Role of the Nurse Practitioner** | **Distinguished**<br>Includes a discussion of the role of NP pertaining to the assessment, work up, collaboration and management of the case presented AND gives at least 1 example pertaining to each of the 4 areas (assessment, work up, collaboration and management).<br>**4 pts** | |
**## RUBRIC.docx**
**Case Study Rubric**
| | | |
| — | — | — |
| Case Study Rubric |
| **Criteria** | **Ratings** | **Points** |
| **Chief Complaint (Reason for seeking health care) – S** | Includes a direct quote from patient about presenting problem | /4 pts |
| **Demographics – S** | Begins with patient initials, age, race, ethnicity and gender <br>(5 demographics) | /2 pts |
| **History of the Present Illness (HPI) – S** | Includes the presenting problem and the 8 dimensions of the problem<br>(OLD CARTS – Onset, Location, Duration, Character, <br>Aggravating factors, Relieving factors, Timing and Severity) | /4 pts |
| **Allergies – S** | Includes NKA (including = Drug, Environemental, <br>Food, Herbal, and/or Latex or if allergies are present <br>(reports for each severity of allergy AND description of allergy) | /2 pts |
| **Review of Systems (ROS) – S** | Includes a minimum of 3 assessments for <br>each body system and assesses at least 9 body <br>systems directed to chief complaint AND uses <br>the words “admits” and “denies” | /9 pts |
| **Vital Signs – O** | Includes all 8 vital signs, (BP (with patient position), HR,<br>RR, temperature (with Fahrenheit or Celsius and route <br>of temperature collection), weight, height, BMI<br>(or percentiles for pediatric population) and pain.) | /2 pts |
| **Labs – O** | Includes a list of the labs reviewed at the visit, <br>values of lab results and highlights abnormal values <br>OR acknowledges no labs/diagnostic tests were reviewed. | /3 pts |
| **Medications – O** | Includes a list of all of the patient reported medications and the medical <br>diagnosis for the medication (including name, dose, route, frequency) | /4 pts |
| **Screenings – O** | Includes an assessment of at least 5 screening tests | /3 pts |
| **Past Medical History – O** | Includes, for each medical diagnosis, year of diagnosis and whether the <br>diagnosis is active or current AND there is a medical diagnosis for each <br>medication listed under medications | /3 pts |
| **Past Surgical History – O** | Includes, for each surgical procedure, the year of procedure and the indication for the procedure | /3 pts |
| **Family History – O** | Includes an assessment of at least 4 family members regarding, <br>at a minimum, genetic disorders, diabetes, heart disease and cancer. | /3 pts |
| **Social History – O** | Includes all 11 of the following: tobacco use, drug use, alcohol use, marital status, <br>employment status, current and previous occupation, sexual orientation, sexually active, <br>contraceptive use, and living situation. | /3 pts |
| **Physical Examination – O** | Includes a minimum of 4 assessments for each body system and assesses <br>at least 5 body systems directed to chief complaint | /9 pts |
| **Diagnosis – A** | Includes a clear outline of the accurate principal diagnosis AND lists <br>the remaining diagnoses addressed at the visit (in descending priority) | /5 pts |
| **Differential Diagnosis – A** | Includes at least 3 differential diagnoses for the principal diagnosis | /5 pts |
| **Pharmacologic treatment plan – P** | Includes a detailed pharmacologic treatment plan for each of the diagnoses<br>listed under “assessment”. The plan includes ALL of the following: drug name,<br>dose, route, frequency, duration and cost as well as education related to pharmacologic<br>agent. If the diagnosis is a chronic problem, student includes instructions on currently <br>prescribed medications as above. | /4 pts |
| **Diagnostic/Lab Testing – P** | Includes appropriate diagnostic/lab testing 100% of the time OR acknowledges<br>“no diagnostic testing clinically required at this time” | /5 pts |
| **Education – P** | Includes at least 3 strategies to promote and develop skills for managing their illness and at least 3 self-management methods on how to incorporate healthy behaviors into their lives. | /5 pts |
| **Anticipatory Guidance – P** | Includes at least 3 primary prevention strategies (related to age/condition<br>(i.e. immunizations, pediatric and pre-natal milestone anticipatory guidance)) <br>and at least 2 secondary prevention strategies (related to age/condition (i.e. screening)) | /4 pts |
| **Follow up plan – P** | Includes recommendation for follow up, including time frame (i.e. x # of days/weeks/months) | /4 pts |
| **References** | High level of APA precision | /3 pts |
| **Grammar** | Free of grammar and spelling errors | /3 pts |
| **Incorporation of Current Practice Guidelines** | Includes recommendations from at least 1 professional set of practice<br>guidelines (although not the current version) | /4 pts |
| **Role of the Nurse Practitioner** | **Distinguished**<br>Includes a discussion of the role of NP pertaining to the assessment, work up, collaboration and management of the case presented AND gives at least 1 example pertaining to each of the 4 areas (assessment, work up, collaboration and management).<br>**4 pts** | |