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NRSG374 Principles of Nursing Assignment Sample

Assignment Detail:

Students are to provide an 1800 word critique of the provided case study using only ONE CPG.

To complete this task you will need to discuss and critique relevant elements of the CPG and case study whilst upholding the National Palliative Care Standards at least one of:


- NMBA standards and/or

Assessment criteria: The assessment will be marked using the criteria-based rubric.Please note that in-text citations are included in the word count whilst the reference list is not included in the word count. Words that are more than 10% over the word count will not be considered

Now that you have read the case study and selected ONE of the CPG provided you are required to:

- Review and critique the care given to the patient against the CPG you have selected and provide evidence to support your critique through additional research that you will undertake

- Highlight the importance of the National Palliative Care Standards and at least one of the NSQHSS and/or the NMBA Standards and how they influence our practice

- Demonstrate knowledge on the illness trajectory of Motor Neurone Disease (MND) in line with Palliative Care Principles

- Provide links between the case study and your chosen CPG to identify highlights or limitations in care

- Ensure that your sources are all contemporary (within the last five years) and from evidence based sources)

- Read all instructions and the rubric very carefully

Case study – Care of the dying patient CPG



Palliative care is a type of care that is a person and its family-centred care with a progressive, active, advanced disease who is going to die or has such prospects of cure. The goal of this type of treatment is to maintain as well as optimize the quality of life (Cheluvappa & Selvendran, 2022). On the other hand, there is a need to mention that the Palliative Care of Australia stated that the chosen palliative care must be strongly responsive to the needs of the diseased person and their family. On the other hand it also strictly considers that all living persons must be provided with the respective care for advanced, progressive diseases and also regardless of the diagnosis (Borbasi et al., 2019). In the respective case study of Tyler, there is palliative care provided by the palliative care team as per his wish, the respective report is trying to critically evaluate CPG with the usage of an appropriate standard to provide the respective person more support and also help his family.

Chosen Clinical Practice Guidelines or CPG with Reason

First of all, there is a need to understand Motor Neuron disease, the illness trajectory of motor neuron disease and the patient's background. In the case of the respective disease of MND, death takes place within a year of diagnosis in most cases and in some cases, it takes two years (Brown et al., 2017). On the other hand Mr Tyler is a young man as his age is only 40 years and has a nice family, so there is a need to consider the EBP means the evidence-based practice and also appropriate standard of care to provide END of life care CPG (Wardle et al., 2019). The respective CPG is that Tyler's death is really unexpected for his family. His babies are too young and he just started his journey of life only a few years ago. On the other hand, Tyler wants to spend quality time with his family as he knows about the disease; he also wants his family reunited though he is not there with his family in future. Sixt, considering all this, there is a chosen END of life care CPG takes place to provide appropriate palliative care to Tyler.

Demonstrate knowledge on the illness trajectory of Motor Neurone Disease
(MND) in line with Palliative Care Principles

Motor neurone disease or MND is a type of progressive disease related to the neurology of a person. The respective disease leads to paralysis in hand, leg. As times go there are the issues of swallowing and problems of breathing also develop in the patient of respective disease (Oliver et al., 2020). As per the principles of the Palliative care, the care always is patient, family and carer centred, so it is able to provide support to Tyler to get appropriate care as well as of to his family and also to carer. On the other hand it is also based on the assessed need. It was the desire of Tyler that his family must be reunited before his death and he can die with honor that must be provided by the palliative care. On the other hand, Palliative care also ensures that the patient, family and carer get the help of local networked services, as per the respective case study Tyler and his family get the help of the local network. On the other hand, palliative care always ensures that the treatment must be evidence-based, clinically and culturally safe. The trajectory of Motor Neuron Disease always needs to be considered. Care is integrated and coordinated, that is also the principle of Palliative care. The integrated and coordinated care supports the patient of motor neuron disease to get physical and mental relief. The sixth principle is in palliative care there is also a clear understanding developed between the care provider team and the patient and his or her family to understand what is the meaning of the care to each of them (Oliver et al., 2020) . So for the respective case study there is at first clear understanding that must be needed to develop what is the meaning of palliative care for Tyler, Catherine and also for the other family members.

Critical Evaluation of the applied care

The respective palliative care that is provided to Tayler needs to consider not only the care of the respective diseased person there are also need to consider the condition of the family members also (Palliative Care Australia, 2018). Because the Australian Palliative Care stated that there is a need to include the care of the family of the ill person also in the respective care (Abbott et al., 2020). Through the case study, it is visible that there are conflicts among the Joycee which means the mother of Tyler and the wife of Tyler means Catherine. On the other hand, it is their wish of Tyler that his children also consider his situation before his death so that he can spend quality time with his family. But such initiatives take place from the side of the Palliative care team, due to the fact that at the end of his life he cannot get his all family members together and close to him except his wife. On the other hand, it is the duty of the registered nurse to provide Evidence-based nursing and consultative nursing and promotion of health and do holistic assessments (Sharplin et al., 2020). In the respective case study, also needs to mention that no such usage of the SAS tool takes place. According to Heslop (2019), SAS tools mean the Symptoms Assessment scale is supportive to understand breathing, pain, insomnia, appetite problems, nausea, fatigue and so on together. On the other hand as per the guideline of the PCOC the usage of the SAS tool is important to measure the appropriate cause by understanding the most important seven symptoms (Eagar, Clapham & Allingham, 2020). There is also a need to consider the Problem Severity score on the time of providing the palliative care to the patient that is also not considered the respective case study and the palliative care team to handle the case of Tayler. Basically, the 4 - point scale is used to understand pain, family problems, spiritual family and so on (Tian et al., 2020). The measurements that take place are either absent, mild, moderate or severe through the respective scale. Hereby also need to include that there is no such usage of the karnofsky Score also takes place within palliative care (Kolakshyapati et al., 2018). The respective score is effective to understand the capability of a diseased person to do some common activity based on the care also provided to increase in quality of life of the family members as well as of the affected person.


The registered nurse has a crucial role in preventive, socio-cultural, therapeutic and also in the promotion of quality patient-centred and family centred palliative care. The World Health Organisation also considers palliative care as an approach that is able to improve the life of patients whether they are adults or children also to their families, especially in the case of life-threatening diseases (Australian Commission on Safety and Quality in Health Care, 2020). On the other hand as per the view of Palliative Care of Australia the Registered nurse plays one of the important roles in the case of providing the END of Life care. The respective care is included with appropriate goals, advanced care planning and monitoring with the appropriate acknowledgement that the patient is improving or not. The National Palliative care of Australia is supported by the nine standards that need to be considered by any registered nurse during the time of providing Palliative Care to a patient. On the other hand the National Safety and Quality Health services provide the appropriate support to the patient (Ritchie et al., 2018). On the other hand, there is also a need to mention that the consideration of NSQHS was also chosen as it in some of the case overlaps with the NMBA nursing standard. This Means NSQHS is able to provide proper care to the patient by maintaining the respective standard.

Figure 1: National Palliative Care Standards
(Source: Cheluvappa & Selvendran, 2022)


If the respective standard is considered by the registered nurse at the time of providing care to Tayler about the Palliative care then continuous changes take place within the developed plan as deterioration takes place in the case of the affected person. On the other hand there are psychological, metaphysical theological and emotional aspects that help Tayler to manage his grief and he may be able to give strength to his family members by reuniting them. As per the respective and considered standard once a patient is identified that due to disease the person is going to be dying soon then appropriate terminal care is provided to the patient. All the spiritual convictions and preferences of the affected person must be considered by the respective standard. So it can be stated that implementation of the NSQHS standard is able to support Tayler to fulfil all his wishes about his family before his death, ultimately able to complete the End of life care CPG. The treatment of Tayler must be incorporated with ACP means the Advanced Care plan, Medical treatment decision maker and Advanced care document ( Cheluvappa & Selvendran, 2022). There is the selection of the final rites, final venues also take place. In the case study it is recognised that the recommendation takes place from the side of the Medical Officer to admit in the hospital though Tayler was not interested in that.

Application of standard 2 of Quality and Safety Management as per the case of Tyler cover underlying theme was "Partnering with Consumers," which necessities for efficient execution of the medical field dealing directly with patients. The foundation for quality and security is laid forth in Standard 2 (Quality Health Service, 2022). Thus, by laying up the typical organizational features and operational flow inside a secure institution adequate palliative care could be given as per NSQHS. Partnering with Tyler standard calls for efficient and relevant patient participation in reviewing, designing, and deployment of services, given that evidence supports doing so that indicates patient participation may lead to enhanced reliability, productivity, and security. Further, if the quality and safety management standard is implemented properly then no such recommendation takes place during the time of providing Palliative Care. The patient’s goal is also not considered by the respective treatment that is also a drawback of the given care that also can be handled through the respective NSQHS for assignment help.

Further with application of standard 1 of Governance for Health Service Quality and Safety. Palliative care team in the health care sector use governance frameworks to establish, and raise the company's productivity while spreading the word of quality management and the patient experience to all employees. In the workplace, the governance systems are used by clinicians and others. Standards for Effective Governance for Health Security and Improvement require adequate Qualifications for Service Organizations and improvements in Quality and Governance techniques for progress. Now, there are unified regulatory frameworks in place to managing the potential dangers to the health of the patient aggressively. Applying Theory to Practice in the Clinic Care given by the clinical staff is governed by NSQHS of the present day (Quality Health Service, 2022).

Management of performance and competence and leaders and the medical staff possess the

Having the necessary training, experience, and attitude to treatment to Tyler with palliative care is effective and risk-free. In order to enhance security measures, data is analyzed along with Liberties of the Patient and Active Participation. A patient's participation and rights are recognized and helped by being under their care (Quality Health Service, 2022).


The most important issue that is related to the chosen standard of NSQHS is partnering with consumers and governance for health and safety lack of knowledge and skills among the service provider that in most cases fail to fulfill the expectations of the patient and also to the family members of the patient in the case of Trajectory Motor neuron disease. Improper infrastructure and incorporation of the family members of the patient is also a big issue and limitation for NSQHS.


Based on the respective case study it can be concluded that Palliative care needs to consider a lot of things and also a particular or more that one standard to provide appropriate relief to the patient not only from the physical pain but also from mental pain. There is not only the consideration of the health of the diseased person that takes place within the respective care by the registered nurse there are also need to include the family members' care. The care that is provided to Tayler was able to support the physical condition of Tayler but no such consideration takes place about his family care. On the other hand there are no such consideration of tools like SAS, PSS, RUG-ADL Score and modified Karnofsky takes place in the care of Tayler by the registered nurse of palliative team, if that is considered with the standard of NSQHS then Tayler must be provided with best palliative care as per the guideline of the Australian Government. The proposed care that takes place with the NSQHs must be provided in the future to the same condition of the person like Tayler it can be hoped.


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