BSN 445 — Concepts of Nursing in the Complex Patient

It aligns with contemporary curricula emphasizing clinical reasoning, systems thinking, and evidence-based management of complex patients across acute and chronic care settings.

This brief is structured to mirror real assignment instructions and grading rubrics used in recent academic years, while remaining adaptable for delivery.

Assessment Overview

Assessment Type: Case-Based Analytical Essay with Integrated Clinical Reasoning

Assessment Weight: 30–40% of course grade

Length: 1,500–2,000 words (excluding title page and references)

Referencing Style: APA (7th edition)

This assessment evaluates the student’s ability to apply nursing concepts to the care of a complex adult patient with multiple comorbidities. Emphasis is placed on synthesis, prioritization, and safe clinical judgment rather than task-level description.

Learning Outcomes Assessed

• Apply advanced nursing concepts to patients with complex, multisystem health needs.
• Demonstrate clinical reasoning and prioritization using patient-specific data.
• Integrate evidence-based practice into nursing care planning.
• Analyze interprofessional roles in managing complex patient care.
• Evaluate ethical, legal, and safety considerations in high-acuity settings.

Assessment Task

You are required to analyze a provided or self-selected complex patient case drawn from acute care, critical care, or transitional care settings. The patient must present with at least two chronic conditions and one acute exacerbation.

Your paper must demonstrate how nursing knowledge is used to manage complexity, uncertainty, and risk.

Required Sections

1. Patient Overview and Clinical ContextBriefly describe the patient’s demographics, diagnoses, care setting, and current clinical status. Focus on factors that contribute to complexity.
2. Pathophysiological AnalysisExplain the interaction between the patient’s conditions. Highlight how comorbidities influence assessment findings, treatment responses, and risks.
3. Nursing Assessment and Priority ProblemsIdentify and justify three to four priority nursing problems using current assessment data. Avoid medical diagnoses; focus on nursing-relevant issues.
4. Clinical Reasoning and Nursing InterventionsDiscuss evidence-based nursing interventions for each priority problem. Justify actions using current research and clinical guidelines.
5. Interprofessional CollaborationAnalyze the role of the registered nurse within the interprofessional team. Address communication, coordination of care, and patient advocacy.
6. Ethical, Legal, and Safety ConsiderationsExamine one ethical or legal issue relevant to the case. Discuss patient safety risks and nursing responsibilities.
7. ConclusionSynthesize key insights. Reinforce the nurse’s role in managing complexity and improving outcomes.

Discussion Board Component (Assessment 2 or Embedded Task)

Initial Post: 300–400 words

Peer Responses: Two responses of 150–200 words each

Prompt

Discuss a key challenge nurses face when caring for complex patients with competing priorities. Use one scholarly source to support your response.

Response Expectations

• Extend peer analysis rather than restating content.
• Apply clinical reasoning or practice-based insight.
• Maintain professional tone and scholarly support.

Marking Criteria / Grading Rubric

Criterion	Weight
Depth of clinical reasoning and prioritization	30%
Integration of evidence-based literature	25%
Application of nursing concepts to complex care	20%
Organization, clarity, and academic writing	15%
APA formatting and referencing accuracy	10%

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Submission Requirements

• Word document format (.doc or .docx)
• APA title page and reference list
• Minimum of 6 peer-reviewed sources published between 2018 and 2025
• Similarity report reviewed prior to submission

Search-Relevant Context

This BSN 445 assessment focuses on nursing care of the complex patient, clinical reasoning, and evidence-based practice. It reflects common nursing school essay and case study requirements used in recent academic years and aligns with current expectations for upper-division undergraduate nursing courses.

The task is designed to support students preparing for real-world clinical decision-making in acute and high-acuity environments.

Peer-Reviewed References

• Benner, P., Sutphen, M., Leonard, V. & Day, L. (2019) Educating nurses: A call for radical transformation. San Francisco: Jossey-Bass. Available at: https://www.wiley.com/en-us/Educating+Nurses-p-9780470457962
• Fawcett, J. & DeSanto-Madeya, S. (2022) Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. 4th edn. Philadelphia: F.A. Davis. Available at: https://www.fadavis.com/product/nursing-theory-contemporary-nursing-knowledge-fawcett
• Levett-Jones, T., Hoffman, K., Dempsey, J., Jeong, S. & Noble, D. (2020) ‘The five rights of clinical reasoning’, Nurse Education Today, 38, pp. 24–29. https://doi.org/10.1016/j.nedt.2016.01.004
• Melnyk, B.M. & Fineout-Overholt, E. (2019) Evidence-based practice in nursing and healthcare. 4th edn. Philadelphia: Wolters Kluwer. Available at: https://shop.lww.com/Evidence-Based-Practice-in-Nursing—Healthcare/p/9781975110642
• World Health Organization (2021) Patient safety: Global action plan 2021–2030. Geneva: WHO. Available at: https://www.who.int/publications/i/item/9789240032705