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• Volume 21, Issue 1
• What is a case study?
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• Roberta Heale 1 ,
• Alison Twycross 2
• 1 School of Nursing , Laurentian University , Sudbury , Ontario , Canada
• 2 School of Health and Social Care , London South Bank University , London , UK
• Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Sudbury, ON P3E2C6, Canada; rheale{at}laurentian.ca

https://doi.org/10.1136/eb-2017-102845

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What is it?

Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research. 1 However, very simply… ‘a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units’. 1 A case study has also been described as an intensive, systematic investigation of a single individual, group, community or some other unit in which the researcher examines in-depth data relating to several variables. 2

Often there are several similar cases to consider such as educational or social service programmes that are delivered from a number of locations. Although similar, they are complex and have unique features. In these circumstances, the evaluation of several, similar cases will provide a better answer to a research question than if only one case is examined, hence the multiple-case study. Stake asserts that the cases are grouped and viewed as one entity, called the quintain . 6  ‘We study what is similar and different about the cases to understand the quintain better’. 6

The steps when using case study methodology are the same as for other types of research. 6 The first step is defining the single case or identifying a group of similar cases that can then be incorporated into a multiple-case study. A search to determine what is known about the case(s) is typically conducted. This may include a review of the literature, grey literature, media, reports and more, which serves to establish a basic understanding of the cases and informs the development of research questions. Data in case studies are often, but not exclusively, qualitative in nature. In multiple-case studies, analysis within cases and across cases is conducted. Themes arise from the analyses and assertions about the cases as a whole, or the quintain, emerge. 6

Benefits and limitations of case studies

If a researcher wants to study a specific phenomenon arising from a particular entity, then a single-case study is warranted and will allow for a in-depth understanding of the single phenomenon and, as discussed above, would involve collecting several different types of data. This is illustrated in example 1 below.

Using a multiple-case research study allows for a more in-depth understanding of the cases as a unit, through comparison of similarities and differences of the individual cases embedded within the quintain. Evidence arising from multiple-case studies is often stronger and more reliable than from single-case research. Multiple-case studies allow for more comprehensive exploration of research questions and theory development. 6

Despite the advantages of case studies, there are limitations. The sheer volume of data is difficult to organise and data analysis and integration strategies need to be carefully thought through. There is also sometimes a temptation to veer away from the research focus. 2 Reporting of findings from multiple-case research studies is also challenging at times, 1 particularly in relation to the word limits for some journal papers.

Examples of case studies

Example 1: nurses’ paediatric pain management practices.

One of the authors of this paper (AT) has used a case study approach to explore nurses’ paediatric pain management practices. This involved collecting several datasets:

Observational data to gain a picture about actual pain management practices.

Questionnaire data about nurses’ knowledge about paediatric pain management practices and how well they felt they managed pain in children.

Questionnaire data about how critical nurses perceived pain management tasks to be.

These datasets were analysed separately and then compared 7–9 and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. 7 Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. 8 There was also a difference in self-reported and observed practices 9 ; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics (NPLCs)

The other author of this paper (RH) has conducted a multiple-case study to determine the quality of care for patients with complex clinical presentations in NPLCs in Ontario, Canada. 10 Five NPLCs served as individual cases that, together, represented the quatrain. Three types of data were collected including:

Review of documentation related to the NPLC model (media, annual reports, research articles, grey literature and regulatory legislation).

Interviews with nurse practitioners (NPs) practising at the five NPLCs to determine their perceptions of the impact of the NPLC model on the quality of care provided to patients with multimorbidity.

Chart audits conducted at the five NPLCs to determine the extent to which evidence-based guidelines were followed for patients with diabetes and at least one other chronic condition.

The three sources of data collected from the five NPLCs were analysed and themes arose related to the quality of care for complex patients at NPLCs. The multiple-case study confirmed that nurse practitioners are the primary care providers at the NPLCs, and this positively impacts the quality of care for patients with multimorbidity. Healthcare policy, such as lack of an increase in salary for NPs for 10 years, has resulted in issues in recruitment and retention of NPs at NPLCs. This, along with insufficient resources in the communities where NPLCs are located and high patient vulnerability at NPLCs, have a negative impact on the quality of care. 10

These examples illustrate how collecting data about a single case or multiple cases helps us to better understand the phenomenon in question. Case study methodology serves to provide a framework for evaluation and analysis of complex issues. It shines a light on the holistic nature of nursing practice and offers a perspective that informs improved patient care.

• Gustafsson J
• Calanzaro M
• Sandelowski M

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

Read the full text or download the PDF:

Writing clinical articles: A step-by-step guide for nurses

Focus on your audience and narrow your topic. .

Editor’s note: Dissemination 101 is a series designed to help nurses share their expertise. To read other articles in the series, visit myamericannurse.com/category/dissemination-101 . 

• Writing for publication allows you to contribute to nursing practice and help build nursing and healthcare knowledge.
• Taking a step-by-step approach to writing a clinical article can help increase the chances for acceptance.

Are you thinking about writing a clinical article for publication? You can write for a general interest nursing journal that addresses a broad audience or a specialty journal that caters to nurses focused on caring for a specific patient population (for example, oncology or wound care). Most clinical articles published in general interest journals aim to help nurses understand the clinical presentation and progression of a disease or health issue and the subsequent care for a specific patient population.

To increase your chances of article acceptance for publication, take a step-by-step approach, as recommended by Mee.

Start with what you know

Write about what you’re most familiar with. Are you working on a hemodialysis unit and recently managed a patient who experienced a cardiovascular event? Then consider writing about managing cardiovascular emergencies in this patient population. Are you an endoscopy nurse who works with patients receiving endoscopic retrograde cho­lan­giopancreatography? Focus your article on the nursing implications of caring for patients after this test.

Strive to keep your topic focused so you can control manuscript length and ensure you deliver relevant content to the reader. For example, an article about caring for patients with pancreatic disorders is too broad. A narrower-focus article might cover cystic fibrosis, specifically on the impact of this condition on health-related quality of life. You can narrow the topic further by a concentrating on adolescents.

Solo vs. team writing

Are you going to write alone or with a team? Pros and cons exist for each. When writing alone, you may have better control of your timeline and content. However, compared to writing with a team, you might miss an opportunity to present a more diverse perspective of the topic. Another advantage of writing with a team includes having more access to resources, including a network of colleagues to interview. With a team, you can distribute the work among the authors and even have more proofreaders. However, delays may arise if one team member lags behind schedule or conflict emerges within the group. When writing with a team, establish authorship early in the process. The International Committee of Medical Journal Editors developed a set of four criteria to establish authorship: authors should make substantial contributions to the manuscript, draft or revise it, have final approval of the published version, and agree to be accountable for all aspects of the work.

Journal selection

Before selecting a journal, establish your intended audience. For example, are you writing for staff nurses, clinical nurse specialists, nurse practitioners, or nurse midwives? Write for the selected audience, keeping in mind what they already know about the topic.

Now you can narrow your journal choices to those that are a good match for your topic and intended audience. You can expect immediate rejection if your manuscript doesn’t match a journal’s purpose and readership. Read at least three to four issues, and explore the table of contents for similar articles related to your topic. An article on a disease or condition similar to your topic doesn’t necessarily make yours ineligible for publication. Your topic may have a different focus.

After you select the target journal, carefully read the author guidelines, which usually can be found on the journal’s website. Follow directions for formatting the manuscript, and comply with page or word limitations. Consider querying the journal editor before submitting your manuscript (in fact, many journals require this step). Querying can help ensure your topic is appropriate for the journal. In addition, the editor may provide feedback to help you focus the manuscript accordingly before submission.

Article type

Elements of a clinical review article.

Clinical review articles typically include the following sections:

• Etiology. The cause or origin of the disease.
• Pathophysiology. The pathologic and physiologic processes associated with the disease.
• Epidemiology. Discussion of disease frequency (number of new cases in a given population) or prevalence (number of cases present at a point in time).
• Clinical presentation. What are the signs and symptoms of the disease?
• Diagnostics. This includes relevant tests and normal and abnormal laboratory values.
• Treatment and interventions. Depending on the journal guidelines, this section might include medications, medical and nursing procedures, and key nursing considerations.
• Patient education. This section focuses on key points for patient education. If your article discusses best practices in your setting, consider including a patient education handout that can be incorporated into any organization.
• Nursing implications. Includes the nursing process from assessment to interventions and outcomes. Some journals want a separate section devoted to nursing implications.

Case studies 

Most nurses are familiar with case studies, first from learning how to write them in nursing school and then in clinical practice when reading progress notes. If you’re a novice writer, you’ll find reading case studies in journals to be helpful.

Published case studies can evolve from real case reports or be a simulated, fictional case. If you choose to write about a real case, obtain permission from the patient and your organization. Although the patient’s identity will be concealed in your article, you may run the risk of readers identifying the patient. Also, don’t choose a case that’s so rare that the reader may never encounter such a situation.

Case studies typically begin with the patient’s health history followed by a discussion of the common clinical presentation, pathophysiology, nursing process, psychosocial considerations, and treatments. Keep in mind that you’re using the case to teach readers, not merely reporting what you experienced.

How-to articles 

How-to articles focus on teaching a skill, procedure, or intervention. For example, caring for patients with a colostomy, proning patients with COVID-19 who haven’t been intubated, or attending to patients after cardiac catheterization. When writing a how-to article, focus on what’s most meaningful to nurses who provide direct care, such as patient and family education, and cite evidence-based recommendations.

Do your research

A fundamental motto for writing is “Read. Read. Read. Write. Write. Write.” In other words, do your research. When you read a wide range of literature on your topic, including relevant nursing models or theories, and access key databases, you’ll soon be ready to write. Organize your notes (paper or digital) and maintain a complete and accurate account of your references, which should be as current as possible.

Create an outline

Use an outline to organize your thoughts and help you stick to one main focus or purpose that’s appropriate for the intended audience. At this stage, you’ll also want to consider what information can be best covered in tables or figures rather than in text. For example, you can create a table that lists signs and symptoms in column one and related pathophysiology in column two. Such a table can effectively present a large amount of information that doesn’t need to be repeated in the text of the article.

Writing and editing

Knowing where to start can be daunting. Consider starting on the section you know best or one for which you have the most information to help build your confidence and spur development of other sections. Other writing tips that can enhance the chances your article will be accepted for publication and engage readers include the following:

• Passive: The patient’s medications were reviewed by the nurse before discharge.
• Active: The nurse reviewed the medications with the patient before discharge.
• Cite relevant references. Support statistics and practice guidelines with appropriate recent references. Follow the journal’s author guidelines for number of references and style.

After completing your manuscript, let a day or two pass and then read it again and start editing. Note that your overall goal during editing is to make the manuscript concise and meaningful for the reader. Check that it aligns with the journal’s author guidelines and requirements. Ask colleagues (including an expert, novice, or someone who’s not familiar with your topic) to read your manuscript, and request their honest feedback. Review tables, figures, and other graphics to ensure they provide relevant information and that they adhere to the journal’s author guidelines. Consider including a box with key points, such as nursing implications.

Follow the journal’s article submission guidelines. Some journals request submission through an author portal that requires you to create an author account, while others prefer to receive submissions via email. Most journals require that you attach a cover letter, sign copyright release and conflict-of-interest forms, and submit information about all authors.

Advance nursing practice and science

When you publish, you contribute to nursing practice and help build nursing and healthcare knowledge by providing guidance for practitioners and future researchers. Regardless of the type of article, include implications for nursing practice and, when appropriate, education, policy, and research. Writing involves hard work, but it’s rewarding and a great way to build your credentials.

Rhoda Redulla is director of nursing excellence and Magnet Recognition at NewYork-Presbyterian in New York, New York, associate editor of Gastroenterology Nursing Journal, and author of Fast Facts for Making the Most of Your Career in Nursing . 

Eldh AC, Almost J, DeCorby-Watson K, et al Clinical interventions, implementation interventions, and the potential greyness in between – a discussion paper. BMC Health Serv Res. 2017;17(1):16. doi:10.1186/s12913-016-1958-5

International Committee of Medical Journal Editors. Defining the role of authors and contributors.

Mee C. Writing the clinical article. In: Saver C ed. Anatomy of Writing for Publication for Nurses. 4th ed. Indianapolis, IN: Sigma; 2021.

Morton P, Ketefian S, Redman R. Writing the research report. In: Saver C, ed. Anatomy of Writing for Publication for Nurses. 4th ed. Indianapolis, IN: Sigma; 2021.

Oermann MH, Ingles TM. Writing manuscripts about quality improvement: Squire 2.0 and beyond. Health. April 30, 2019.

Roush K. What types of articles to write. Am J Nurs. 2017;117(5):68-71. doi:10.1097/01.NAJ.0000516278.97098.02

2 Comments . Leave new

I could have used this when I was writing articles years ago. Excellent resource

Thank you for this helpful article. I believe that when we publish good articles, we help healthcare providers to give a high quality of care to patients. I encourage all knowledgeable healthcare to write and publish many articles in order to help others for the betterment of patients. Thank you

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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

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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.

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Evidence-Based Practice Copyright © by Various Authors - See Each Chapter Attribution is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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INA-MHPEC 2022: Character Building and Competence Development in Medical and Health Professions Education pp 15–24 Cite as

An Exploration of Nursing Students’ Experiences Using Case Report Design: A Case Study

• Yayu Nidaul Fithriyyah 6 ,
• Arif Annurrahman 7 ,
• Khudazi Aulawi 6 ,
• Atikah Kurnia Alda 7 &
• Astrid Pratidina Susilo 8  
• Conference paper
• First Online: 05 October 2023

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Part of the book series: Springer Proceedings in Humanities and Social Sciences ((SPHSS))

Case report design in nursing practice and education encourages active learning, scientific writing, and critical thinking. This study explores the experiences of nursing students using a case report design. This study used a case study design. Data collection for the nursing student professional program from January to September 2022 included demographics, case report data, educational media, and semi-structured interviews. The thematic analysis followed Braun and Clarke’s framework. The results showed no difference in the characteristics of the four nursing students, who are all women. Differences were found in the patient characteristics and the type of educational media. Two themes emerge: (1) Students learn from patient case reports; and (2) Students learning for scientific writing of case reports. Each theme consists of three sub-themes. Results showed that the case studies can improve students’ clinical reasoning in providing quality care. In conclusion, according to the evidence, this study can assist professional nursing education in understanding and improving the integration of clinical practice skills and students' writing skills. In the future, clear guidelines, training, and guidance from lecturers and clinical supervisors are needed.

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Acknowledgements

We appreciate everyone involved, both the educational institution of the Bachelor of Nursing Study Program and the Academic Hospital of Universitas Gadjah Mada, which are not all individually identifiable, who have contributed to this case study.

There is no financial support from any organization. The authors declare that they have no conflict of interest.

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Department of Medical-Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia

Yayu Nidaul Fithriyyah & Khudazi Aulawi

School of Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia

Arif Annurrahman & Atikah Kurnia Alda

Department of Medical Education and Bioethics, University of Surabaya, Surabaya, 60293, Indonesia

Astrid Pratidina Susilo

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Yayu Nidaul Fithriyyah —responsible for the conceptualization, methodology of collecting data, and writing the initial manuscript draft.

Arif Annurrahman —responsible for collecting data, conducting transcription and analysis, and writing manuscript drafts.

Khudazi Aulawi— responsible for reviewing the data collection and analysis and revising the manuscript draft.

Atikah Kurnia Alda— responsible for collecting data, conducting transcription and analysis, and writing manuscript drafts.

Astrid Pratidina Susilo —responsible for methods and analysis and writing manuscript drafts.

All authors have read and approved the published version of the manuscript.

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Correspondence to Yayu Nidaul Fithriyyah .

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Mora Claramita

Department of Medical Education, Universitas Indonesia, Jakarta, Indonesia

Diantha Soemantri

Rachmadya Nur Hidayah

Ardi Findyartini

Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Dujeepa D. Samarasekera

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Fithriyyah, Y.N., Annurrahman, A., Aulawi, K., Alda, A.K., Susilo, A.P. (2023). An Exploration of Nursing Students’ Experiences Using Case Report Design: A Case Study. In: Claramita, M., Soemantri, D., Hidayah, R.N., Findyartini, A., Samarasekera, D.D. (eds) Character Building and Competence Development in Medical and Health Professions Education. INA-MHPEC 2022. Springer Proceedings in Humanities and Social Sciences. Springer, Singapore. https://doi.org/10.1007/978-981-99-4573-3_2

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Nursing Case Studies with Answers

Explore Nursing Case Studies with Answers and examples in Carepatron's free downloadable PDF. Enhance your nursing knowledge and prepare for exams with practical scenarios.

By Wynona Jugueta on Apr 08, 2024.

Fact Checked by Ericka Pingol.

What is a case study?

A case study in medicine is a detailed report of a patient's experience with a disease, treatment, or condition. It typically includes the patient's medical history, symptoms, diagnostic tests, treatment course, and outcome.

Some key things to know about medical case studies template . First, they delve deep into the specifics of a single case, providing a rich understanding of a particular medical situation.

Medical professionals use case studies to learn about rare diseases, unusual presentations of common conditions, and the decision-making process involved in complex cases.

Case studies can identify exciting areas for further investigation through more rigorous clinical trials. While informative, they can't be used to develop general treatment guidelines because they only focus on a single case.

Overall, medical case studies are valuable tools for medical education and research, offering insights into human health and disease complexities.

Printable Nursing Case Studies with Answers

Download this Nursing Case Studies with Answers to analyze complex clinical situations, identify priority needs, and develop effective care plans tailored to individual patients.

What is in a nursing case study?

A nursing case study is a detailed examination of a patient's health condition, treatment plan, and overall care journey, specifically from the perspective of nursing practice. These case studies are essential components of nursing education and professional development, providing valuable insights into clinical scenarios and patient care experiences.

In a case nursing study template , various elements are typically included to comprehensively understand the patient's situation. First and foremost, the case study outlines the patient's demographic information, including age, gender, medical history, and presenting symptoms. This demographic overview sets the stage for understanding the context in which healthcare interventions occur.

Moreover, nursing case studies often delve into the nursing assessment process, highlighting the initial and ongoing assessments nurses conduct to gather relevant patient health status data. These assessments involve physical examinations, vital sign monitoring, and assessment tools to identify potential health issues and risk factors.

Critical thinking skills are essential in nursing case studies, as they enable nurses to analyze complex clinical situations, identify priority needs, and develop effective care plans tailored to individual patients. Nursing students and experienced nurses use case studies as opportunities to enhance their critical thinking abilities and clinical decision-making processes.

Nursing case studies serve several vital purposes within healthcare education and professional practice, whether they are a primary care physician or a group of nursing students. Let's explore each purpose in detail:

Enhancing clinical reasoning skills

One primary purpose of nursing case studies is to enhance nursing students' and practicing nurses' clinical reasoning skills. By presenting realistic patient scenarios, case studies challenge individuals to analyze clinical data, interpret findings, and develop appropriate nursing interventions. This process promotes critical thinking and problem-solving abilities essential for effective nursing practice.

Applying theoretical knowledge to practice

Nursing case studies provide a bridge between theoretical knowledge and practical application. They allow nursing students to apply concepts learned in the classroom to real-world patient care situations. By engaging with case studies, students can integrate theoretical principles with clinical practice, gaining a deeper understanding of nursing concepts and their relevance to patient care.

Facilitating interdisciplinary collaboration

Another purpose of nursing case studies is to facilitate interdisciplinary collaboration among healthcare professionals. Nurses often collaborate with physicians, specialists, therapists, and other team members in complex patient cases to deliver comprehensive care. Case studies offer opportunities for nurses to explore collaborative decision-making processes, communication strategies, and teamwork dynamics essential for providing quality patient care.

Promoting evidence-based practice

Nursing case studies are crucial in promoting evidence-based practice (EBP) within nursing and healthcare settings. Nurses can make informed decisions about patient care interventions by analyzing patient scenarios and considering current research evidence. Case studies encourage nurses to critically evaluate research findings, clinical guidelines, and best practices to ensure the delivery of safe, effective, and patient-centered care.

Fostering professional development

Engaging with nursing case studies contributes to the ongoing professional development of nurses at all stages of their careers. For nursing students, case studies provide valuable learning experiences that help prepare them for clinical practice. For experienced nurses, case studies offer opportunities to refine clinical skills, stay updated on emerging healthcare trends, and reflect on past experiences to improve future practice.

How to write a nursing case study?

Writing a nursing case study involves several essential steps to ensure accuracy, relevance, and clarity. Let's break down the process into actionable steps:

Step 1: Select a patient case

Begin by selecting a patient case that presents a relevant and compelling healthcare scenario. Consider factors such as the patient's demographic information, medical history, presenting symptoms (e.g., joint stiffness, pain), and healthcare needs (e.g., medication administration, vital signs monitoring). Choose a case that aligns with your learning objectives and offers meaningful analysis and discussion opportunities.

Step 2: Gather relevant data

Collect comprehensive data about the selected patient case, including medical records, test results, nursing assessments, and relevant healthcare documentation. Pay close attention to details such as the patient's current health status, past medical history (e.g., diabetes), treatment plans, and any ongoing concerns or challenges. Utilize assessment tools and techniques to evaluate the patient's condition thoroughly and identify areas of clinical significance.

Step 3: Assess the patient's needs

Based on the gathered data, evaluate the patient's needs, considering physical, emotional, social, and environmental factors. Assess the patient's pain levels, mobility, vital signs, and other relevant health indicators. Identify any potential complications, risks, or areas requiring immediate attention. Consider the patient's preferences, cultural background, and individualized care requirements in your assessment.

Step 4: Formulate nursing diagnoses

Formulate nursing diagnoses that accurately reflect the patient's health needs and priorities based on your assessment findings. Identify actual and potential nursing diagnoses related to the patient's condition, considering factors such as impaired mobility, ineffective pain management, medication adherence issues, and self-care deficits. Ensure your nursing diagnoses are specific, measurable, achievable, relevant, and time-bound (SMART).

Step 5: Develop a care plan

Develop a comprehensive care plan outlining the nursing interventions and strategies to address the patient's identified needs and nursing diagnoses. Prioritize interventions based on the patient's condition, preferences, and care goals. Include evidence-based nursing interventions to promote optimal health outcomes, manage symptoms, prevent complications, and enhance the patient's overall well-being. Collaborate with other healthcare professionals as needed to ensure coordinated care delivery.

Step 6: Implement and evaluate interventions

Implement the nursing interventions outlined in the care plan while closely monitoring the patient's response to treatment. Administer medications, provide patient education, perform nursing procedures, and coordinate care activities to effectively meet the patient's needs. Continuously evaluate the effectiveness of interventions, reassessing the patient's condition and adjusting the care plan as necessary. Document all interventions, observations, and outcomes accurately and comprehensively.

Step 7: Reflect and seek assistance

Reflect on the nursing case study process, considering what worked well, areas for improvement, and lessons learned. Seek assistance from nursing instructors, preceptors, or colleagues if you encounter challenges or have concerns about the patient's care. Collaborate with interdisciplinary team members to address complex patient issues and ensure holistic care delivery. Continuously strive to enhance your nursing practice through ongoing learning and professional development.

Nursing Case Studies with Answers example (sample)

Below is an example of a nursing case study sample created by the Carepatron team. This sample illustrates a structured framework for documenting patient cases, outlining nursing interventions, and providing corresponding answers to guide learners through the analysis process. Feel free to download the PDF and use it as a reference when formulating your own nursing case studies.

Download this free Nursing Case Studies with Answers PDF example here 

Why use Carepatron as your nursing software?

Carepatron stands out as a comprehensive and reliable solution for nursing professionals seeking efficient and streamlined workflows in their practice. With a range of features tailored to the needs of nurses and healthcare teams, Carepatron offers unparalleled support and functionality for managing various aspects of patient care.

Nurse scheduling software

One of the key advantages of Carepatron is its nurse scheduling software , which simplifies the process of creating and managing schedules for nursing staff. With intuitive scheduling tools and customizable options, nurses can easily coordinate shifts, manage availability, and ensure adequate staffing levels to meet patient needs effectively.

Telehealth platform

In addition, Carepatron offers a robust telehealth platform that facilitates remote patient monitoring, virtual consultations, and telemedicine services. This feature enables nurses to provide continuity of care beyond traditional healthcare settings, reaching patients in remote areas or those unable to attend in-person appointments.

Clinical documentation software

Furthermore, Carepatron's clinical documentation software streamlines the documentation process, allowing nurses to easily capture patient data, record assessments, and document interventions. The platform supports accurate and efficient documentation practices, ensuring compliance with regulatory standards and promoting continuity of care across healthcare settings.

Commonly asked questions

In clinical terms, a case study is a detailed examination of a patient's medical history, symptoms, diagnosis, treatment, and outcomes, typically used for educational or research purposes.

Case studies are essential in nursing as they provide real-life scenarios for nurses to apply theoretical knowledge, enhance critical thinking skills, and develop practical clinical reasoning and decision-making abilities.

Case studies in nursing education offer benefits such as promoting active learning, encouraging problem-solving skills, facilitating interdisciplinary collaboration, and fostering a deeper understanding of complex healthcare situations.

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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

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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

View articles

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.

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Prostate cancer cases worldwide likely to double by 2040, analysis finds

Largest study of its kind predicts 85% increase in deaths from the disease in same period as more men live longer

The number of men diagnosed with prostate cancer worldwide is projected to double to 2.9 million a year by 2040, with annual deaths predicted to rise by 85%, according to the largest study of its kind.

Prostate cancer is already a major cause of death and disability, and the most common form of male cancer in more than 100 countries. But with populations ageing and life expectancy rising globally, a new analysis forecasts a dramatic surge in cases and deaths over the next 15 years.

Diagnoses are projected to increase from 1.4m a year in 2020 to 2.9m by 2040, which will mean about 330 men being told they have the disease every hour.

The number of deaths worldwide is predicted to rise by 85% over the 20-year period, from 375,000 in 2020 to almost 700,000 by 2040. The true death toll will probably be higher, experts say, because of underdiagnosis and missing data in low- and middle-income countries.

The findings were published in the Lancet as part of its landmark commission on prostate cancer, and will be presented at the European Association of Urology’s annual congress in Paris on Saturday.

Ageing populations and increasing life expectancy mean the number of older men worldwide who are living for longer is rising. As the main risk factors for prostate cancer – such as being 50 or older and having a family history of the disease – are unavoidable, experts say it will be impossible to prevent the surge in cases simply via lifestyle changes or public health interventions.

However, wider awareness of the symptoms of the disease, access to testing initiatives, earlier diagnosis, and advances in treatments could still help reduce the burden and save lives, according to the authors of the 40-page report.

“As more and more men around the world live to middle and old age, there will be an inevitable rise in the number of prostate cancer cases,” said Prof Nick James, the lead author of the study. “We know this surge in cases is coming, so we need to start planning and take action now.”

“Evidence-based interventions, such as improved early detection and education programmes, will help to save lives and prevent ill health from prostate cancer in the years to come,” added James, a professor of prostate cancer research at the Institute of Cancer Research, London, and a consultant clinical oncologist at the Royal Marsden NHS foundation trust.

James said there was a global need for new and improved ways to test for the disease, to reduce overdiagnosis and overtreatment while detecting potentially lethal tumours earlier.

Boosting knowledge among men and their families of signs to look for was also key, according to the report.

Symptoms of prostate cancer can include needing to urinate more frequently, often during the night; needing to rush to the toilet; difficulty in starting to pee; feeling that your bladder has not emptied fully, and blood in your urine or semen.

These symptoms do not always mean you have prostate cancer. Many men’s prostates become larger as they get older because of a condition called benign prostate enlargement. Signs that prostate cancer may have spread include testicle, back or bone pain, a loss of appetite, and unintentional weight loss.

The study also highlighted the need for more research to better understand prostate cancer in black men, as most research has focused on white men.

Alfred Samuels was 54 when he learned he had advanced prostate cancer in 2012. He had worked in the entertainment industry for three decades, providing security for celebrities including Beyoncé and Bob Dylan – but the shock diagnosis ended his career overnight. Doctors ruled out surgery when tests showed his cancer had spread, and the father of six started to lose hope.

However, he then joined a clinical trial and began treatment with a drug that is now extending the lives of thousands of men worldwide. Twelve years later, Samuels, from Harrow in north-west London, has welcomed six grandchildren to the world and pivoted to a second career raising awareness of cancer research.

“Due to the late stage that my prostate cancer was diagnosed, I wouldn’t be here today if I hadn’t been able to access a clinical trial. It was my lifeline,” said Samuels, now 66. “This report has been a long time coming. Now it needs to be mandatory to record ethnicity in clinical trials, and trials must reflect the ethnic diversity of the population, so that we can find better treatments for people like me.”

Amy Rylance, the head of improving care at the charity Prostate Cancer UK, said the Lancet report was a “a timely call to action”. She added that healthcare systems must do better at recognising those at highest risk: black men and men with a family history of prostate cancer or genetic risk factors such as BRCA variations .

• Prostate cancer
• Cancer research
• Medical research
• Men's health

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Study offers hope in identifying high-risk prostate cancer patients

Getting fitter can reduce prostate cancer risk by 35%, study finds

New prostate cancer treatment may be ‘on the horizon’, say scientists

Lock, Stock and Two Smoking Barrels actor Jake Abraham dies aged 56

Radiotherapy doses for prostate cancer could be cut by three-quarters, trial finds

BBC presenter Nick Owen announces prostate cancer diagnosis

UK prostate cancer screening programme ‘could be running in three years’

Thousands of UK men to benefit after NHS approves prostate cancer drug

Scientists launch search for genetic test to spot killer prostate cancer

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• v.29(3); 2021 Oct

Nursing Students’ Views and Suggestions About Case-Based Learning Integrated Into the Nursing Process: A Qualitative Study

Rukiye burucu.

1 Department of Nursing, Necmettin Erbakan University, Seydişehir Faculty of Health Science, Konya, Turkey

Selda Arslan

2 Department of Nursing, Necmettin Erbakan University, Faculty of Nursing, Konya, Turkey

This study aimed to evaluate students’ views and suggestions about case-based learning.

: The research was planned by using qualitative method of phenomenological type. Case-based learning was integrated into the nursing process and implemented in four sessions, and then, students’ views and suggestions were collected. In the interview, a semi-structured interview form was used, in-depth interviews were made, and the data were evaluated by qualitative data analysis. Phenomelogical approach of Colazzi was used in the analyzes and Huberman method was applied. The COREQ was used to analyze and report the qualitative data. The sample consisted of second-year students in the nursing department of a public university in Anatolia in the academic year 2017-2018. Participants attended the case-based learning program. A focus group interview was conducted with 10 of the participants.

Participants are 10 students with a mean age of 19.86 ± 0.78 years. A total of 65 opinions and suggestions were presented during the focus group meeting. These were grouped under two main and seven sub-themes. Participants had positive views on the program and gave practical suggestions.

Case-based learning integrated into the nursing process is a practical nursing method that helps students learn and understand the nursing process better and approach patients from a holistic perspective.

Introduction

The goal of nursing education is to encourage students to develop personal and professional skills (Sharif & Masoumi, 2005). Using nursing students’ teaching methods of choice promotes learning, ensures learning retention, and improves academic performance (Vizeshfar & Torabizadeh, 2018). Different methods should be used for high-quality nursing education ( Azizi et al. , 2018 ; Holland et al. , 2017 ). One of these methods is case-based learning (CBL) ( Aluisio et al. , 2016 ; Hong & Yu, 2017 ), which allows students to acquire academic knowledge (Yoo & Park, 2015), develop critical thinking ( Chan et al. , 2016 ; Hong & Yu, 2017 ) and problem-solving skills (Yoo & Park, 2015), and improve professional self-efficacy ( Kim, 2018 ). Cases can be taught through brainstorming, group discussions, concept maps (Laver & Croxon, 2015), role play ( Kim, 2018 ; Tucker et al. , 2015 ), simulation and software ( Tucker et al. , 2015 ), and demonstration ( MacDonnell et al. , 2010 ).

CBL is a method of learning through analysis of a situation that has been or is likely to be experienced ( Kırımsoy et al. , 2013 ). It is a student-centered method that involves the teaching of a topic through a scenario, resulting in improved learning outcomes and decision-making skills (Kanbay & Okanli, 2017), and in permanent and in-depth learning ( Aluisio et al. , 2016 ). CBL promotes active engagement and self-assessment and decision-making, allowing students to gain insight into how they should react in real life situations (Oermann & Kuzu Kurban, 2015). Nurse education should be based on theoretical and practical training to provide students with the opportunity to put their knowledge to use. However, not all students get the chance to encounter all cases in clinical settings. To overcome this problem, nursing education should incorporate the CBL ( Altınbaş & Derya İster, 2020 ), which, however, has not been sufficiently studied so far ( Majeed, 2014 ). It is recommended that researchers provide the CBL to nursing students and then find out about their views and recommendations on it ( Altınbaş & Derya İster, 2020 ). Collecting and analyzing qualitative data is a recommended method of evaluating views and recommendations ( Chan et al. , 2016 ). Qualitative methods are used to collect data on the environment, processes, and perceptions ( Karataş, 2015 ), and can also be applied to data on teaching methods. Students’ views can provide important information about the effectiveness of a method and help create a framework to overcome its shortcomings ( Chan et al. , 2016 ; Kermansaravi et al. , 2015 ; Raymond et al. , 2018 b; van Hooft et al. , 2018 ). Investigating students’ opinions about a teaching method causes them to feel stressed, but also encourages them to improve themselves ( Gholami et al. , 2017 ). This study aimed to determine what nursing students thought about the CBL and what kind of suggestions they would offer to improve it.

Research Questions

• What kind of method do nursing students think the CBL is?
• What do nursing students suggest about the CBL?

Study Design

This was a qualitative study that employed phenomenology.

Nursing education varies across countries. Nursing programs in Turkey offer a 4-year undergraduate education. The sample for this study consisted of second-year nursing students from a public university in Turkey. Purposive sampling does not set a limit on the sample size, but it is believed that too large a sample can make interpretation challenging ( Baltacı, 2018 ). Therefore, this study was completed with 10 volunteers after the CBL intervention.

Data Collection

Prior to the CBL intervention, a detailed lesson plan was developed (Appendix 1) and integrated into the nursing process. Each CBL session lasted 100 minutes. An expert was consulted for the cases in the CBL program (Appendix 2). The integration of the cases into the CBL program was based on the Nursing Interventions Classification, Nursing Outcomes Classification, and NANDA-International (NANDA-I) ( Bulechek et al. , 2017 ; Carpenito-Moyet, 2012). The sample was divided into two for the CBL program, which was applied in classrooms between February and May 2018. One week after the CBL program, a focus-group interview (120 minutes) was conducted with 10 of the 37 participants. The focus-group interview was held using a semi-structured interview form (Appendix 3), for which an expert was consulted (Appendix 2). The interview was audio-recorded. Notes were taken during the interview. One of the researchers acted as a director, while the other acted as a reporter during the interview. Data were collected by the focus-group interview method. It is impossible to prevent respondents from interacting in the focus-group interviews. To minimize this, the researchers asked the interview questions and received answers in order. There were two focus groups of five respondents each. Data collection was terminated when no more data adding new information or insight was forthcoming (data saturation) (Yağar & Dökme, 2018). The interviews were held at the participants’ convenience, so that they would feel comfortable answering the questions. A semi-structured interview form was used during the interviews for consistency. An interview flow template was used for flow and order. Whenever the researchers were in doubt, they consulted with an academic specialized in qualitative research.

In this research, a semi-structured interview form was used to collect the data. There are four questions in this form;

• Can I learn your positive and negative feelings and thoughts about the “case-based teaching method?”
• Have you been taught such a lesson before?
• Compare the “case-based teaching method” with your current courses. What are the differences between the two courses?
• What are your suggestions for this method?

For confirmation, results should be corroborated by those of other studies (Creswell, 2017). Therefore, the researchers discussed the results in line with the related literature.

Reliability

Interrater reliability was calculated for both the semi-structured interview form and the themes using the formula [Reliability = (number of agreements)/(number of agreements + number of disagreements) × 100] (Arastaman et al., 2018; Guba, 1981 ; Ocak & Kutlu Kalender, 2017 ). The interrater reliability was higher than 80, indicating acceptable reliability. Both researchers analyzed the data independently and then combined it based on the order specified by encoders ( Table 1 ). The researchers consulted with an academic specialized in qualitative research to reach a consensus on the parts on which they had disagreed during coding. Bias was reduced using Colaizzi’s phenomenological methodology, which consists of seven steps: (1) recording data, (2) determining significant statements, (3) making sense of the statements, (4) classifying themes into groups, (5) improving the groups, (6) stating the phenomenon clearly, and (7) constructing a fundamental structure ( Onat Kocabıyık, 2016 ).

Colaizzi’s Method of Data Analysis

Statistical Analysis

Themes were developed and categorized. Data were analyzed using conventional qualitative data analysis ( Sönmez & Alacapınar, 2014 ). In the qualitative data analysis, Colaizzi’s phenomenological methodology was used to disclose the meaning attributed by respondents to the intervention in question ( Demir et al. , 2017 ). Colaizzi’s phenomenological methodology is used to reveal the meaning attributed by people to an event/phenomenon ( Onat Kocabıyık, 2016 ). The Consolidated Criteria for Reporting Qualitative Research, which is a 32-item checklist, was used to analyze and report the qualitative data ( Tong et al. , 2007 ).

Ethical Consideration

The study was approved by the Non-Clinical Research Ethics Committee of the Faculty of Health Sciences of Selçuk University (2017/58). Written permission was obtained from the department of nursing. Written informed consent was obtained from participants. The researchers kept the names of the respondents anonymous during data report and kept the audio-recordings and transcripts in encrypted files on their computers.

The focus-group interview was conducted with 10 participants (2 men and 8 women) with a mean age of 19.86 ± 0.78 years. In the focus-group interview, the respondents presented 65 views and recommendations, categorized into two main themes; “Opinions” and “Suggestions.” The theme “opinions” consisted of four subthemes; “The CBL program helped me acquire more academic knowledge and learn the nursing process better”; “The CBL program increased my motivation and appealed to me”; “It was good that the CBL classes were not crowded”; and “The question–answer (Q&A) during the CBL class was helpful.” Theme “suggestions” consisted of three subthemes; “The CBL should be integrated into the current curriculum”; “Nurses and instructors should be role models for students”; and “The CBL nursing education should be offered to other students as well.” The respondents stated that they had never had a case-based course before. Respondents 5 and 7 did not answer question 3, while respondent 8 did not answer question 4. Table 1 shows the distribution of the responses and themes.

Theme 1 Opinions

Subtheme: The CBL program helped me acquire more academic knowledge and learn the nursing process better: All respondents stated that the CBL program made them more aware and knowledgeable about academic content, nursing process, and care planning. The following are direct quotations from three respondents:

• Respondent 1: “...I‘ve learned to approach patients from a holistic perspective and to tackle not only complications but also psychological and social problems, and now I can combine parts and see things as a whole...”
• Respondent 2: “….I didn’t know how to use the nursing process when planning care, but the CBL is helping me manage care now, it‘s also increased my knowledge on medication and helped me understand what nursing diagnosis is…”
• Respondent 10: “…I can plan care more easily and distinguish between descriptive and related factors. I got to see what I’d been (doing wrong during care planning. I used to get bored planning care, but the CBL program helped me better understand the nursing process. The nursing diagnosis book is too general and confusing. It is too broad, but now I understand that I can go beyond that knowledge and that it is practically possible…”

Subtheme: The CBL program increased my motivation and appealed to me : The respondents noted that they felt more confident when they saw that they could easily reach the teacher and ask him/her questions to plan care without fear of being graded. The following are direct quotations from three respondents:

• Respondent 3: “…I was more efficient because I had no fear of being graded, I was more comfortable during the internship than usual ... The CBL classes were more active than others, I was more motivated and engaged because I had no fear of being graded…”
• Respondent 4: “… It was a privilege for me to participate in this training. No one had the chance to do as thorough an examination as the students attending this training, which was an advantage. …”
• Respondent 6: “…I liked it when I saw that I could plan care, it motivates me now…”

Subtheme: It was good that the CBL classes were not crowded: The respondents saw it as a great advantage that they had all their questions answered because the CBL classes were not crowded. The following are direct quotations from three respondents:

• Respondent 2: “…In other classes, we would ask our questions in haste and get some answers because the classes were too crowded, but in the CBL class we could ask our questions in detail.…”
• Respondent 6: “… the CBL class was less crowded than others, and so it was more like a Q&A type of class, so they were more efficient. Besides, the group of 37 was divided into two, which was very good for the CBL class.…”
• Respondent 10: “…we all asked and answered questions, everybody got to talk, which is not possible in other classes because they are too crowded…”

Subtheme: The Q&A during the CBL class was helpful: The respondents remarked that Q&A in the CBL class was better for them because all their questions were answered, which promoted their learning. The following are direct quotations from three respondents:

• Respondent 6: “…theoretical classes were very intense, and the instructors would think that we knew about theory, and so, they sometimes wouldn’t answer our questions, and those classes offered nothing much when it comes to practice, but in the CBL class we examined what was taught in theory, and I thought that I could put it into practice…”
• Respondent 7: “…we always had time constraints in other classes, but in the CBL class we got to ask all our questions one by one and got answers, I mean we kind of had to ask questions, but in the end, we learned…”
• Respondent 10: “…we had Q&A throughout the CBL class, which was very productive, I got to ask all the questions I had in mind and got answers to all of them …”

Theme 2 Suggestions

Subtheme: the CBL should be integrated into the existing curriculum: All but respondents 1 and 8 recommended that the CBL should be integrated into clinical practice or offered by the current curriculum as an elective course. The following are direct quotations from three respondents.

• Respondent 2: “…the CBL should be integrated into the curriculum, there is no need to make extra time for it, I mean, I had to come to school for the CBL class apart from the courses I already have, so it was kind of a hurdle for me…”
• Respondent 5: “… the CBL should be offered as an elective course, and students could be split into groups of 30 and work on cases …”
• Respondent 7: “…In the first week of clinical practice, the instructor should bring a case and present it to her students, just like what we have in the CBL, and tell them that she expects the same from them …”

Subtheme: Nurses and instructors should be role models for students: Respondents 1, 6, 7, and 10 stated that clinical nurses and instructors should adopt a common language and serve as role models for the nursing process and care planning. The following are direct quotations from three respondents:

• Respondent 1: “…nurses should be role models for this…”
• Respondent 6: “… instructors should use a common language and be role models when it comes to planning care.”
• Respondent 7: “… we plan care, but each instructor says something different about it and has different styles... We don‘t even know which one is right and which one is wrong, but they are supposed to serve as models…”

Subtheme: the CBL nursing education should be offered to other students as well: Respondents 4, 7, 9, and 10 highlighted that the CBL program should be offered to all students because they all have difficulty in learning the nursing process and planning care. The following are direct quotations from three respondents:

• Respondent 4: “…we now know it and can put it into practice, but we couldn‘t do it at all in our first year, so nursing students of all grades should attend the CBL program...”
• Respondent 7: “… I believe that other students should also learn these things because no one had taught them to us before, and we didn‘t get to learn them in other classes. There should be a case group or something like that could discuss cases with younger students once a week…”
• Respondent 9: “…care planning is hard for all students, so older students should help younger students with it, so peer education could be helpful …”

The discussion is based on the summarized data in Table 2 .

Distribution of Participants’ Opinions and Suggestions

Note: * Themes and subthemes.

CBL makes nursing students more knowledgeable and prone to teamwork, helps them with better clinical performance, develops more positive attitudes toward clinical practice, helps them understand the holistic approach better and improve themselves professionally ( Forsgren et al. , 2014 ), resulting in higher learning retention, quality of care, and patient safety ( Ward et al. , 2018 ). The more the students know, the more motivated they are, further facilitating learning ( Holland et al. , 2017 ). People who acquire new knowledge are likely to develop more positive attitudes and better skills ( Patiraki et al. , 2017 ). Adequate and comfortable learning environments support motivation ( Palumbo, 2018 ; Raymond et al. , 2018 a), minimize communication problems, and contribute to high-quality care (Sharif & Masoumi, 2005).

Aluisio et al. (2016) divided Indian nursing students into three groups (CBL, standard training, and simulation) to teach them about disasters. They found that the CBL group had the highest knowledge score (55.3 ± 11.3), followed by the simulation (46.9 ± 10.6) and standard training (43.8 ± 11.0) groups. Lee et al. (2020) provided nurses working in nursing homes with the CBL (integrated with online and simulation training) on interventions for heart attacks, and found that the participants felt more competent after the training (post-CBL = 4.11 ± 0.37) than before (pre-CBL = 3.79 ± 0.41) and had higher post-CBL knowledge scores (12.82 ± 2.03) than pre-CBL knowledge scores (10.06 ± 2.28). Therefore, they concluded that the CBL integrated with online and simulation training improved nurses’ knowledge and promoted their learning. Kim and Yang (2020) provided nurses with training based on a case of dementia and found that the training helped nurses learn more about dementia ( z = −4.86, p < .001) and interventions for dementia ( z = −4.55, p < .001) and develop more positive attitudes toward people with dementia ( t = −3.04, p = .003). Nursing students are expected to acquire knowledge and put them into practice in the nursing process. Therefore, we can state that the CBL integrated into the nursing process can contribute to nurses’ education.

Cases appeal to students ( Chan et al. , 2016 ; Gholami et al. , 2017 ) and satisfy their expectations ( Hong & Yu, 2017 ). CBL helps nurses make fewer mistakes ( Patiraki et al. , 2017 ; Uysal et al. , 2016 ) and makes them more motivated ( Cui et al. , 2018 ), and therefore, it should be an integral part of nursing education ( McLean, 2016 ). Focus-group interviews are of significance for detecting the strengths and weaknesses of nursing interventions, correcting errors, eliminating deficiencies, and developing new programs. Opinions and suggestions about methods are sound guides that allow us to see the errors and weaknesses of interventions, helping us generate strategies for reform and revise curricula ( Azizi et al. , 2018 ).

Class size is an important factor affecting education and communication during education because the greater the class size, the less time the teacher has for each student ( Raymond et al. , 2018 a), resulting in reduced learning and motivation. However, because class size remains be an important factor, correct planning ( Kocaman & Yurumezoglu, 2015 ; Palumbo, 2018 ) and Q&A is recommended to overcome this problem. Q&A-based classes can increase students’ awareness, concentration, confidence, and self-assessment capacity ( Kaddoura, 2011 ). In short, educational conditions (setting, time, class size, etc.) play a key role in learning ( Gholami et al. , 2017 ). Therefore, education programs should be based on small class size.

The nursing process and care planning provide a common language for nurses and improve the profession through evidence-based protocols ( Patiraki et al. , 2017 ). Nursing students make more mistakes than are acceptable because they cannot clarify the nursing diagnosis while performing the nursing process ( Andsoy et al. , 2013 ). A common language makes nursing care more visible, standardized and record-based, and better understood. This helps both healthcare professionals and instructors meet at a common point and serve as role models ( van Hooft et al. , 2018 ). Nursing students think of the nursing process as too abstract, hard-to-understand, and challenging. This suggests that we need a more concrete educational paradigm ( Zamanzadeh et al. , 2015 ), and we believe we can use the CBL to teach the nursing process.

Nurses and instructors should serve as role models and use a common language to help students put the nursing process into practice. Especially, first- and second-year students find it difficult to comprehend the nursing process and planning care, and therefore, need support ( Andsoy et al. , 2013 ; Patiraki et al. , 2017 ; Uysal et al. , 2016 ). Student communities play an important role in making students socially aware and collaborative, and thus support learning ( Mohan Bursalı & Aksel, 2016 ). Case communities and peer education can provide nursing students with the support in question. Integrating the CBL into the curriculum can be a promising alternative for nursing students.

Conclusion and Recommendations

CBL promotes nursing students’ learning and makes them more motivated because they enjoy Q&A sessions and interaction during CBL-based lectures. They believe that the CBL should be integrated into the existing curriculum and that instructors and nurses should be role models as they put the nursing process in practice. CBL turns abstract concepts of the nursing process into tangible and visual representations. Nursing students think that sharing with younger students what they learn from CBL-based lectures can help those students learn the nursing process more easily.

As a result, it would be appropriate for CBL to be integrated into the existing curriculum and used to train both students and nurses in small groups.

Ethics Committee Approval

Ethics committee approval was obtained from the Non-Clinical Research Ethics Committee of the Faculty of Health Sciences of Selçuk University (2017/58).

Author Contributions

Concept – R.B., S.A.; Design – R.B., S.A.; Supervision – S.A.; Resources – R.B., S.A.; Materials – R.B., S.A.; Data Collection and/or Processing – R.B., S.A.; Interpretation – R.B., S.A.; Literature Search – R.B.; Writing Manuscript – R.B.; Critical Review – S.A.

Appendix 1: CBL Sample Curriculum

Case presentation and analysis (100 Min)

• Showing the case electronically to the group one day prior to intervention
• Remembering the case (10 Min)
• Presenting the theory of disease (10 Min)
• Presenting medications used (15 Min)
• Sorting out the patient problems (15 Min)
• Diagnosis Nursing of NANDA and determining interventions (35 Min)
• Identifying descriptive and etiological factors (10 Min)
• Evaluation and summary (5 Min)

Objectives of the CBL Program

Appendix 2: expert list.

• Prof. Veysel Sönmez, Hacettepe University, Faculty of Education, retired
• Prof. Füsun Gülderen Alacapınar, Necmettin Erbakan University, Faculty of Education
• Assoc. Prof. Selda Arslan, Selçuk University, Faculty of Nursing
• Assoc. Prof. Şerife Kurşun, Selçuk University, Faculty of Nursing
• Assoc. Prof. Pınar Zorba Bahçeli, Selçuk University, Faculty of Nursing

Appendix 3: Semi-structured Interview Form Items

• Could you please tell us about your positive and negative emotions and thoughts about the case-based learning program?
• Have you ever had such a course before?
• Please, compare the case-based learning program with your current courses. What is the difference between them?
• What suggestions can you make concerning the case-based learning program?

Funding Statement

The authors declared that this study has received no financial support.

Informed Consent: Written consent was obtained from students who participated in this study.

Conflict of Interest: The authors have no conflicts of interest to declare.

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