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iRubric: Disease Management Case Study rubric

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Disease Management Case Study Disease Management Case Study This rubric is designed for the assessment of Wound Care Nurse Students in developing patient assessment, and treatment Rubric Code: V9XC6A By covertsmile Ready to use Public Rubric Subject: Medical Type: Writing Grade Levels: Undergraduate

I. History
	Unacceptable 0 pts	Marginally Acceptable 5 pts	Satisfactory 7.5 pts	Exceptional 15 pts
Chief Complaint (CC) and HPI 15 pts	Unacceptable Chief Complaint and History of Present Illness is scant. The majority of vital information to the chief complaint is missing. Remediation Required	Marginally Acceptable Chief Complaint and History of Present Illness is age and gender appropriate, however is missing some vital information relevant to the chief complaint.	Satisfactory Chief Complaint and History of Present Illness is age and gender appropriate. Some non-vital information relevant to chief complaint is missing. .	Exceptional Chief Complaint and History of Present Illness is complete and age and gender appropriate. It is written in a logical format.
II. History II
	Unacceptable 0 pts	Marginally Acceptable 5 pts	Satisfactory 7.5 pts	Exceptional 10 pts
Past Medical History I (PMH) 15 pts	Unacceptable Complete Past Medical History is missing. Remediation Required	Marginally Acceptable Past Medical History is incomplete. There are key components missing from: Adult medical illnesses; Surgeries, OB/GYN;	Satisfactory Past Medical History complete however there are missing key components from: Adult medical illnesses; Surgeries, OB/GYN;	Exceptional A complete Past Medical History is present and contains: Adult medical illnesses; Surgeries, OB/GYN;
Past Medical History II 10 pts Current Medications Allergies Social History	Unacceptable Complete Past Medical History is missing. Remediation Required	Marginally Acceptable Two components of the complete past medical history are missing: Current medications, allergies, social history.	Satisfactory One component of the complete past medical history is missing: Current medications, allergies, social history.	Exceptional A complete history is present regarding current medications, allergies, social history.
III. Physical Examination
	Unacceptable 0 pts	Marginally Acceptable 7.5 pts	Satisfactory 15 pts	Exceptional 20 pts
Physical Examination 25 pts	Unacceptable The physical examination is missing or grossly incomplete. Remediation Required	Marginally Acceptable Four components of the physical examination are missing: Vital Signs General Assessment Skin (includes wound assessment), HEENT, Cardiovascular, Respiratory, GI, GU, Musculoskeletal, and Neurologic assessment.	Satisfactory Two components of the physical examination are missing: Vital Signs General Assessment Skin (includes wound assessment), HEENT, Cardiovascular, Respiratory, GI, GU, Musculoskeletal, and Neurologic assessment.	Exceptional All components of the physical examination are present: Vital Signs General Assessment Skin (includes wound assessment), HEENT, Cardiovascular, Respiratory, GI, GU, Musculoskeletal, and Neurologic assessment.
IV. Labs/Diagnostics/Problem List
	Unacceptable 0 pts	Marginally Acceptable 1.5 pts	Satisfactory 3.5 pts	Exceptional 5 pts
Labs/Diagnostic Tests 5 pts	Unacceptable There are no mention of laboratory testing or diagnostic imaging. Remediation Required.	Marginally Acceptable Some of the appropriate labs and diagnostic studies have been addressed. Abnormal findings are not flagged as high (H) or low (L).	Satisfactory All appropriate labs and diagnostic studies are recorded. Abnormal findings are not flagged as high (H) or low (L).	Exceptional All appropriate labs and diagnostic studies are recorded. All abnormal findings are flagged as high (H) or low (L).
V. Assement and Plan
	Unacceptable 0 pts	Marginally Acceptable 7.5 pts	Satisfactory 15 pts	Exceptional 20 pts
Assessment and Plan 40 pts -assessment -treatment plan -rationale for choice patient education	Unacceptable The diagnosis(s), assessments, or treatment plan is not documented. Remediation Required.	Marginally Acceptable The assessment lists the chief complaint but is missing other problems. The treatment plan is incomplete for the complaints presented.	Satisfactory The assessment lists the chief complaint but one or more problems is missing. The treatment plan is complete for the complaints presented.	Exceptional The assessment lists ALL of the pertinent problems for the patient, not just the chief complaint. The plan is ordered properly and follows evidence based medicine, is appropriate for the patient and demonstrates a logical progression of knowledge.

Keywords:

wound care nurse

Subjects:

Medical

Types:

Writing

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