KALINGA INSTITUTE OF NURSING SCIENCES

CAMPUS-5 BHUBANESWAR-24
ADVANCE NURSING PRACTICE- M.Sc. (N) Ist Year

EVALUATION PERFORMA FOR CASE STUDY

Name of the Student…………………….…………………Year …………………………………
Area of Specialty……..……………………………………………………………………..............
Name of client/Patient………………………………IPD No……………Age & Sex…………….
Date of starting Case study………………………….to……………………………………………
Diagnosis: - ………………………………………………………………………………………...

Total: 50
Marks
S. No. Evaluation Characteristic/Criteria Marks
1 Bio-data of the patient 2
2 Personal & family history 2
3 Past medical history Chief complaints on admission/ HOPI 2
4 Physical Assessment / Examination 3
5 Investigations 2
7 Medical / Surgical / Nutritional Management 3
8 Brief study About the disease 5
- Anatomy & Physiology
- Definition
- Etiology
- Pathophysiology
9 Clinical manifestations (In patient, In Book) 2
10 Diagnostic evaluation(compare with patient picture) 2
11 Medical / Surgical management of the patients(compare with patient picture) 2
12 Dietary management for the patients 2
13 Nursing management 12
(a) Nursing assessment
(b) Nursing diagnosis
(c) Objectives
Short term goal
Long term goal
(d) Intervention
(e) Implementation
(f) Evaluation
14 Summary of nursing care 2
15 Prognosis 2
14 Health teaching R/T discharge planning, dietary management & follow up care 3
15 Bibliography 2
16 A.V. Aids 2

Signature of the student

Signature of the Clinical supervisor with remarks:

………………………………………………………………………………………………………
………………………..
…………………………………………………………………........................................................
......................................................................................................................
Signature of the Subject Coordinator