1. CASE STUDY
15 year old female, Hispanic patient recently diagnosed with ALL admitted to
Levine’s Children hospital oncology floor in double room. Scheduled for her
third chemotherapy treatment and found crying in the corner of her room
while alone.
2. Health Care Needs
Needs in the case study
include reassurance and
support from the health care
team while undergoing her
chemotherapy treatment.
Additional needs involve
family support. The patient
was alone when the nurse
found her crying on the floor.
Privacy is another need; she
is sharing a double room
with another patient.
CONCEPTS MATCHED TO CASE STUDY
Comforting Interventions
The nurse can try to communicate
with the patient’s family to determine
what factors may be contributing to the
limited support. The Child Life Specialist
in the hospital can identify ways to
increase the patient’s comfort, making
the hospital stay more enjoyable during
her admission. The nurse will provide
appropriate medication administration
before meals to ease pain from her
mouth sores and reduce chemotherapy
side effects. The staff will provide
additional pillows and blankets to help
increase the patient’s ability to sleep.
Connecting the patient to resources that
assist with providing a wig or turban for
when alopecia and baldness occur. The
nurse can use the gentle touch technique
when providing patient care to allow
additional reassurance during the
patient's treatment.
Intervening Variables
Areas that aren’t likely to
change in the patient’s
current situation are the
diagnosis of Acute
Lymphocytic Leukemia (ALL)
and the double room
assignment. Additional
factors include limited family
support and her language
barrier.
3. Enhanced Comfort
To enhance the patient’s
comfort level the hospital staff
should use an interpreter
when interacting with the
patient. The nurse can provide
education to the patient on
procedures and medications to
help decrease concerns. The
team should increase the
patient's privacy by closing the
curtain when providing care.
Continuously using these
techniques throughout the
patient’s hospital stay will add
to increasing the patient’s
overall comfort level.
CONCEPTS MATCHED TO CASE STUDY
Health Seeking
Behavior
Institutional
Integrity
Internal Behaviors
Healing of the patient’s
mouth sores. White blood
cells are staying within the
normal range during
chemotherapy treatment
and using special
precautions as needed.
Peaceful Death
Doesn’t apply to
current case study
External Behaviors
Functional with ADLs. To
ensure optimal care, the
patient should stay during
the entire hospital
admission until the
physician discharges her.
Best Practices
Providing comfort and
reassurance throughout the
hospital visit can increase the
Hospital’s satisfaction scores to
ensure the hospital is
providing adequate care.
Providing the patient with
access to care after hospital
discharge can prevent
reoccurring admissions
unrelated to the
chemotherapy treatment.
Best Policies
The diagnostic code
used during the
admission will target
the appropriate length
of stay for the patient
based on recommended
treatment.
4. PROPOSITIONS MATCHED TO CASE STUDY
• The nurse will identify the needs of the patient to provide comfort during her hospital admission. Needs can include identifying any pain, fatigue,
or anxiety and providing interventions to increase the comfort.
• The nurse will use appreciate techniques that contribute to increasing the patient’s overall comfort level, providing medication and relaxation
techniques. Also, by providing the patient with education, resources, and using an interpreter.
• The nurse will identify ways to increase the patient’s comfort after recognizing the intervening variables. In the current case study, the nurse, can
provide education on the patient's ALL diagnosis, use the interpreter services in the hospital, call the family while in the patient’s room if they are
unable to come, and always provide privacy.
• The patient and the nurse can agree the patient will follow up with support groups to provide empowerment and encouragement throughout her
chemotherapy treatment.
• By increasing the comfort the patient will complete all required chemotherapy and any additional treatment requirements outpatient to improve
health-seeking behaviors.
• Increased support can lead to increase satisfaction. The patient and family will acknowledge the Hospital for providing excellent care and report
during the hospital survey.
5. REFERENCES
Comfort Theory and Nursing Practice. (n.d.). Retrieved March 17, 2017, from http://comfortcareinnursing.blogspot.com/p/comfort-theory-and-
nursing-practice_08.html
Comfort Theory by Katharine Kolcaba. (n.d.). Retrieved March 17, 2017, from
http://currentnursing.com/nursing_theory/comfort_theory_Kathy_Kolcaba.html
Kolcaba, K. (2010). An introduction to comfort theory. Retrieved March 17, 2017, from http://www.thecomfortline.com/home/intro.html
6. THANK YOU FOR VIEWING OUR
MIDDLE RANGE THEORY
PRESENTATION
Jaclyn, Megan, Lauren, Suzanna, Macey,
and Courtney
