Nursing Case Study Sepsis Adpie Assignment Sample
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This nursing case study assignment sample examines the care of a 78-year-old woman who develops sepsis following a urinary tract infection. It applies the ADPIE nursing process, NEWS2 assessment and Sepsis Six interventions, providing useful insights for students seeking assignment help. It also covers delirium management and SMART goals to evaluate clinical decisions, patient outcomes and evidence-based adult nursing practice.
Nursing Case Study Assignment Sample: Sepsis in an Older Adult
Condensed worked sample for UK adult nursing students. Fictional patient. Built on the nursing process (ADPIE), the NMC Code (2018) and Harvard referencing.
What Does a High-Scoring Nursing Case Study Look Like?
A high-scoring nursing case study anonymises the patient, follows the nursing process in order, and justifies every decision with evidence instead of simply describing events. This nursing case study sample applies that structure to one realistic ward scenario: an older adult whose urinary infection becomes sepsis on day two of admission.
Read it with your own marking criteria open. The "Examiner's note" lines show where marks are usually won or lost.
Sample brief: Using the nursing process, critically discuss the care of an adult whose condition deteriorates during admission. Anonymise the patient in line with the NMC Code (2018).
Introduction and Case Background
The patient is called Patient A. The NMC Code (2018) requires nurses to protect confidentiality, so dates, ward names and hospital details are removed. The scenario is fictional.
Patient A is a 78-year-old woman admitted to an acute medical ward with a suspected urinary tract infection. She has type 2 diabetes and hypertension, lives alone, and was fully independent before admission. On day two, a nurse completing routine observations notices new confusion and a change in her vital signs. This assignment follows her care from that moment, using ADPIE: Assessment, Diagnosis, Planning, Implementation, Evaluation.
Examiner's note: Keep the background brief. The marks sit in the analysis that follows.
Assessment: What Did the Nurse Find?
The nurse used the ABCDE approach (Resuscitation Council UK, 2021) and calculated a NEWS2 score (Royal College of Physicians, 2017).
| Parameter | Finding | NEWS2 points |
|---|---|---|
| Respiration rate | 22 breaths/min | 2 |
| Oxygen saturation (scale 1) | 95% on air | 1 |
| Supplemental oxygen | None | 0 |
| Systolic blood pressure | 104 mmHg | 1 |
| Pulse | 108 beats/min | 1 |
| Consciousness | New confusion | 3 |
| Temperature | 38.4°C | 1 |
| Total | 9 |
Subjective data added context. Patient A said she felt "cold and muddled", and her daughter reported that she had been drowsier since the previous evening. Further objective findings were a urine output of 60 ml over four hours, a capillary glucose of 13.2 mmol/L and a urine dipstick positive for leucocytes and nitrites.
A NEWS2 of 9, with a red score for consciousness, places her in the high-risk group in NICE guideline NG253 (NICE, 2025). That means immediate escalation.
Examiner's note: Show the NEWS2 calculation, not only the total. Markers want proof you know what the number triggers.
Diagnosis: How Should the Nurse Prioritise the Problems?
Nursing needs are ranked by risk, with the reasoning stated. A bare list loses marks.
| Priority | Problem | Rationale |
|---|---|---|
| 1 | Risk of rapid deterioration from suspected sepsis | Life-threatening organ dysfunction from a dysregulated response to infection (Singer et al., 2016); time-critical |
| 2 | Acute confusion (suspected delirium) | Affects safety, communication and consent (NICE, 2023) |
| 3 | Risk of hypovolaemia and acute kidney injury | Low urine output; systolic pressure of 104 mmHg |
| 4 | Unstable blood glucose | Diabetes combined with acute infection |
Confusion ranks second because treating the infection is the main route to resolving it.
Planning: What Do SMART Goals Look Like in a Case Study?
| Problem | SMART goal |
|---|---|
| 1 | All Sepsis Six actions and antibiotics completed within one hour of the NEWS2 calculation; NEWS2 below 5 within 12 hours |
| 2 | 4AT screen shows delirium unlikely within 72 hours |
| 3 | Urine output at or above 0.5 ml/kg/hr by hour six |
| 4 | Blood glucose within the range set by the diabetes team over the next 24 hours |
Examiner's note: Every goal needs a measure and a time limit. "Patient will feel better" cannot be evaluated.
Implementation: What Did the Nurse Do, and Why?
The nurse stayed with Patient A, escalated using SBAR and requested urgent senior review, acting on the Code's duty to act without delay when safety is at risk (NMC, 2018). Care then followed the Sepsis Six bundle (Daniels et al., 2011) and the high-risk pathway in NG253 (NICE, 2025):
- Blood cultures were taken before the first antibiotic, with a blood gas for lactate.
- A prescribed broad-spectrum IV antibiotic was given within one hour of the NEWS2 calculation.
- An IV fluid bolus was given within the hour, with reassessment after each bolus.
- Strict fluid balance was recorded, and NEWS2 was recalculated every 30 minutes.
- Oxygen was not needed because saturations stayed within target.
Delirium care ran alongside this. The nurse screened with the 4AT, kept the bay quiet and lit, returned her glasses and hearing aid, and involved her daughter (NICE, 2023).
Capacity needed careful handling. Under the Mental Capacity Act (2005), capacity is assumed and is decision-specific, so the nurse assessed it for each decision rather than treating confusion as lost capacity. Patient A agreed to antibiotics after a short, plain explanation. Where she could not weigh information, decisions were made in her best interests and recorded contemporaneously, as the Code requires (NMC, 2018).
Examiner's note: Do not list tasks. Pair every action with its evidence, as above.
Evaluation: Were the Goals Met?
- Goal 1, met. Antibiotics were given 48 minutes after the NEWS2 calculation, and her score had fallen to 4 by hour twelve.
- Goal 2, partly met. Orientation improved by day three, but night-time confusion continued. The plan was revised to include a consistent evening routine led by her daughter.
- Goal 3, met. Urine output reached target after a second bolus.
- Goal 4, not met at first. Glucose rose above range at hour eight. The diabetes team reviewed her insulin, and checks became more frequent.
Naming what did not work reads as stronger critical analysis than claiming every goal was achieved.
Where Does Reflection Fit in a Nursing Case Study?
Only include it if your brief asks. Gibbs' cycle (1988) works well: description, feelings, evaluation, analysis, conclusion, action plan. A short example: "I felt anxious when the score reached 9. On analysis, my SBAR was clear but slow to start. Next time I will rehearse the opening line so escalation is faster." For a fuller model, see our clinical reflection using Gibbs cycle sample.
Conclusion
Patient A's deterioration was recognised through a scored, repeatable assessment and ranked by risk. Care was timely, and the evaluation was honest about one goal that failed. That is the pattern to copy: assess with a recognised tool, prioritise with reasons, set measurable goals, justify each intervention, and judge the outcome candidly.
Need guidance on your own case? Explore our nursing assignment help for support with structure, evidence and referencing.
References
- Daniels, R., Nutbeam, T., McNamara, G. and Galvin, C. (2011) 'The sepsis six and the severe sepsis resuscitation bundle: a prospective observational cohort study', Emergency Medicine Journal, 28(6), pp. 507–512.
- Gibbs, G. (1988) Learning by doing: a guide to teaching and learning methods. Oxford: Further Education Unit, Oxford Polytechnic.
- Mental Capacity Act 2005, c. 9. [Add legislation.gov.uk URL and access date]
- National Institute for Health and Care Excellence (2023) Delirium: prevention, diagnosis and management in hospital and long-term care (CG103). London: NICE. [Verify edition year]
- National Institute for Health and Care Excellence (2025) Suspected sepsis in people aged 16 or over: recognition, assessment and early management (NG253). London: NICE. [Verify current version and date]
- Nursing and Midwifery Council (2018) The Code: professional standards of practice and behaviour for nurses, midwives and nursing associates. London: NMC.
- Resuscitation Council UK (2021) The ABCDE approach. London: Resuscitation Council UK. [Add URL, access date and verify year]
- Royal College of Physicians (2017) National Early Warning Score (NEWS) 2: standardising the assessment of acute-illness severity in the NHS. London: RCP.
- Singer, M., Deutschman, C.S., Seymour, C.W. et al. (2016) 'The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)', JAMA, 315(8), pp. 801–810.
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This model solution is provided free of charge to serve as a structure reference guide for research, planning, or referencing formatting study. It should not be submitted directly as your own final coursework.