Summer 2020

NURS 6624-LAR Psychiatric Mental Health Nurse Practitioner (PMHNP) Diagnosis & Management II: Clinical Application

All students are responsible for checking their UTHSCSA Livemail account regularly (i.e., daily or several times every week) to obtain Official University Communication regarding their courses, program and student status.

COVID-19
Students are expected to follow all policies related to COVID-19 found on the university webpage: https://wp.uthscsa.edu/coronavirus/.

NOTE: Our campus has enabled the CANVAS MOBILE LEARN application. CANVAS tools such as discussions, quizzes or videos May or May NOT function on all mobile devices. This is because mobile devices are available with rapidly changing and different configurations. Hence, students must not depend on only a mobile device to access course materials. Students must have access to a laptop or desktop device to access course materials and complete assignments.

This course is Web Enhanced with WebCT icon
Please be sure to check the Current Computer Requirements

Link to Graduate Clinical Experiences and Typhon guidelines: http://nursing.uthscsa.edu/gradclinical/

You may begin Clinical Practicum once the Dean announces clinical practicums may resume and as soon as your completed IOR is faxed to the Graduate Office you receive approval.

Please see Canvas for overview and materials for the course.

Note: All seminars will be held virtually using either Microsoft Teams or the Canvas Conference tool. 

Seminar classes are scheduled for select Mondays 5:00 - 7:50 PM except for the mandatory Barkley DRT Exam which will be taken on Tuesday, June 9, 2020 from 4:00 - 5:30 precisely, followed by debriefing 5:40 - 6:50 PM with your supervising faculty. 

Monday, May 11, 2020 - On-Canvas Conference (Recorded) - Clinical Seminar - 5:00 - 7:50 PM – Course Orientation

Tuesday, June 09, 2020 - Barkley DRT Exam- 4:00 - 5:30 PM 

followed by debrief with Dr. Saldivar 5:40 - 6:50 PM


Monday, June 22, 2020 - On-Canvas Conference or Microsoft Teams - Clinical Seminar - 5:00 - 7:50 PM

Seminar Reflective Discussion


Monday, July 13, 2020 -  On-Canvas or Microsoft Teams - 

Clinical Seminar - 5:00 - 7:50 PM

Seminar Reflective Discussion

Monday, July 27, 2020 - On-Canvas or Microsoft Teams -

Clinical Seminar - Patient Management Presentations 5:00 - 7:50 PM


FACULTY CONTACT INFORMATION

Mark Soucy, PhD, RN, APRN, FAANP
Associate Professor/Clinical
PMHNP Coordinator
Email: 
soucy@uthscsa.edu 
Office Phone: 210-567-5893
Mobile Phone: 210-269-8651
Office Room: 2.134
Office Hours: By Appointment & Through Starfish


Rose Saldivar, DNP, RN, APRN, FNP-BC, FPMHNP-BC
Clinical Assistant Professor
Course Faculty
Email: SaldivarR@uthscsa.edu
Office Phone:  956-326-2573
Mobile Phone: 956-236-1824
Office Room: TAMIU CNS 315L
Office Hours: By Appointment & Through Starfish



COURSE DESCRIPTION

The focus of this course is refinement of the Psychiatric Mental Health Nurse Practitioner role in health promotion, diagnosis and management in psychiatric practice in diverse populations across the lifespan. Emphasis is placed on care of persons with complex health problems. In addition, the nurse practitioner’s role as a collaborative member of the interprofessional team will be evaluated.

CREDIT AND TIME ALLOCATION

Credit hour allocation: 6 semester credit hours
Clock hour allocation:
 300 clock hours clinical practicum; 15 clock hours seminar

PREREQUISITES


PROGRAM OUTCOMES

Upon completion of the Master of Science in Nursing Program (MSN) students will:

  1. Integrate scientific findings from nursing and related sciences, including genetics and genomics, into the delivery of advanced nursing care to populations in diverse settings.
  2. Demonstrate organizational and systems leadership to assure ethical and critical decision-making at all systems’ levels for quality and patient safety.
  3. Incorporate performance improvement strategies for quality, safety, and patient-centered care delivery.
  4. Use improvement science to achieve optimal patient care and care environment outcomes.
  5. Integrate meaningful and usable information systems and healthcare technologies to support safe, quality patient care and healthcare systems effectiveness.
  6. Advocate for policy changes that influence healthcare at appropriate levels.
  7. Lead interprofessional teams using collaborative strategies to effect quality patient care and population health outcomes.
  8. Analyze and incorporate broad ecological and social health determinants to design and deliver evidence-based clinical prevention and population healthcare and services to individuals, families, and aggregates/identified populations.
  9. Integrate the advanced competencies expected of a master’s prepared nurse to design, deliver, and evaluate outcomes of systems of care for individuals, families, and diverse populations.

CLINICAL OUTCOMES

  1. Demonstrate progressive self-directed learning of clinical experience and concepts by applying knowledge of acute and chronic psychiatric illness to diagnose and manage patients and families across the lifespan as health status varies (Essentials I, IV, IX).
  2. Use advanced diagnostic reasoning and differential diagnosis for disease management (Essentials I, IV, IX).
  3. Integrate history and physical exam data with the knowledge of pathophysiology and psychopathology of acute and chronic disorders across the life span to develop appropriate differential diagnoses, and initiate appropriate patient-centered interventions (Essentials I, IX).
  4. Integrate traditional and complementary pharmacological interventions into the treatment and management of psychiatric illnesses (Essentials I, IX).
  5. Integrate social, cultural, and spiritual components in patient-centered plans of care for patients and families (Essentials I, IX).
  6. Demonstrate core professional values and ethical/legal standards in the implementation of the Nurse Practitioner role (Essentials, I, VIII, IX).
  7. Evaluate the relationships among access, cost, quality, and safety and their influence on health care (Essentials I, III).
  8. Continue to identify and integrate evidence-based findings to the diagnosis and management of psychiatric illnesses across the life span (Essential IV, IX).
  9. Use self-reflection to evaluate progress in professional development in the role of the nurse practitioner as a member of an interprofessional team (Essential II, VII, VIII, IX).
  10. Analyze patient safety, quality indicators, and outcome improvement in the delivery of quality primary care to patients (Essentials I, III).

GRADING SCALE FOR GRADUATE COURSES

A = 4 points (90-100)
B = 3 points (80-89)
C = 2 points (75-79)
D = 1 point (66-74)
F = 0 points (65 or below)

CRITERIA FOR EVALUATION / GRADES

  Component/Item
Weighting
Description
Patient encounter entries are entered by the student no later than one week after the encounter.  Also must log in and log out shift time entries for each day in clinical in Typhon.  The preceptor must “approve” hours in Typhon for hours to count.
Pass/Fail
Each student will enter their patient encounters no more than 1 week following the actual encounter date. Failure to enter encounters weekly may result in course failure. Each student logs in and out for each shift worked

The student evaluates Clinical Site at mid and end of semester (2)

Student Evaluates Preceptor at mid and end of semester (2)

Pass/Fail

Pass/Fail

Complete/Incomplete

Complete/Incomplete
Barkley DRT Examination - Required
Pass/Fail
Complete/Incomplete
Faculty evaluation (2+)
Pass/Fail
At least 2 clinical site visits will be conducted during the semester. An additional site visit may be conducted as deemed appropriate by the faculty. Each element of the evaluation must be passed to pass the course
Preceptor evaluation (2+)
Pass/Fail
The preceptor must complete one midterm evaluation and one final evaluation. Faculty uses input from preceptor evaluation in determining faculty evaluation.
(Shift) Hours Report (2)
Pass/Fail
Student to submit one clinical hours report at mid-semester and one clinical hour report at end of the semester in order to pass with hours equalling 300 at minimum after incomplete is satisfied. 
Experience Summary Report (2)
Pass/Fail
Student to submit one experience summary report (graphical) at mid semester and one experience hours report at end of semester in order to pass
Written Assignments
Pass/Fail
*Must earn 75% or better for all written assignments (*) combined/averaged to pass


*SOAP Notes (2-3)
60 %
3 required if either of first 2 less than 75%
Seminar Reflective Discussions (2)

20 %

*Patient Management Presentation (1)

20 %

Total
100 %

Final Grade
Pass/Fail
Must pass all the criteria listed above to pass the course.

CLASSROOM ATTENDANCE

Attendance in class is an expectation of each student.

CLINICAL ATTENDANCE

The School of Nursing faculty expects that its students will recognize that they have entered a profession in which commitment to full participation in clinical experiences is an essential component as students are considered to be part of the nursing team. Therefore, regular attendance in clinical, laboratory and simulation experiences is mandatory.

Missed hours can prevent adequate development and assessment of the required knowledge, skills, attitudes and clinical judgment. Absence from clinical/lab/simulation jeopardizes the student’s ability to successfully meet the required clinical course outcomes and competencies.

Punctuality is expected in professional workplaces. Students are expected to arrive on time for clinical/lab/simulation experiences and stay for the entire time allotted for that clinical/lab/simulation experience. Important information affecting patient care is communicated to students at the start of clinical experiences. Therefore, tardiness for clinical/lab/simulation experiences jeopardizes the student’s ability to give safe nursing care.

CLINICAL ABSENCES:
Absences from clinical experience are closely monitored by faculty and should occur only in rare circumstances. Clinical absences will be evaluated on an individual basis. If the student has any clinical absences during the semester, clinical may be made up through a plan developed by the clinical/lab instructor. However, the opportunity to make up absences may not be possible, depending on the length of the clinical rotation, the availability of the faculty and/or the agency to which the student is assigned and may result in inability of the student to meet course outcomes.

If it is determined by the faculty team that a student will be unable to meet course objectives due to clinical absences or if a pattern of absence develops or excessive absences exist, the appropriate course coordinator will refer the student the Associate Dean for Undergraduate Studies to determine progression in the program.
 
NOTIFICATIONS:
A student who is unable to attend a clinical experience must contact the clinical faculty personally prior to the beginning of the clinical experience. Leaving a message or e-mail for the faculty is not acceptable. Faculty will share specifics regarding appropriate means of communicating during orientation.

Travel to surrounding communities may be necessary.

PATIENT SAFETY:
Students are expected to demonstrate achievement of clinical objectives by the end of a clinical course. If, in the instructor‘s professional judgment, a student is consistently unable to provide safe nursing care to patients and cannot remedy the deficit in the given clinical time, the student will receive a grade of ―F for the course. Faculty, or staff in the clinical agency, has
the right to remove a student from the clinical area at any time for any cause.

CLINICAL PASSPORT:
Students are required to maintain a clinical passport and have this on their person at all times while in the clinical setting.

CPR REQUIREMENT:
Students are required to maintain American Heart Association Health Care Provider Basic Life Support certification.

APA GUIDELINES

The APA Publication Manual 7th edition is required for use in all nursing school programs. 

SCHOLASTIC DISHONESTY

Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.



PROFESSIONAL CODE OF CONDUCT

Students who are nurses or are preparing to enter the profession of nursing are expected to treat others with respect and compassion. “The principle of respect for persons extends to all individuals with whom the nurse interacts. The nurse maintains compassionate and caring relationships with colleagues and others with a commitment to the fair treatment of individuals, to integrity-preserving compromise and to resolving conflict. This standard of conduct precludes any and all prejudicial actions, any form of harassment or threatening behavior, or disregard for the effects of one’s actions on others” (American Nurses Association Code for Nurses, Interpretive Statement 1.5).

The students, faculty, Department Chairs, Associate Deans, and the Dean of the School of Nursing of the University Texas Health Science Center San Antonio subscribe to the highest standards of conduct. Our aim is professional behavior beyond reproach. Failure to abide by the signed code of professional conduct may lead to suspension and/or permanent dismissal from the UTHSCSA SON. In particular, we subscribe to the provisions of the Code of Ethics for Nurses (http://bit.ly/1mtD5p2) and the following points of conduct.

http://catalog.uthscsa.edu/schoolofnursing/policiesandprocedures/

School of Nursing Netiquette Guidelines for Online Interaction

Netiquette guidelines provide information for behaving properly online, when using email, tweets or texts so that you may successfully communicate your thoughts in a manner that is respectful and avoids misunderstandings with others.

ADA ACCOMMODATIONS

Any student seeking reasonable accommodations through the Americans with Disabilities Act (ADA) should contact either the Associate Dean for Admissions and Student Services within the first week of the semester or schedule a meeting with the UTHSCSA ADA Compliance Office so that appropriate accommodations may be arranged. A request for accommodations (Form ADA-100: http://uthscsa.edu/eeo/form100-Faculty-student-resident.pdf) must be completed and submitted to the Executive Director of the ADA Compliance Office before accommodations can be provided. Additional information can be provided in the Student Success Center, Room 1.118 or through the ADA Compliance Office website: http://uthscsa.edu/eeo/request.asp.

REQUIRED TEXT / REFERENCE

All texts listed are prior required or recommended textbooks except for two texts.   Please see the new required and new recommended text in this and the next section:

Please see the two new required and new recommended text in this and the next section:

Zakhari, R. (2020). The Psychiatric Mental Health Nurse Practitioner Certification Review Manual., 1st Edition: Springer Publishing ISBN: 9780826179425


Neuroscience Education Institute  (2020) Student Membership: 
https://www.neiglobal.com/Members/Become/MBROverview/tabid/186/Default.aspx
 


American Nurses Association (2014) Psychiatric-Mental Health Nursing Scope and Standards of Practice 2nd Ed (2014 Edition). Nursebooks.org ISBN: 

  • 9781558105553

  • American Nurses Association (2015). Nursing: Scope and standards of practice, 3rd Ed. Silver Springs, MD: Nursingbooks.org. ISBN: 9781558106192


    American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Paperback (DSM-5). American Psychiatric Association. ISBN 978-0-89042-555-8 (you should already have this text)

    Beck, J.S. (2011). Cognitive Behavioral Therapy: Basics and Beyond 2nd Edition. Guilford Press. ISBN: 978-1-60918-504-6 you should already have this text

    Blazer DG, Steffens DG, Busse EW. The American Psychiatric Publishing Textbook of Geriatric Psychiatry. 4th ed. Washington, DC: American Psychiatric Publishing; 2009. Use the electronic edition available through the library

    Goldberg H & Goldberg I. (2013) Family Therapy: An Overview 8th Ed. Belmont CA: Thomson Higher Education. ISBN: 978-0-8400-2812-9

    Perese, E.F. (2012) Psychiatric Advanced Practice Nursing: A Biopsychosocial Approach. F.A. Davis. ISBN 98-0-8036-2247-0

    Sadock, B.J., Sadock, V.A., & Ruiz, P.  (2015). Kaplan & Sadock’ s Synopsis of psychiatry: Behavioral sciences/Clinical psychiatry, 11th Ed. Philadelphia: Lippincott Williams & Wilkins.

    Stahl, S.M. (2017). Stahl’s essential psychopharmacology : The prescriber’s guide. 6th Ed. Cambridge University Press. ISBN 978-1-107-67502-2 (Also available through Briscoe Library using VPN)

    Wheeler, K. (2013). Psychotherapy for the advanced practice psychiatric nurse: A how to guide for evidence based practice 2nd Edition Springer Publishing. ISBN: 9780826110008

    Yearwood E, Pearson G, &Newland J. (Eds.) (2012). Child and Adolescent Behavioral Health: A Resource forAdvanced Practice Psychiatric and Primary Care Practitioners in Nursing.Hoboken, NJ: Wiley; ISBN: 978-0-8138-0786-7




    RECOMMENDED (OPTIONAL) TEXT / REFERENCE

    New Text:



    NP Exam Secrets Test Staff (2017). Psychiatric Mental Health Nurse Practitioner Exam Practice Questions: NP Practice Tests & Exam Review for the Nurse Practitioner Exam (2017). ISBN 9781935213796
    ------------------------------------------------------------------------------------

    Barnhill, J.W. (Ed.) (2014). DSM-5 Clinical Cases. Arlington VA: American Psychiatric Publishing. Available through library under Psychiatric Online

    Muskin, P.R., Dickerman, A.L., & Stroeh, O.M. (2018) StudyGuide to Child and Adolescent Psychiatry 5th Ed.: A companion toDulcan’s Textbook of Child and Adolescent Psychiatry, 2nd Ed. ArlingtonVA: American Psychiatric Association Publishing


    Dulcan, M.K. (2016). Dulcan's textbook of child and adolescent psychiatry (2nd Ed.) Arlington, VA: American Psychiatric Publishing, Inc. PsychiatryOnline.com Online ISBN . (Available online at Briscoe Library).

    Gabbard, G.O. (2007). Gabbard’s Treatments of Psychiatric Disorders, 4th Ed. Arlington, VA: American Psychiatric Publishing, Inc. PsychiatryOnline.com Online ISBN 978-1-58562-298-6. (Available online at Briscoe Library).


    Schatzberg, A. F. & Nemeroff, C.B. (Eds). (2017). The American Psychiatric Association Publishing Textbook of Psychopharmacology 5th Ed.  Arlington, VA: American Psychiatric Publishing, Inc. PsychiatryOnline.com Online ISBN 9781585625239 (Available online at Briscoe Library).



     



    CONTENT OUTLINE

    See Canvas

    Students are expected to demonstrate progressive beginner level competencies in each domain measured in the clinical practicum as evidenced by preceptor and faculty evaluations of performance. 

    Students are responsible for understanding and demonstrating performance of all elements of the clinical practicum as outlines in the Graduate Student Preceptor, Faculty Handbook (see pages 57 through 59 of the handbook:
    http://nursing.uthscsa.edu/gradclinical/documents/graduate_preceptor_handbook.pdf

    Areas of evaluation include:

    A. Assessment
            Obtains an accurate health history
            Performs an organized comprehensive and problem-focused psychiatric examination
            Identifies age, gender, and cultural differences
            Assesses support resources for patient and/or caregiver
            Selects age and condition-specific diagnostic tests and screening         procedures

    B. Diagnosis
            Identifies signs & symptoms of common physical and mental illness
            Appropriately analyzes collected data, (Chief Complaint, HPI, mental         status exam) and other diagnostic data
            Differentiates between normal and abnormal findings
            Formulates differential diagnoses by priority
            Diagnoses acute, complex and/or chronic mental illness

    C. Plan and Implementation
            Formulates plan of care based on selected patient outcomes
            Identifies appropriate pharmacologic therapy
            Identifies appropriate non- pharmacologic interventions modalities
            Plan allows for differences in age, gender and culture
            Plans care in the context of safety, cost, and risk reduction
            Identifies appropriate referrals and consultations with specialist and         support services

    D. Nurse Practitioner - Patient Relationship
            Maintains confidentiality and privacy
            Builds therapeutic relationship with patients and families
            Develops a mutually acceptable plan of care
            Facilitates patient and family decision making regarding care and         health promotion decision making

    E. Teaching and Coaching
            Provides anticipatory guidance, teaching, counseling, and information         to patients, families and caregivers.
            Educates patients, families, and caregivers regarding current health
            problems, treatment, complications, health promotion, and disease         prevention as appropriate.

    F. Professional Role
            Utilizes an evidence-based approach to care using current standards
            Collaborates effectively with members of the health care team
            Provides care recognizing professional limitations
            Accepts feedback and constructive criticism
            Demonstrates self-direction and seeks opportunities to assist other         health care team members
            Utilizes time effectively and efficiently
            Demonstrates professional approach to patients, families, and         colleagues

    Works collaboratively to manage transitions across the healthcare delivery system

            Promotes efficient, cost effective use of resources
            Identifies how situations related to access, cost, efficacy and quality  influence care decisions
            Demonstrates responsibility in monitoring practice for quality of care
            Functions within credentialing and scope of practice

    G. Communication

    Accurately documents comprehensive evaluation, assessment and plan of care and is appropriate for client’s age and culture

            Oral report to preceptor is effective and accurate

    Typhon Case entries to demonstrate level of participation at levels well beyond observation after orientation to clinical practicum

    CALENDAR - 1st Day Only

    Please check the schedule for recent updates on Class Dates & Room.

    Clinical Practicum may begin once the Dean approves students returning to clinical practicum, the IOR is completed, submitted to the graduate office and approved following the official first day of the semester.

    There are synchronous online seminars meetings which are mandatory and required for this course.  See Canvas for details.

    First Day of Seminar is on Canvas:

    May 11, 2020 - 5:00 - 7:50 PM for a recorded (or live) orientation

    Check Canvas for assignments each on-campus day.

    Students are responsible for making sure preceptor has a copy of the Graduate  Preceptor Handbook. 

    Students must provide the preceptor with a copy of the evaluation components that the preceptor will evaluate the student on at the beginning of each practicum experience



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