Spring 2021

NURS 6410-001 PMHNP Diagnosis and Management: Concepts and Theory 1

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/.

Welcome to the first of three courses focusing on the Psychiatric Mental Health Nurse Practitioner’s Diagnosis and Management, Concepts and Theory.  This is one of 8 courses designed to prepare you for your role as a Psychiatric Mental Health Nurse Practitioner.

This course uses the Learning Management System,Canvas.  Please log in to the course for detailed materials and content, course packet, course calendar, assignments, grading criteria and other course related information.

Synchronous class meetings are held virtually to protect your health and reduce the potential for transmission of Covid-19 during the current pandemic.  We will meet using either the CanvasConference Tool (Big Blue Button) or Microsoft Teams.  Faculty office hours are also held virtually.

Microsoft Teams:

Please download Microsoft Teams software, available from your Office 365 account, through the UT Health San Antonio website.

The first day of class includes an introduction to Psychiatric Advanced Practice Nursing including a historical perspective and principles of the therapeutic use of self, and therapeutic communication.  These concepts are the foundation for your practice in the role.

Required Readings:

Perese, E.F. (2012): Chapters 1 - 5


FACULTY CONTACT INFORMATION

Mark Soucy, PhD, RN, APRN, FPMHNP-BC, PMHCNS-BC, FAANP
Associate Professor/Clinical
Course and Track Coordinator
School of Nursing
UT Health San Antonio
7703 Floyd Curl Drive
San Antonio, TX 78229
Email: soucy@uthscsa.edu
Telephone: 210-269-8651
FAX: 210-567-2788
Office Hours: See Starfish for Virtual Hours by Appointment


Douglas Dillon, DNP, RN, APRN, FPMHNP-BC
Lt Col USAF (Retired)
Assistant Professor/Clinical
Course Faculty
School of Nursing – Room NSG 2.114
UT Health San Antonio
7703 Floyd Curl Drive
San Antonio, TX 78229
Email: DillonD@uthscsa.edu
Telephone: 210-567-5925
Mobile: 719-494-4747
FAX 210-567-5822
Office Hours: See Starfish for Virtual Hours by Appointment

Marta Vives, DNP, RN, APRN, FPMHNP-BC, PMHCNS-BC
Lt Col USA (Retired)
Assistant Professor/Clinical
PMHNP Course Faculty
School of Nursing
UT Health San Antonio
7703 Floyd Curl Drive
San Antonio, TX 78229
Email: vivesm@uthscsa.edu 
Office Phone: 210-450-8475
Office Room: 2.330
Office Hours: See Starfish (on the left inside Canvas) for Virtual Hours by Appointment




COURSE DESCRIPTION

This course provides the theoretical foundations for the Psychiatric Mental Health Nurse Practitioner. Students will use a holistic perspective to examine the etiologies, meaning and consequences of human behavior. Problem-based and self-directed learning strategies are used to learn methods for gathering data in conducting a psychiatric assessment, formulating differential diagnoses and developing evidence-based treatment recommendations with individuals and families across the lifespan. Collaboration with interprofessional teams is examined as well as legal and ethical principles informing psychiatric care.

CREDIT AND TIME ALLOCATION

Credit hour allocation: 4 semester credit hours
Clock hour allocation: 60 clock hours class

PREREQUISITES

NURS 6338 Advanced Pathophysiology
NURS 6302 Advanced Pharmacotherapeutics
NURS 6210 Advanced Health Assessment & Clinical Reasoning
NURS 6110 Advanced Health Assessment & Clinical Reasoning: Clinical Application

PROGRAM OUTCOMES

Upon completion of the Doctor of Nursing Practice (DNP) Program students will:

  1. Integrate nursing science, ethics, biophysical, psychosocial, analytical, and organizational sources to provide the highest level of specialty nursing practices.
  2. Develop, implement, and evaluate healthcare practices in healthcare systems that ensure quality improvement and patient safety.
  3. Use analytic methods and evidence based practices to improve practice outcomes and the practice environment.
  4. Implement and evaluate ethical healthcare information systems and patient care technology to improve the quality of patient health outcomes and care systems.
  5. Advocate for healthcare practices that advance social justice, equity, and ethical policies within all healthcare arenas.
  6. Employ interprofessional collaborative teams to improve patient and population health outcomes and healthcare delivery systems.
  7. Lead the integration and institutionalization of (evidence based) clinical prevention and population based health guidelines.
  8. Use clinical judgment, systems thinking, accountability, and specialized knowledge to design, deliver, and evaluate evidence based, culturally proficient care to improve patient, population, and health systems outcomes.

COURSE OUTCOMES

1.  Illustrate the therapeutic use of self in the management of clients with actual and potential mental health problems (DNP Essentials I, VIII; NONPF Competencies: Scientific Foundation 1-4, Quality 1-3, Independent Practice 1, 3)
2.  Demonstrate theoretical concepts of patient-centered care with an emphasis on health promotion, disease prevention, health protection, anticipatory guidance, counseling, and disease management to patients and families experiencing mental health problems and lifestyle adjustments. (DNP Essentials I, II, VII, VIII; NONPF Competencies: Scientific Foundation 1-4, Quality 1-3, Independent Practice 1, 3)
3.  Classify knowledge of the structure and function of the central nervous system, developmental, psychological and behavioral theories to patients with mental health problems. (DNP Essentials I, VIII; NONPF Competencies: Scientific Foundation 1-4, Quality 1-3, Independent Practice 1, 3)
4.  Examine the process of a comprehensive psychiatric assessment including screening, use of evaluation instruments, psychiatric history, medical history, family history, social history, substance use history, mental status examination, laboratory testing, imaging studies, and neuropsychological testing. (DNP Essentials I, VIII; NONPF Competencies: Scientific Foundation 1-4, Quality 1-3, Independent Practice 1, 3)
5.  Develop differential diagnoses for persons with mental disorders using the Diagnostic and Statistical Manual of Mental Disorders. (Essentials I, VIII); (NONPF Competencies: Scientific Foundation 1-4, Independent Practice 1, 3)
6.  Illustrate the application of crisis intervention to patients experiencing psychiatric emergencies as well as those experiencing maturation, situational and adventitious crises.  (DNP Essentials I, VIII; NONPF Competencies: Scientific Foundation 1-4, Independent Practice 1, 3)
7.  Construct patient centered plans of care integrating social, developmental, psychological, cultural, explanatory models and spiritual components. (DNP Essentials I, III, VIII; NONPF Competencies: Scientific Foundation 1-4, Independent Practice 1, 3)
8.  Translate evidence-based findings into the diagnosis and management of select psychiatric illnesses across the lifespan to improve health outcomes. (DNP Essentials I, III, VI, VIII; NONPF Competencies: Scientific Foundation 1-4, Quality 1, 2, 5, Independent Practice 1-5, 8)
9.  Demonstrate core professional values and ethical/legal standards in the implementation of the psychiatric mental health nurse practitioner role.  (DNP Essentials I, V, VIII; NONPF Competencies: Scientific Foundation 1-4, Ethics 1-3, Independent Practice 1, 2, 4, 5, 6, 8)
10.  Analyze the use and efficacy of various somatic therapies with persons with mental disorders. (DNP Essentials I, III, VIII; NONPF Competencies: Scientific Foundation 1-4, Independent Practice 1-5, 8)
11.  Evaluate patient safety, quality indicators, and outcomes improvement in the delivery of quality psychiatric care to patients. (DNP Essentials II, III, VI; NONPF Competencies: Scientific Foundation 1-4, Leadership 1, 3, 4, 5, Quality 1-5, Practice Inquiry 1-4, 6, Independent Practice 1-4)

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

Grading Scale:

A = 90-100%
B = 80-89%
C = 75-79%
D = 66-74%
F = Below 66%


For details and information on grading criteria, assignments, and exams, please refer to the course inside Canvas. 

CLASSROOM ATTENDANCE

Attendance in class is an expectation of each student.

WRITTEN ASSIGNMENTS

  1. If written assignments are made in a course they are required.
  2. Students are expected to submit written work on the scheduled date and time.
  3. The student must notify the course coordinator prior to the scheduled due date and time if they are unable to submit the written work as scheduled. Failure to make this notification in advance will result in a "zero" for that written work.
  4. If the excuse is accepted as reasonable and necessary, arrangements will be made for an alternative due date and time.
  5. Each student is responsible for making sure that he or she has completed the written work prior to submission.
  6. Late work will be accepted with consequences as outlined per course syllabi.

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

American Nurses Association. (2015) Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD: Nursesbooks.org ISBN: 9781558105997

American Nurses Association (2013) Psychiatric-Mental Health Nursing Scope and Standards of Practice 2nd Ed. Nursebooks.org ISBN: 9781558105553

American Nurses Association (2015). Nursing: Scope and standards of practice, 3rd Ed. Silver Springs, MD: Nursingbooks.org.ISBN: ISBN: 978-1-55810-619-22

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Paperback (DSM-5).  American Psychiatric Association. ISBN: 9780890425558

American Psychological Association (2020). Publication Manual of the American Psychological Association, 7th Ed. American Psychological Association: ISBN: 9781433832161

Carlat, D.J. (2017). The Psychiatric Interview 4th Ed. Wolters Kluwer.  ISBN: 978-1496327710

First, M.B. (2013) DSM 5 Handbook of Differential Diagnosis. American Psychiatric Publishing, Inc. ISBN: 9781585624621

Neuroscience Education Institute – Membership Student Rate https://www.neiglobal.com/Members/Become/MBRRates/tabid/192/Default.aspx

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. (Eds) (2017). Kaplan& Sadock’s Comprehensive Textbook of Psychiatry, 10th Ed. Philadelphia: Wolters Kluwer. ISBN: 9781451100471

Stahl, S. (2014). The Prescriber’s Guide, 7th Edition. New York, Cambridge University Press. ISBN: 978-1108926010 (see your NEI membership)

Stahl, S. (2013) Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications 4th Edition.  Paperback Edition.  ISBN:  9781107686465 (see your NEI membership)

Tusaie, K.R. & Fitzpatrick, J.J. (Eds.) (2017). Advanced practice psychiatric nursing: Integrating psychotherapy, psychopharmacology, and complementary and alternative approaches across the life span, 2nd Ed. New York, Springer Publishing Company. ISBN: 978-0-8261-3253-6

Van Leeuwen, A.M. & Bladh, M.L. (2019). Davis' comprehensive manual of laboratory and diagnostic tests with nursing implications 8th Ed. FA Davis. ISBN 9780803674950

RECOMMENDED (OPTIONAL) TEXT / REFERENCE

Kreisman, JJ & Straus, H (2010)  I Hate You - Don't Leave Me: Understanding the Borderline Personality  Check inside Canvas course


Shea, S.C. (2017) Psychiatric Interviewing: The Art of Understanding: A Practical Guide for Psychiatrists, Psychologists, Counselors, Social Workers, Nurses, and Other Mental Health Professionals, with online video modules 3rd Edition.  Elsevier. ISBN: 978-1437716986

CONTENT OUTLINE

Therapeutic Use of Self – Therapeutic Communication (Course Outcome 1)

  Children & Adolescents
  Adults
  Geriatrics
  Special Populations
  LGBT Clients

Neural Sciences - (Course Outcomes 2 & 3)

  Functional Neuroanatomy
  Neural Development and Neurogenesis
  Neurophysiology and Neurochemistry
  Psychoneuroendocrinology
  Immune System and Central Nervous System Interactions
  Neurogenetics
  Applied Electrophysiology
  Chronobiology

Developmental & Psychological Theories - (Course Outcomes 2, 3, & 7)

  Piaget & Cognitive Development
  Attachment Theory
  Learning Theory
  Biology of Memory
  Normality and Mental Health

Theories of Personality and Psychopathology - (Course Outcomes 2, 3, & 7)

  Freud
  Erikson
  Other Psychodynamic Schools
  Positive Psychology

 
Assessment of Mental Health across the Lifespan - (Course Outcomes 2, 3, 4, 7, & 8)

  Psychiatric Interview
  CC
  HPI
  Past Psychiatric History
  Past Medical History
  Current Medications
  Substance Use
  Allergies
  Last Menstrual Period
  Family History
  Family Genogram
  Social History

Complete Mental Status Examination
  Screening Instruments
  Child & Adolescent 
  Adults
  Geriatrics
  Evaluation Instruments
  Child & Adolescent 
  Adults
  Geriatrics
  Laboratory Testing
  Imaging Studies

Scope and Standards of Practice for the Psychiatric Mental Health Nurse Practitioner – (Course Outcomes 1, 2, 3, 4, 5, & 8) 

Psychopathology & Differential Diagnosis
  Classification Systems for Mental Disorders
  DSM – 5
  ICD-10 – CM

Patient-Centered Care Principles (Course Outcomes 1, 2, 3, 4, 5, 7, 8, & 9) 
  Pickering - https://nexusipe.org/informing/resource-center/picker-institute%E2%80%99s-eight-principles-patient-centered-care
  Health promotion
  Disease prevention
  Health protection
  Anticipatory guidance
  Counseling
  Disease management
 
Crisis Intervention (Course Outcomes 1, 2, 3, 4, 5, 6, 7, 8, 9, & 11) 
  Situational
  Developmental - Maturational
  Adventitious
  Existential
  The Suicidal Patient

Legal and Ethical Issues in Psychiatric Care (Course Outcomes 1, 2, 4, 5, 6, 7, 8, 9, 10, & 11) 
 
  Legal – Mental Health Code
  Consent
  Hospitalization
  Involuntary Detention
  Order of Protective Custody
  Involuntary Commitment
  Order to Compel (Medications)

Introduction to Evidence-Based Treatments (Course Outcomes 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 & 11) 

  Psychotherapies (Intro)
  Pharmacotherapies (Intro)
  Brain Stimulation Methods
  ECT
  Transcranial Magnetic Stimulation
  Complementary and Alternative Therapies

CALENDAR - 1st Day Only

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

Therapeutic Use of Self – Therapeutic Communication (Course Outcome 1)

  Children & Adolescents
  Adults
  Geriatrics
  Special Populations
  LGBT Clients

Required Reading:

See inside Canvas Week 1 including:
 
Perese, E.F. (2012) Chapters 1 - 5

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