Consider the following questions in your initial discussion post:
Ponder interactions you have had with primary care health care providers in recent years.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Consider the following questions in your initial discussion post:
Review the SOAP note accessed through this link. For purposes of the assignment, the patient is a ‘new patient’ in the practice.
New Patient SOAP Note
Initial Post
Use your lecture materials to determine what CPT E&M Code to utilize for this ‘new patient’ encounter.
You may choose to assign the code based on the anticipated/guestimate amount of time the provider would spend with the patient in the encounter or you may choose to utilize the Medical Decision Making (MDM) approach. If you choose the MDM include the following information in your discussion:
the level of history taking achieved – identify the history elements present
the type of exam performed – identify the number of systems and bulleted points in the note
the level of medical complexity encompassed – include # of points for a) diagnoses/management options, b) amount/complexity of data reviewed, and c) level of risk for complications, morbidity, mortality
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Consider the following questions in your initial discussion post:
Initial Post
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Consider the following questions in your initial discussion post:
Consider the knowledge you have gained from this week’s lecture.
Use your lecture materials to determine three priority Social Determinants of Health (SDH) to assess for in the patient represented in the SOAP note. NOTE: Priority may refer to a strength in an SDH category necessary for the individual to attain/maintain health OR the priority may be a challenge in an SDH category identified as needing support or intervention for the individual to attain/maintain health.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Unit 6 Discussion – Evidence-Based Practice
Consider the following questions in your initial discussion post:
Initial Post
Post a discussion constructed as the ‘P’ (treatment plan) that completes the partial SOAP note accessed through the link above.
Include in the discussion:
These are the interventions that relate to each individual, numbered diagnosis.
Document individual plans directly after each corresponding assessment (Ex. Assessment Plan). Address the following aspects (they should be separated out as listed below):
Diagnostics: labs, diagnostics testing – tests that you planned for/ordered during the encounter that you plan to review/evaluate relative to your workup for the patient’s chief complaint
Therapeutic: changes in meds, skincare, counseling, include full prescribing information for any pharmacologic interventions including quantity and number of refills for any new or refilled medications.
Educational: information clients need in order to address their health problems. Include follow up care. Anticipatory guidance and counseling.
Consultation/Collaboration: referrals or consult while in clinic with another provider. If no referral made was there a possible referral you could make and why? Advance care planning.
NOTE: please input N/A where appropriate for the above 4 categories, do not assume that your clinical faculty person will know it was not applicable.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Consider the following questions in your initial discussion post:
Utilize the information below that is copied-and-pasted out of the SOAP Note Assignment instructions to assist you in formatting your post:
Diagnosis/Diagnoses: Start with the presenting chief complaint diagnosis first. Number each diagnosis.
A statement of current condition and all other chronic illnesses that were addressed during the visit must be included (i.e. HTN-well managed on medication}.
Remember the data you provide in the ‘S’ data set and the ‘O’ data set must support this diagnosis (or these diagnoses if more than one is listed}. Pertinent positives and negatives must be found in the write-up.
These are the interventions that relate to each individual, numbered diagnosis.
Document individual plans directly after each corresponding assessment (Ex. Assessment Plan). Address the following aspects (they should be separated out as listed below):
Diagnostics: labs, diagnostics testing – tests that you planned for/ordered during the encounter that you plan to review/evaluate relative to your work up for the patient’s chief complaint
Therapeutic: changes in meds, skin care, counseling, include full prescribing information for any pharmacologic interventions including quantity and number of refills for any new or refilled medications.
Educational: information clients need in order to address their health problems. Include follow up care. Anticipatory guidance and counseling.
Consultation/Collaboration: referrals or consult while in clinic with another provider. If no referral made was there a possible referral you could make and why? Advance care planning.
NOTE: please input N/A where appropriate for the above 4 categories, do not assume that your clinical faculty person will know it was not applicable.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Here are the course learning objectives for your review:
Instructions:
Instructions
Topic: Suicidal Ideation
Suicide Assessment CCSRS
The Columbia Lighthouse Project. (2016). Identify risk. Prevent suicide (Links to an external site.). https://cssrs.columbia.edu/
For this week utilize the tool listed above to complete the assignment.
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in a bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations.
You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
Each week you will be given a prompt to write a reflective journal assignment that will allow you to investigate areas for clinical preparation in psychiatric mental health. The reflective journal should abide by APA writing standards, include a minimum of one reference in APA format, and be a minimum of 250 words.
Read the article on informed consent:
Complete an online search for mental health informed consent. You can search for psychiatry or psychotherapy clinics and most will have information posted on their websites. Review the informed consent documents. Give a brief summary of what you located then identify the main components of informed consent for psychiatric mental health treatment. Must include information related to SI, HI, A/VH, signs and reporting of abuse, etc… Note when informed consent can be breached, what are additional considerations for minors.
Choose one diagnosis from the Psychotic Disorders group
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in a bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations. You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
Each week you will be given a prompt to write a reflective journal assignment that will allow you to investigate areas for clinical preparation in psychiatric mental health. The reflective journal should abide by APA writing standards, include a minimum of one reference in APA format, and be a minimum of 250 words.
Review the Psychiatric Mental Health Assessment Template.
Give a brief summary of your thoughts about a psychiatric mental health initial assessment. Why is this critical to the care of the mental health patient? What areas were you surprised to see on a psychiatric mental health initial assessment?
Choose one diagnosis from the Bipolar and Related Disorders group
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations. You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
Each week you will be given a prompt to write a reflective journal assignment that will allow you to investigate areas for clinical preparation in psychiatric mental health. The reflective journal should abide by APA writing standards, include a minimum of one reference in APA format, and be a minimum of 250 words.
Review the following resources for mental status exam:
Give a brief summary of the components of the mental status exam. Why is this critical to the care of the mental health patient?
Choose one diagnosis from the Anxiety Disorders group
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations. You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
Each week you will be given a prompt to write a reflective journal assignment that will allow you to investigate areas for clinical preparation in psychiatric mental health. The reflective journal should abide by APA writing standards, include a minimum of one reference in APA format, and be a minimum of 250 words.
Review the article related to the ACEs study:
Review Tool Kit:
What are the main components of trauma-informed care why is the ACEs model of screening is so important in primary care and psychiatric mental health care for ALL patients?
Choose one diagnosis from the Depressive Disorders group
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations. You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
Each week you will be given a prompt to write a reflective journal assignment that will allow you to investigate areas for clinical preparation in psychiatric mental health. The
reflective journal should abide by APA writing standards, include a minimum of one reference in APA format, and be a minimum of 250 words.
Review the Mnemonics’ in Psychiatric Mental health Care article:
Write a brief summary of how you will utilize these in practice. Are there any others you have used in your nursing career in the past that you still recall? What other tips are helpful to you in clinical practice to retain information?
Tip: Choose 1 to memorize and implement it into practice each week for the remainder of the term. Create a memory notecard with the mnemonic information on one side and the NAME on the other to help you recall them.
Example: DIGFAST; Distractibility, Indiscretions, Grandiosity, Flight of Ideas, Activity Increase, Sleep deficits, Talkative.
Choose one diagnosis from the Substance-Related and Addictive Disorders group
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations. You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
Choose one diagnosis from the Neurocognitive Disorders group use w/Mini-Mental Status Exam (MMSE) as your tool
Choose one of the tools/instruments from the pdf link:
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations. You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
Choose diagnosis ADHD for either adult or pediatric
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations. You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
Choose one diagnosis from the Sleep/Wake Disorders group
As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments. This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.
You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.
Instrument/ Tool criteria:
For each assessment, you are tasked with selecting, you will identify an instrument and:
Use the following template in completing your portfolio assignments. Your information can be in a bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations. You are NOT required to write this in a paper format. Turn in one document for each week’s topics. (However, create a file on your desktop to compile your portfolio as you move through the term.) This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice. Throughout the program, you will continue to add to the portfolio in each course.
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