Assignment 2: Practicum – Assessing Client Progress

Learning Objectives

Students will:

· Assess progress for clients receiving psychotherapy

· Differentiate progress notes from privileged notes

· Analyze preceptor’s use of privileged notes

To prepare:

· Reflect on the client you selected for the Week 3 Practicum Assignment.

· Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.

The Assignment

Part 1: Progress Note

Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):

· Treatment modality used and efficacy of approach

· Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)

· Modification(s) of the treatment plan that were made based on progress/lack of progress

· Clinical impressions regarding diagnosis and/or symptoms

· Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)

· Safety issues

· Clinical emergencies/actions taken

· Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)

· Treatment compliance/lack of compliance

· Clinical consultations

· Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)

· Therapist’s recommendations, including whether the client agreed to the recommendations

· Referrals made/reasons for making referrals

· Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)

· Issues related to consent and/or informed consent for treatment

· Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported

· Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment.

· The privileged note should include items that you would not typically include in a note as part of the clinical record.

· Explain why the items you included in the privileged note would not be included in the client’s progress note.

· Explain whether your preceptor uses privileged notes, and if so, describe the type of information he or she might include. If not, explain why.

 

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Learning Objectives Students will:  •Assess clients presenting for psychotherapy • Develop genograms for clients presenting for psychotherapy 

                                                                                                                                                                                   

To prepare: • Select a client whom you have observed or counseled at your practicum site. • Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.  

The Assignment 

Part 1: Comprehensive Client Family Assessment With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations):  •Demographic information  •Presenting problem  •History or present illness  •Past psychiatric history   •Medical history • Substance use history  •Developmental history  •Family psychiatric history   •Psychosocial history  •History of abuse/trauma  •Review of systems   •Physical assessment  •Mental status exam  •Differential diagnosis  •Case formulation  •Treatment plan 

Part 2: Family Genogram Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents). 

Required Readings: 

(1) Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

ATTACHED WITH THIS HOMEWORK IS A SAMPLE OF THIS ASSIGNMENT AND REMEMBER IT HAS TWO  PARTS.

 

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Practicum Assignment 

As your practicum proceeds, consider the topics addressed this week. By tomorrow 5/11/19 6 pm, write a 550-word essays in APA format with a minimum of four scholarly references (see list below). Include the level one headers as numbered below:

1) Conduct research to further your understanding of how issues related to intra- and interdisciplinary collaboration and the design of outcomes could influence the implementation of your proposed change.

2) To further your understanding of how issues associated with multiple systems or spheres of influence relate to the implementation of your proposed evidence-based change.

Required Readings

White, K. M., & Dudley-Brown, S.(2016). Translation of evidence into nursing and health care practice. (2nd edition)  New York, NY: Springer Publishing Company.

• Review Chapter 14, “Creating a Culture that Promotes      Translation”
• Review Chapter 11  “Information Technology: A      Foundation and Enabler for Translation”
• Review Chapter 15 “Best Practices in Translation:      Challenges and Barriers in Translation”

Kutney-Lee, A., Germack, H., Hatfield, L., Kelly, S., Maguire, P., Dierkes, A., & … Aiken, L. H. (2016). Nurse Engagement in Shared Governance and Patient and Nurse Outcomes. Journal of Nursing Administration, 46(11), 605-612. doi:10.1097/NNA.0000000000000412

Sung-Heui, B. (2016). CNE SERIES. The Centers for Medicare & Medicaid Services Reimbursement Policy and Nursing-Sensitive Adverse Patient Outcomes. Nursing Economic$, 34(4), 161-181. 

Twigg, D. E., Gelder, L., & Myers, H. (2015). The impact of understaffed shifts on nurse-sensitive outcomes. Journal of Advanced Nursing, 71(7), 1564-1572. doi:10.1111/jan.12616

Yankovsky, A., Gajewski, B. J., & Dunton, N. (2016). Trends in Nursing Care Efficiency From 2007 to 2011 on Acute Nursing Units. Nursing Economic$, 34(6), 266-276.

Braithwaite, J., Westbrook, M., Nugus, P., Greenfield, D., Travaglia, J., Runciman, W., & … Westbrook, J. (2013). Continuing differences between health professions’ attitudes: the saga of accomplishing systems-wide interprofessionalism. International Journal for Quality in Health Care, 25(1), 8-15. doi:10.1093/intqhc/mzs071

Hoyle, C., & Johnson, G. (2015). Building skills in organizational and systems change. Nurse Practitioner, 40(4), 15-23. doi:10.1097/01.NPR.0000461948.38539. fc

Jeungok, C., & Zucker, D. M. (2013). Self-assessment of nursing informatics competencies for Doctor of Nursing practice students. Journal of Professional Nursing, 29(6), 381-387. doi:10.1016/j.profnurs.2012.05.014

Toussaint, J. S. (2015). The Framework for a Whole-System Transformation. Journal of Healthcare Management, 60(6), 386-389. 

 

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Practicum Experience Journal 4-7

By tomorrow Saturday 1/12/19 2 pm, write a 550 words essay in APA format with at least 3 scholarly references less than 5 years old that summarizes the level one headers as numbered below. Please refer to the attached file in the file section to summarize the activities in question one.

1) Describe the observed activity (see attached file).

2) Using an evidence-based approach, analyze the problem, issue, or situation. Address questions posed in the weekly practicum pages if appropriate. 

3) Reveal how the real-world might mirror or diverge from program-related evidence, concepts, and/or theories. 

This assignment is due by Tomorrow Saturday 1/12/19 by 2 pm America/New York time.

 

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Assignment: Practicum Experience NURS 8600

In order to ensure that you are building nursing-related skills and competencies within your practicum setting, it is important to develop specific, appropriate objectives for your practicum hours each quarter. The Practicum Experience allows you to compile your learning objectives and planned timeline for completing your practicum hours and developing your specialty area knowledge and skills. At the end of this quarter, you will use the information in your Practicum Experience to evaluate your progress and achievements in your practicum setting.

If you have previously enrolled in NURS 8600, be sure to develop unique objectives for your Practicum Experience. These may be extensions of previous objectives, or they may be completely new and original objectives intended to expand your experiences in the practicum setting. If you are experiencing difficulty formulating new objectives for your Practicum Experience, consult with your Instructor in this course for additional guidance.

To prepare:

• Think      about learning objectives that would guide your practicum hours, as well      as the activities you will undertake to achieve those objectives. Draft      three learning objectives that are related to the AACN Essentials      (see attached file), your practice area specialty competencies, and the      focus of this course.
• Refer      to the Practicum Time Log and Journal document.
• Develop      a timeline for your Practicum Experience. 

To complete:

By tomorrow 8/28/19, write a 2-page paper in APA format with at least 3 scholarly references that includes the level one headers as numbered below:

1) Three learning objectives for your practicum hours that are aligned to the American Association of Colleges of Nursing (AACN) Essentials, your specialty area competencies, the focus of this course (i.e., implementation, evaluation, and dissemination of an evidence-based project), and other aspects of your professional growth and development (see attached file).

2) Activities you will undertake to fulfill your identified learning objectives

3) A proposed timeline for accomplishing your practicum hours (a total of 216 hours over 11 weeks)

P.S.  Use the template attached to complete this assignment. Also, refer to previous class learning objectives to help you write this assignment

Required Reading

Class Learning Objectives

Students will:

• Participate      in a scholarly forum with colleagues and the course Instructor
• Develop      practicum objectives aligned to the American Association of Colleges of      Nursing Essentials, professional standards, and specialty guidelines

The primary objective of your practicum is to “build and assimilate knowledge for advanced specialty practice at a high level of complexity,” (AACN, 2006, p. 19). Thus, focus on ways to expand your specialty practice knowledge at the aggregate level and consider roles you are interested in occupying after the completion of the DNP program.

American Association of Colleges of Nursing (AACN). (2006). The essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf (see attached file).

Use the information in this report to guide the formulation of goals for your practicum experience.

Su, W. M., & Osisek, P. J. (2011). The revised Bloom’s Taxonomy: Implications for educating nurses. The Journal of Continuing Education in Nursing, 42(7), 321-327. (See attached file)

Bleich, M. R. (2011). IOM report, The Future of Nursing: Leading Change, Advancing Health: milestones and challenges in expanding nursing science. Research in Nursing & Health, 34(3), 169-170. doi:10.1002/nur.20433 (see attached file)

IOM report, The Future of Nursing: Leading Change, Advancing Health: milestones and challenges in expanding nursing science. Research in Nursing & Health by Bleich, M. R., in Research in Nursing & Health, Vol. 34/Issue 3. Copyright 2011 by John Wiley & Sons – Journals. Reprinted by permission of John Wiley & Sons – Journals via the Copyright Clearance Center.

Pritham, U. P. (2016). Assessing DNP impact using program evaluations to capture healthcare system change. The Nurse Practitioner, (4), 44.

Kotter, J. P. (2007). Leading change: Why transformation efforts fail. Harvard Business Review, 85(1), 96-103. Retrieved from https://cb.hbsp.harvard.edu/cbmp/pl/76758028/76758030/42e82c2469b7f33387aa79dc5736bb1f

In this foundational reading, Dr. John Kotter discusses errors commonly made as organizations undergo change, and he recommends steps leaders can take to help avoid them (see attached file).

Moriber, N. A., Wallace-Kazer, M., Shea, J., Grossman, S., Wheeler, K., & Conelius, J. (2014). Transforming Doctoral Education Through the Clinical Electronic Portfolio. Nurse Educator, 39(5), 221-226. doi:10.1097/NNE.0000000000000053

Murphy, M. P., Staffileno, B. A., & Carlson, E. (2015). Original Article: Collaboration Among DNP- and PhD-Prepared Nurses: Opportunity to Drive Positive Change. Journal of Professional Nursing,31388-394. doi: 10.1016/j.profnurs.2015.03.001

Sherrod, B., & Goda, T. (2016). DNP-Prepared leaders guide healthcare system change. Nursing Management, (9). 13. 

 

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