MSU College of Nursing
Family Psychiatric Mental Health Nurse Practitioner Option
NRSG 528 Family Mental Health Nursing IV
Clinical Faculty Site Visit Documentation
Date of Clinical Site Visit/Meeting/Call:
Type of Review:
(i.e. phone call, clinical site visit, on campus, etc.)
Student’s Name:
Preceptor’s Name:
Clinical Facility:
Location:
Term (i.e. Summer/Fall or Winter/Spring):
Year:
Clinical Faculty Reporting:
Evaluation of Learning Experience (from Preceptor, Student, Clinical Site):
_________________________________________
Clinical Faculty Signature
____________________
Date
Adapted from the University of Tennessee Health Science Center, College of Nursing, DNP Psychiatric Mental Health Nursing Option
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MSU College of Nursing
Family Psychiatric Mental Health Nurse Practitioner Option
NRSG 528 Family Mental Health Nursing IV
Clinical Faculty Evaluation of Student
Student name:
S = Satisfactory Performance
U = Unsatisfactory Performance
Behavior
S
U
Comments
Objective 1: Analyze a mental health practice setting emphasizing strengths, limitations, and resources.
a)
Understands the population served in the setting
and identifies their comprehensive needs.
b) Evaluates care management practices including
triage, referrals and factors that optimize efficiency
and quality of service and care.
c)
Assesses workflow management including
treatment planning, discharge planning, and follow
up services.
d) Identifies and analyzes internal and external
resources that support provision of mental health
services in the setting.
Objective 2: Apply selected theories to diverse clients in mental health settings.
a)
Assesses and analyzes factors that affect mental
health, including the influence of culture, ethnicity,
spirituality, genetics, functional status, and
developmental stage.*
b) Bases interventions on bio-psychosocial theories,
evidence-based standards of care, and practice
guidelines.
c)
Provides rationale for the utilization of
psychotherapeutic modalities across the life-span.
d) Promotes trusting relationships and uses the nursepatient relationship to facilitate positive clinical
outcomes.
e)
Treats identified symptoms based on current
understanding of neurobiological etiology and riskbenefit analysis, as well as research and clinical
evidence.*
f)
Identifies and monitors clinical and behavioral
outcomes to assess the efficacy of the plan of care.
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Objective 3: Apply legal and ethical principles in the care of clients in mental health practice settings.
a)
Analyzes legal and ethical aspects of the FPMHNPpatient relationship.
b) Shows sensitivity to the complexities of dual
relationships, particularly in rural areas.
c)
Engages in oral communications and written
documentation that meets established medico-legal
standards and adheres to HIPAA standards.
d) Acts as an advocate for the individual’s/family’s
rights regarding medico legal issues and develops
treatment plans that take into consideration legal
and ethical issues.
e)
Manages psychiatric emergencies by determining
level of risk and initiating and coordinating
emergency care.*
Objective 4: Demonstrate skills in the role of family psychiatric nurse practitioner including comprehensive psychiatric
mental health assessment, diagnosis and interventions.
a)
Performs comprehensive psychiatric/physical
histories and assessments of patients across the life
span: child/adolescent, middle adult, and older
adult.
b) Assesses for past and current substance use and
considers the impact this has on appropriate
diagnosis and treatment.
c)
Demonstrates the ability to differentiate psychiatric
presentations of medical illnesses from psychiatric
disorders.
d) Identifies differential diagnoses and develops a
multi-axial DSM-IV diagnosis through the collection
and synthesis of assessment data.
e)
Prescribes psychotropic and related medications,
identifies target symptoms, and obtains appropriate
baseline data and monitors response and potential
side effects.
f)
Applies and adapts individual therapy skills, group
process and facilitation skills, and family therapy
process and facilitation skills, to a variety of clinical
situations.*
g)
Assesses, educates, and/or refers the client in
regard to the appropriate use of complementary
and alternative therapies.*
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h) Identifies appropriate treatment interventions and
strategies that promote improved functioning and
quality of life.
Objective 5: Employ evidence-based clinical practice guidelines to guide screening and diagnostic testing as appropriate.
a)
Demonstrates critical thinking in all assessments
and clinical decision-making to ensure evaluations
are comprehensive.
b) Uses assessment techniques that are appropriate to
the individual’s / family’s language, culture and
developmental stage.
c)
Demonstrates a working knowledge of psychiatric
rating scales, genograms, and standardized
instruments and utilizes them appropriately.
Objective 6: Demonstrate care management abilities consistent with the clinical setting, individuals and families with
mental health problems and psychiatric disorders.
a)
Expresses an understanding of the role of the
psychiatric nurse practitioner in care management
activities.
b) Assesses the community’s mental health care
system and its ability to meet the mental health
needs of that community or population, including
mental health promotion and risk reduction,
obstacles to access, and strategies to improve
access. *
c)
Takes into consideration the potential for abuse,
neglect, and danger of risk to self and others and
works to provide care in the least restrictive
environment that provides safety.
d) Demonstrates an awareness of community
resources when evaluating individuals and family’s
needs, initiating referrals, and coordinating care.
e)
Understands other health and mental health
provider roles in the community while
implementing the role of the PMHNP, including as a
health care systems change agent.*
f)
Facilitates continuity of care and support through
assisting individuals and families with the transition
between mental health care settings, medical
settings, and community agencies.
g)
Plans care with a holistic approach and integrates
cultural, spiritual, and family values.
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Objective 7: Participate in self-evaluation in conjunction with preceptor and faculty
a)
Understands and examines the role of the APRN in
the assigned clinical setting.
b) Understands the scope of practice of the APRN in an
interdisciplinary context.
c)
Monitors self for personal growth and enhancement
of therapeutic effectiveness.
d) Describes and discusses personal model of practice,
including rationale for interventions.
e)
Collaborates as a member of the interdisciplinary
team.
f)
Engages in active and on-going dialogue with
preceptor to develop and evaluate personal
development of advanced practice role.
Objective 8: Demonstrate the ability to provide care for individuals and families with mental health needs within
appropriate time frames for the client complaint/presentation and site parameters.
a)
Plans and implements evidence-based interventions
for psychiatric mental health disorders or mental
health problems.
b) Plans care to minimize the development of
complications, and prioritize interventions
appropriately.
Objective 9: Integrate collaboration with primary care providers to improve care of individuals and families with mental
health problems or psychiatric disorders.
a)
Assesses for symptoms of ongoing or new medical
disorders.
b) Coordinates referral to primary health care
providers as appropriate.
c)
Provides appropriate referral information, including
lab values and documentation of reason for referral
to primary and other health care providers.
d) Engages in professional communication with
primary care provider and other health care
professionals as necessary, to ensure continuity of
care.
e)
Acts as an advocate for the FPMHNP’s role to other
health care providers.
__________________________________________________
Clinical Faculty Signature
____________________________
Date
*Denotes sections adopted from Oregon Health Science University School of Nursing PMHNP Competencies
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MSU College of Nursing
NRSG 528 Family Mental Health Nursing IV
Clinical Faculty Evaluation of Student Clinical Activities
Student name:
S = Satisfactory Performance
Student Activity
U = Unsatisfactory Performance
S
U
Comments
Clinical Log:
1.
Submitted to faculty in a timely manner
2.
Clear, succinct recording of progress notes
3.
Documents nursing strategies for implementing
treatment, prevention & health promotion with
individuals and/or families
Synchronous Group Meeting:
1.
Actively participates in group discussions
2.
Presents required case presentations
3.
Utilizes pertinent research articles in case
presentations
Individual Meetings with Clinical Faculty:
1.
Clinical objectives completed in a timely manner
2.
Utilizes time to explore clinical questions, ethical
dilemmas or role issues
3.
Participates in self evaluation
4.
Receptive to mentoring and constructive
feedback
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Narrative summary of the student’s overall performance including observations from clinical site visits (this should be a
summation of the clinical site checklist):
Student’s Strengths:
Areas for Improvements:
Please give a brief statement about the student’s progress in the areas of role issues, nursing identity and expertise:
Evaluation of Student Clinical Performance Criteria:
Grade (Select One):
Pass
Satisfactory
Unsatisfactory
Fail
_____________________________________________
Clinical Faculty Signature
_________________________
Date
_____________________________________________
Student’s Signature
_________________________
Date
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