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MSU College of Nursing
Preceptor’s Evaluation of the FPMHNP Student
NRSG 528 Family Mental Health Nursing IV
Preceptor Name: ___________________________ Student Name: ___________________________________
Agency Name: _____________________________ Today’s Date: ____________________________________
Please assist with the evaluation of the Family Psychiatric Mental Health Nurse Practitioner student by completing this
evaluation tool. Please check the box that corresponds with the number from 1 to 5 which best represents your evaluation
of the listed behavior. Feel free to include any additional written comments or suggestions.
NA = Cannot evaluate, 1 = Unsatisfactory, 2 = Needs improvement,
3 = Average, 4 = Above average, 5 = Excellent
BEHAVIOR
NA
1
2
3
4
5
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 biopsychosocial theories, evidencebased standards of care, and
practice guidelines.
c)
Provides rationale for the utilization
of psychotherapeutic modalities
across the life-span.
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d) Promotes trusting relationships and
uses the nurse-patient 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.
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 FPMHNP-patient
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)
Manage 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.
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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.*
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 decisionmaking to ensure evaluations are
comprehensive.
b) Uses assessment techniques that are
appropriate to the individual’s /
family’s language, culture and
developmental stage.
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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)
Understand 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 integrate 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 client 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 evidencebased 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.
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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
PMHNP’s role to other health care
providers.
Additional Comments:
I verify that the student, ___________________________________________ worked ________ hours in my agency.
________________________________________ _____
Student Signature
Date
_____________________________________________
Preceptor Signature
Date
* Denotes sections adopted from Oregon Health Science University School of Nursing PMHNP Competencies