PRAC 6675 WEEK 9 DISCUSSION: SPECIAL CONSIDERATIONS RELATED TO PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN
PRAC 6675 WEEK 9 DISCUSSION: SPECIAL CONSIDERATIONS RELATED TO PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN
GRAND ROUNDS
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ASSIGNMENT 1
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ASSIGNMENT 2
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RESOURCES
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LOOKING AHEAD
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ORDER A CUSTOMIZED, PLAGIARISM-FREE PRAC 6675 WEEK 9 DISCUSSION: SPECIAL CONSIDERATIONS RELATED TO PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN HERE
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INTRODUCTION
At your practicum site, you have been strengthening your communication, assessment, diagnostic reasoning, and treatment planning skills. This week, you highlight these skills as you conference with your peers in a Grand Rounds Discussion. You also continue to track your clinical time and patients in Meditrek.
Your readings this week support your understanding of prescribing for two special populations: older adults and pregnant women. Like prescribing for children and adolescents, which you explored in an earlier course, psychopharmacological treatments for these groups must often involve assessments of risks and benefits based on best available knowledge from the literature.
LEARNING OBJECTIVES
Students will:
Describe clinical hours and patient encounters
Assess and diagnose patients in mental health settings*
Develop plans of care for patients in mental health settings*
Develop a case study presentation based on a clinical patient*
Analyze cases involving advanced practice care of patients in mental health settings
Advocate health promotion and patient education strategies across the lifespan
*This week’s presenters only
What do I have to do? When do I have to do it?
Review your Learning Resources.
Days 1–7
Grand Rounds Discussion: Complex Case Study Presentation
Presenters post their videos by Day 3. Participants continue the discussion through Day 7.
Assignment: Clinical Hour and Patient Logs Record your clinical hours and patient encounters in Meditrek.
his is a graded discussion: 100 points possible
COMPLEX CASE STUDY PRESENTATION
This week you participate in the final of three clinical discussions called grand rounds. When it is your week to present, you will create a focused SOAP note and a short didactic (teaching) video presenting a real (but de-identified) complex patient case from your practicum experience.
You should have received an assignment from your Instructor letting you know which week of the course you are assigned to present. Any student who has not yet presented should present this week.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
TO PREPARE:
Review this week’s Learning Resources and consider the insights they provide. Also review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.
Select an older adult patient from your clinical experience that presents with a significant concern. Create a focused SOAP note for this patient using the template in the Resources. All SOAP notes must be signed by your Preceptor. When you submit your SOAP note, you should include the complete SOAP note as a Word document and PDF/images of the completed assignment signed by your Preceptor. You must submit your SOAP note using Turnitin.
Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Late Policies.
Then, based on your SOAP note of this patient, develop a video case study presentation. Set aside time to practice what you will say beforehand and ensure that you have the appropriate lighting and equipment to record the presentation.
Your presentation should include objectives for your audience, at least 3 possible discussion questions/prompts for your classmates to respond to, and at least 5 scholarly resources to support your diagnostic reasoning and treatment plan.
Video assignment for this week’s presenters:
Record yourself presenting the complex case study for your clinical patient. In your presentation:
Dress professionally and present yourself in a professional manner.
Display your photo ID at the start of the video when you introduce yourself.
Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information).
State 3–4 objectives for the presentation that are targeted, clear, use appropriate verbs from Bloom’s taxonomy, and address what the audience will know or be able to do after viewing.
Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management.
Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.
Pose three questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video.
Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide.
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms.
Plan: What was your plan for psychotherapy (include one health promotion activity and patient education)? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Discuss an identified social determinate of health impacting this patient’s mental health status and provide your recommendation for a referral to assist this patient in meeting this identified need (students will need to conduct research on this topic both in the literature and for community resources).
Reflection notes: What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow-up, discuss what your next intervention would be.
A note on grading:
Presenters: Review the Grand Rounds Presenter Rubric attached to this discussion to ensure you meet the scoring criteria.
Participants: Review the Grand Rounds Participant Rubric located on the following Week 9 Assignment 1 page to ensure you meet the scoring criteria. Note the Week 9 Assignment 1 page is for viewing the participant rubric only. Your response should be posted in the forum of this page.
WEEK 9 PRESENTERS:
BY DAY 3
Post your video and your focused SOAP note to the Grand Rounds Discussion forum. You must submit two files for the SOAP note, including a Word document and scanned PDF/images of completed assignment signed by your Preceptor. Then, actively respond to and guide the conversation as your colleagues post responses to your video.
WEEK 9 PARTICIPANTS:
BY MULTIPLE DAYS BETWEEN DAYS 4 AND 7
Respond at least 2 times each to all colleagues who presented this week (should be 2-3 presenters each week). The goal is for the discussion forum to function as robust clinical conferences on the patients. Provide a response to 1 of the 3 discussion prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient.
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ReplyReply to Week 9: Discussion
Collapse SubdiscussionErin Lutchkus
Erin Lutchkus
May 25, 2023Local: May 25 at 6:20am<br>Course: May 25 at 5:20am
Manage Discussion Entry
GRAND ROUNDS PRESENTER SCHEDULE
I have sent this out via email through Canvas but wanted to post in several places for ease of viewing.
Hi All!
I have assigned each of you to present on specific weeks for Grand Rounds as follows:
Week 4 Grand Rounds presenters:
– Oladeji Ajani
Brigitte Michelle Boll
Susan Floyd Elium
Week 7 Grand Rounds presenters:
Danny Farr
Agnes Chioma Obi
Claudette Ponton
Week 9 Grand Rounds presenters:
Basirat Shomuyiwa
Allison R Wilson
A FEW CLARIFICATIONS ABOUT THIS:
– You will be submitting your presentations (and required components) to Grand Rounds ONLY WHEN YOU ARE ASSIGNED TO PRESENT (as noted in above list).
– The other Grand Rounds weeks- in which you do not present- you will just need to do the appropriate responses to the Grand Rounds participants, as per the discussion board participant rubric
THE WEEK THAT YOU PRESENT:
Follow the Grand Rounds Presentation Rubric on the week you are assigned to present. PLEASE FOLLOW THE RUBRIC CLOSELY (I grade STRICTLY by the rubric). The rubric for the grand rounds presenters are located under the appropriate week under DISCUSSIONS: WEEK X DISCUSSIONS: 3 DOTS IN UPPER RIGHT CORNER: SHOW RUBRIC.
The only part of the rubric that I will show ‘wiggle room’ with grading is the wearing the white lab coat. If you have a lab coat, please wear it. If you do not have a lab coat, , please be dressed professionally and you must show your ID (as per rubric).
THE DISCUSSION WEEKS IN WHICH YOU ARE NOT PRESENTING AND PARTICIPATING ONLY-
Please follow the rubric closely. To receive full credit as a participant: you must respond at least TWICE to EACH colleague who presented this week. Responses are carried out over multiple days between Days 4 and 7 – with credible sources cited and referenced appropriately.
On the Grand Rounds weeks that you are not presenting, you only need to respond to the presenters as required in the instructions/rubric. PLEASE FOLLOW THE RUBRIC CLOSELY (I grade by the rubric). The rubric for the grand rounds peer response/participants are located under: ASSIGNMENTS: WEEK X ASSIGNMENT 1: SCROLL TO BOTTOM OF PAGE
Please let me know if you have any further questions or need any additional clarification!
Professor Lutchkus
ReplyReply to Comment
LEARNING RESOURCES
Required Readings
MeditrekLinks to an external site.
https://edu.meditrek.com/Default.html
Note: Use this website to log into Meditrek to report your clinical hours and patient encounters.
to an external site.Stern, T. A., Fava, M., Wilens, T. E., & Rosenbaum, J. F. (2016). Massachusetts General Hospital psychopharmacology and neurotherapeutics. Elsevier.
Chapter 14, “Dementia” (pp. 146–147 only)
Document: Focused SOAP Note Template (Word document)Download Focused SOAP Note Template (Word document)
Document: Focused SOAP Note Exemplar (Word document)Download Focused SOAP Note Exemplar (Word document)
Required Media
Recommended Resources
Office of Disease Prevention and Health Promotion. (n.d.). Social Determinates of Health.Links to an external site. Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/priority-areas/social-determinants-health
American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers Criteria for potentially inappropriate medication use in older adultsLinks to an external site.. Journal of the American Geriatrics Society, 67(4), 674–694. https://doi.org/10.1111/jgs.15767
Links to an external site.
Chisolm , M. S., & Payne, J. L. (2016). Management of psychotropic drugs during pregnancyLinks to an external site.. British Medical Journal, 352. https://doi.org/10.1136/bmj.h5918
Recommended Resources
PRAC_6675_Week9_Discussion_Presenter_Rubric
PRAC_6675_Week9_Discussion_Presenter_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomePhoto ID Display and Professional Attire
5 to >0.0 pts
Excellent
Photo ID is displayed. The student is dressed professionally with a lab coat.
0 pts
Fair
0 pts
Good
0 pts
Poor
Photo ID is not displayed. Student must remedy this before grade is posted. The student is not dressed professionally with a lab coat.
5 pts
This criterion is linked to a Learning OutcomeTime
5 to >0.0 pts
Excellent
The video does not exceed the 8-minute time limit.
0 pts
Fair
0 pts
Good
0 pts
Poor
ORDER A CUSTOMIZED, PLAGIARISM-FREE PRAC 6675 WEEK 9 DISCUSSION: SPECIAL CONSIDERATIONS RELATED TO PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN HERE
The video exceeds the 8-minute time limit. (Note: Information presented after the 8 minutes will not be evaluated for grade inclusion.)
5 pts
This criterion is linked to a Learning OutcomeObjectives for the Presentation
5 to >4.0 pts
Excellent
3–4 objectives provided and written in terms of what the audience will know or be able to do after viewing. Appropriate Bloom’s verbs are used. Objectives are targeted and clear.
4 to >3.5 pts
Good
3–4 objectives provided and written in terms of what the audience will know or be able to do after viewing. Appropriate Bloom’s verbs are used.
3.5 to >3.0 pts
Fair
At least 3 objectives provided and written in terms of what the audience will know or be able to do after viewing, but are somewhat vague or unclear. Appropriate Bloom’s verbs may be missing.
3 to >0 pts
Poor
Fewer than 3 objectives provided. Objectives for the presentation are vague, unclear, or missing.
5 pts
This criterion is linked to a Learning OutcomeDiscuss subjective data:• Chief complaint• History of present illness (HPI)• Medications• Psychotherapy or previous psychiatric diagnosis• Pertinent histories and/or ROS
5 to >4.0 pts
Excellent
The video is a Kaltura video and accurately and concisely presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis.
4 to >3.5 pts
Good
The video is not a Kaltura video but easily opened and accurately presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis.
3.5 to >3.0 pts
Fair
The video is not a Kaltura video and did not open without needing to reach the student. The 2nd attempt video presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis but is somewhat vague or contains minor inaccuracies.
3 to >0 pts
Poor
There is no video submission or video presents an incomplete, inaccurate, or unnecessarily detailed/verbose description of the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis. Or subjective documentation is missing.
5 pts
This criterion is linked to a Learning OutcomeDiscuss objective data:• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses
10 to >8.0 pts
Excellent
The video accurately and concisely documents the patient’s physical exam for pertinent systems. Pertinent diagnostic tests and their results are documented, as applicable.
8 to >7.0 pts
Good
The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are documented, as applicable.
7 to >6.0 pts
Fair
Documentation of the patient’s physical exam is somewhat vague or contains minor inaccuracies. Diagnostic tests and their results are documented but contain inaccuracies.
6 to >0 pts
Poor
The response provides incomplete, inaccurate, or unnecessarily detailed/verbose documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or objective documentation is missing.
10 pts
This criterion is linked to a Learning OutcomeDiscuss results of assessment:• Results of the mental status examination• Provide a minimum of three possible diagnoses in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and is supported by the patient’s symptoms.
20 to >17.0 pts
Excellent
The video accurately documents the results of the mental status exam. Video presents at least 3 differentials in order of priority for a differential diagnosis of the patient, and a rationale for their selection…. Response justifies the primary diagnosis and how it aligns with DSM-5-TR criteria.
17 to >15.0 pts
Good
The video adequately documents the results of the mental status exam…. Video presents 3 differentials for the patient and a rationale for their selection. Response adequately justifies the primary diagnosis and how it aligns with DSM-5-TR criteria.
15 to >13.0 pts
Fair
The video presents the results of the mental status exam, with some vagueness or inaccuracy…. Video presents 3 differentials for the patient and a rationale for their selection. Response somewhat vaguely justifies the primary diagnosis and how it aligns with DSM-5-TR criteria.
13 to >0 pts
Poor
The response provides an incomplete, inaccurate, or unnecessarily detailed/verbose description of the results of the mental status exam and explanation of the differential diagnoses. Or assessment documentation is missing.
20 pts
This criterion is linked to a Learning OutcomeDiscuss treatment plan:• A treatment plan for the patient that addresses psychotherapy; one health promotion activity and one patient education strategy; plan for treatment and management, including alternative therapies; pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters; and a rationale for the approaches selected. Discusses an identified social determinate of health impacting this patient’s mental health status and provide your recommendation for a referral to assist this patient in meeting this identified need Edit Delete this row Add Alignments
20 to >17.0 pts
Excellent
The video clearly and concisely outlines an evidence-based treatment plan for the patient that addresses psychotherapy, health promotion and patient education, treatment and management, pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A clear and concise rationale for the treatment approaches recommended is provided. Discussion includes a social determinate of health need impacting mental health status with referral recommendation and evidence of researching literature and incorporating local community resources
17 to >15.0 pts
Good
The video clearly outlines an appropriate treatment plan for the patient that addresses psychotherapy, health promotion and patient education, treatment and management, pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A clear rationale for the treatment approaches recommended is provided. Discussion includes a social determinate of health need impacting mental health status with referral recommendation but no evidence of researching literature and incorporating local community resources
15 to >13.0 pts
Fair
The response somewhat vaguely or inaccurately outlines a treatment plan for the patient and provides a rationale for the treatment approaches recommended. Discussion includes a social determinate of health need impacting mental health status with no referral recommendation or evidence of researching literature and incorporating local community resources
13 to >0 pts
Poor
The response does not address the diagnosis or is missing several elements of the treatment plan.
20 pts
This criterion is linked to a Learning OutcomeReflect on this case. Discuss what you learned and what you might do differently. Pose 3 questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video.
5 to >4.0 pts
Excellent
Reflections are thorough, thoughtful, and demonstrate critical thinking…. Questions or prompts for colleagues are thought-provoking and will require substantive responses and critical thinking.
4 to >3.5 pts
Good
Reflections demonstrate critical thinking. Questions or prompts for colleagues are appropriate and will require substantive responses.
3.5 to >3.0 pts
Fair
Reflections are somewhat general or do not demonstrate critical thinking. Questions or prompts for colleagues are somewhat general and may not require substantive responses.
3 to >0 pts
Poor
Reflections are incomplete, inaccurate, or missing. Questions or prompts for colleagues are general, inappropriate, or missing.
5 pts
This criterion is linked to a Learning OutcomeFocused SOAP Note
10 to >8.0 pts
Excellent
Student chose an older adult for the case presentation. The response clearly, accurately, and thoroughly follows the SOAP format to document the selected patient case. Preceptor signature and date pdf/image is uploaded on the completed assignment (not an electronic signature).
8 to >7.0 pts
Good
Student chose an older adult for the case presentation. The response accurately follows the SOAP format to document the selected patient case. Preceptor signature and date pdf/image is uploaded on the completed assignment but is an electronic signature.
7 to >6.0 pts
Fair
Student chose an older adult for the case presentation. The response follows the SOAP format to document the selected patient case, with some vagueness and inaccuracy. Preceptor signature and date pdf/image is uploaded on the completed assignment but is an electronic signature.
6 to >0 pts
Poor
Student did not choose an older adult for the case presentation. The response incompletely and inaccurately follows the SOAP format to document the selected patient case. No preceptor signature submitted.
10 pts
This criterion is linked to a Learning OutcomePresentation Style
5 to >4.0 pts
Excellent
Presentation style is exceptionally clear, professional, and focused.
4 to >3.5 pts
Good
Presentation syle is clear, professional, and focused.
3.5 to >3.0 pts
Fair
3 to >0 pts
Poor
Presentation style is unclear, unprofessional, and/or unfocused.
5 pts
This criterion is linked to a Learning OutcomeDiscussion Facilitation
10 to >8.0 pts
Excellent
Presenters effectively lead, sustain, and engage the discussion from Day 4 through Day 7.
8 to >7.0 pts
Good
Presenters lead, sustain, and engage the discussion from Day 4 through Day 7.
7 to >6.0 pts
Fair
Presenters lead, sustain, and engage the discussion at least three out of four days between Days 4 and 7.
6 to >0 pts
Poor
Presenters did not sustain and engage the discussion through Day 7.
10 pts
Total Points: 100