Mental Health

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Doctor of Nursing Practice Graduate Degree Psychiatric/Mental Health Clinical Manual for Students 2017-2018 Reviewed and Approved August, 2017 Associate Dean for Research and Graduate Education

TABLE OF CONTENTS

Introduction .................................................................................................................................... 4 Goals of Advanced Clinical Education ............................................................................................. 4 Clinical Faculty Roles and Responsibilities ...................................................................................... 4 Appropriate Clinical Sites ................................................................................................................ 5 Clinical Courses ............................................................................................................................... 5 Preceptor Roles .............................................................................................................................. 6 Who Can Be A Preceptor?............................................................................................................... 7 Areas of Practice ............................................................................................................................. 8 Preceptor Interview ........................................................................................................................ 8 Scheduling Clinical Hours ................................................................................................................ 8 Attendance...................................................................................................................................... 9 Travel to Clinical Sites ..................................................................................................................... 9 Professional Behavior and Professional Dress ................................................................................ 9 Clinical Placement ........................................................................................................................... 9 Compliance with College of Nursing Policies ................................................................................ 11 Documentation of Clinical Hours – Time Logs and Case Logs (Using Typhon) ............................. 12 Preceptor Evaluation of the DNP (P/MH) Student ....................................................................... 13 Student Evaluation of the Preceptor ............................................................................................ 14 Clinical Faculty Evaluation of the DNP (P/MH) Student ............................................................... 14 DNP (P/MH) Program Forms ......................................................................................................... 14 Montana Area Health Education Centers ..................................................................................... 15 Looking For a Clinical Site? Go Rural ............................................................................................ 15 Certification Examinations ............................................................................................................ 15 ANCC Certification ........................................................................................................................ 16 References .................................................................................................................................... 16 Clinical Reference Guide ............................................................................................................... 17 DNP (P/MH) Graduate Student Clinical Placement Plan .............................................................. 18 Five Steps to Clinical ..................................................................................................................... 19 DNP Psychiatric/Mental Health Clinical Hours Record ................................................................. 20 Clinical Nursing Course Confidentiality Agreement (HIPAA) ........................................................ 21 Preceptor Vita Short Form ............................................................................................................ 22 2

Preceptor Information Sheet ........................................................................................................ 23

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Introduction Welcome to Montana State University College of Nursing Doctor of Nursing Practice (DNP) Psychiatric/ Mental Health (P/MH) graduate degree program. This manual will serve as a guide for the DNP (P/MH) graduate student to achieve a successful clinical experience. Within this manual are sections that will assist students in identifying their responsibilities for:    

Clinical preparation and placement Scheduling clinical hours Establishing clinical objectives Proper documentation Goals of Advanced Clinical Education

1. 2. 3. 4. 5. 6. 7. 8.

Expand student’s exposure to clinical situations, strategies and variety of treatment modalities. Provide the opportunity to apply theory. Work with and learn from an experienced clinician as a preceptor. Develop and expand expertise in clinical skills. Expand knowledge about the operation of clinical sites. Develop knowledge of the financial aspects of mental health care practice. Expand experience in the care of individuals and families in mental health care. Provide opportunities for collaboration with other disciplines in the provision of health care services. Clinical Faculty Roles and Responsibilities

Roles       

Mentor, facilitator Assist in student role development and accommodation to practice setting Coordinate student experience with the preceptor Facilitate the preceptor in role development Guardian for nursing identity, graduate education, holism, family Provide episodic on-site supervision and role modeling Evaluate the student’s learning experience in an ongoing manner

Responsibilities  Formally evaluate the student twice each semester. (Works with student ½ day in clinical area) • Activate problem-solving discussions with preceptor and student if problems arise  Maintain monthly contact with preceptor  Provide hourly supervisory conferences with students twice monthly  Evaluate and provide guidance to aid student to progress in health assessment process  Evaluate, provide guidance and support for leveled learning  Assess and problem solve the student’s role assimilation  Identify and control for nursing, health promotion, and family foci  Evaluate and provide guidance for student’s record keeping  Track student clinical time and quality of the learning experience 4

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Evaluate the preceptor at semester’s end Maintain balance between academic and clinical goals Review selected cases seen by student in the clinical area for in-depth discussions of differential diagnosis and management issues Help identify personal style of student, evaluate its effectiveness, and assist in refinement over time (therapeutic communication, advocacy, role issues, collaboration, conflict resolution, paternalism, timing and pacing, artful use of self, biases, assumptions, judgments, etc.) Appropriate Clinical Sites

To prepare for their clinical education, students will complete and send to the DNP (P/MH) Clinical Coordinator (Rebecca Bourret) a clinical plan by February 15th of their first year of graduate study (see DNP (P/MH) Graduate Student Clinical Placement Plan, page 20). This plan is intended to be a rough draft of the student’s plans/goals. To facilitate the clinical placement and paperwork process, the student must provide a preceptor information sheet and a current short form vita from each preceptor prior to receiving approval for the anticipated clinical rotation. A new vita is required from preceptors on a yearly basis. The preceptor information sheet and current short form vita are located online at: http://www.montana.edu/nursing/student/graduate.html and also attached in this manual. Clinical placements must be completed prior to the start of the semester. A deadline for having all of the necessary components in place for the clinical component of each course will be set each semester. If students do not have everything in place for their clinical rotation by this date, they will not be allowed to enroll in the course. If an emergency situation arises, approval for an extension of the deadline must be granted by the Associate Dean for Research and Graduate Education and the DNP (P/MH) Clinical Coordinator (Rebecca Bourret, MS, APRN, PMHNP-BC). Please limit preceptors to 1 or 2 per semester for consistency and a richer learning experience. All clinical sites and preceptors must be approved by the DNP (P/MH) Clinical Coordinator. Students must complete their clinical education with their identified preceptor (s). Students may not identify one preceptor in a clinical site and then float among preceptors. If a student believes they would benefit from more than 2 preceptors this must be approved by the DNP (P/MH) Clinical Coordinator. Clinical Courses NRSG 631 (135 hours) - Advanced Clinical I - Advanced Nursing Practice and Psychiatric Care Formulation The first clinical course requires 135 hours of direct patient care supervised by a psychiatric medication preceptor. Students are encouraged to spend all of the 135 hours with an adult practitioner or split between an adult practitioner and a child/adolescent practitioner (see Who Can Be a Preceptor, page 7). In this course, students will explore the role and scope of advanced psychiatric nursing practice, foundational legal/ethical issues in psychiatric advanced practice nursing, psychiatric and mental health disorders, and assessment and diagnostic techniques. Emphasis will be placed on advanced mental health nursing assessment and diagnosis for health promotion and managing mental health problems and psychiatric disorders for individuals and families across the lifespan within culturally diverse environments. 5

NRSG 632 (135 hours) - Advanced Clinical II - Psychotherapeutic Modalities Across the Lifespan The second clinical course requires 135 hours of direct patient care supervised by a combination of 1-2 preceptors to fulfill the necessary requirements. 90 hours will be spent with a psychiatric medication preceptor focusing on the assessment, diagnosis and psychotropic medication management of mental health problems. These 90 hours will be spent with an adult practitioner, split between an adult practitioner and a child/adolescent practitioner or with only a child/adolescent practitioner (depending on needed population hours for each student). Students will work with preceptors conducting individual and group therapy to obtain a total of 45 hours in psychotherapy experience. 35/45 hours will be spent conducting individual psychotherapy and 10/45 hours will be spent conducting group psychotherapy. See page 6 for appropriate preceptors for this rotation. NRSG 633 (135 hours) - Advanced Clinical III - Advanced Care of Individuals and Families with Acute and Chronic Mental Health Conditions The second clinical course requires 135 hours of direct patient care supervised by a combination of 1-2 preceptors to fulfill the necessary requirements. 90 hours will be spent with a psychiatric medication preceptor focusing on the assessment, diagnosis and psychotropic medication management of mental health problems in special populations. These 90 hours will be spent with an adult practitioner, split between an adult practitioner and a child/adolescent practitioner or with only a child/adolescent practitioner (depending on needed population hours for each student). Students will work with preceptors conducting families and couples therapy to obtain a total of 45 hours in psychotherapy experience. 35/45 hours will be spent conducting family psychotherapy and 10/45 hours will be spent conducting couples psychotherapy. See page 6 for appropriate preceptors for this rotation. NRSG 634 (270 hours) - Advanced Clinical IV - Advanced Practice Leadership in Community and Acute Settings The goal of the final clinical course is to enable the student to progress from a novice to a more expert mental health clinician. Most of the student’s 270 hours will be spent with a psychiatric medication provider focusing on the assessment, diagnosis, psychotropic treatment and psychotherapeutic treatment of mental health disorders across the lifespan within culturally diverse environments. A primary focus of the clinical experience will be integrating all components of the APRN role for practice including assessment, diagnosis and management of psychiatric illnesses, management of ongoing mental health problems and psychiatric illness, psychotherapy and medication management. APRN professional practice components, including developing a personal model of professional practice are stressed. Interventions will include health promotion, the coordination and use of organizational or community resources, consultation, teaching/coaching, and the application of nursing leadership skills. Preceptor Roles   



Introduce the student to the practice setting, including policies and procedures. Assist the student in a systematic approach to clinical problems and record keeping. Assist the student with role progression (student observes then does some of the psychiatric assessment and interview, then completes psychiatric assessment and interview, etc. Student puts forth possible diagnoses, plan and discusses). Introduce student to record keeping format. 6

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Review record keeping and provide feedback. Engage student in differential discussions. Engage student in critical thinking and problem solving discussions. Engage student in discussions regarding long-term management issues, helping the student to determine reasonable follow-up plans. Demonstrate consistent and appropriate use of referrals and community strategies. Demonstrate a commitment to multicultural skills for health promotion and management of mental health problems and psychiatric disorders. Discuss own practice model, in terms of outreach/follow-up strategies for acute, chronic, and unstable clients. Demonstrate cost-effective/cost-conscious approach to diagnosis and treatment. Engage student in discussion of philosophical positions regarding client autonomy (including interactions and decision-making). Demonstrate client advocacy. Demonstrate a commitment to collaboration with clients and other providers. Who Can Be A Preceptor?

Psychiatric Mental Health Nurse Practitioners (NP) —Psychiatric Clinical Nurse Specialists (CNS)  Actively involved in clinical practice  Nationally certified as an NP or CNS in mental health  Holds at least a master’s degree with at least 1 year of clinical experience  Recognized as an APRN with prescriptive authority or recognized as APRN meeting federal guidelines. (Federal facility requirements as VA clinics, military, US Public Health Service Corps (USPHSC), etc.)  Must provide medication management of mental health disorders; may also provide psychotherapy Psychiatrists  Actively involved in clinical practice  Board certified preferred  Licensed as MD, DO or recognized as MD/DO meeting federal guidelines.  Must provide medication management of mental health disorders; may also provide psychotherapy Psychologists and Licensed Mental Health Counselors  Discuss placements individually with clinical faculty and/or P/MH Clinical Coordinator  Must be actively involved in clinical practice  Board certified or licensed with at least 1 year of clinical practice  Examples include Licensed Clinical Social Workers (LCSW), Licensed Clinical Professional Counselors (LCPC) or Board Certified Psychologist

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Areas of Practice            

Clinical practice settings Crisis intervention & emergency services Acute in-patient Intermediate & long-term care Partial hospitalization & intensive outpatient care Residential care Community-based care Integrative Programs Tele-health Self Employment Forensic Mental Health Disaster Mental Health Preceptor Interview

Some preceptors request an interview with the student. The interview: 1. Provides the preceptor with an understanding of the level, ability, and personality of the student; and 2. Enables the preceptor to assess if the student would be a “good fit” for the clinical site and the population it serves. Remember you are a guest in the clinical practice. The preceptor has the right to make a decision about whether you are a good match for that particular practice. Scheduling Clinical Hours Clinical practicum hours are to be scheduled at the convenience and availability of the preceptor.  Prior to beginning the clinical rotation, students and preceptors need to agree on the days and times that the student will be in the clinical agency.  Students are not to ask preceptors to conform to a schedule that meets their personal and employment needs.  The student’s personal and work schedules are expected to accommodate the required number of clinical hours prescribed by the clinical course.  Each clinical course requires 9-12 hours per week or 135 total hours except NRSG 634, which requires 270 total clinical hours over 15 weeks or 18 hours per week.  Clinical hours are to be completed over the course of the semester, done on a weekly basis. At times clinical hours may need to be scheduled in “chunks” of time; however, prior approval for this must be obtained from the Clinical Coordinator.  It is the student’s responsibility to procure clinical sites. The clinical coordinator and clinical faculty can offer direction and guidance, but the student is the one who makes contact with potential preceptors.  Start early! Some clinics book 6-12 months out in advance for student placement. It often works best to talk with the clinical manager or if you have a good working relationship with a potential preceptor talk directly with them. If they are unable to accommodate you for a semester, ask about the next semester. It’s never too early to procure future clinical slots.  There is an evolving list of preceptors in Typhon that will be provided to you before your first clinical rotation and then you will be able to access this list in Typhon for future rotations. 8

Attendance    

It is the student’s responsibility to monitor the number of clinical hours. Failure to notify the preceptor as negotiated is unacceptable and may place the student and clinical placement in jeopardy. Absences resulting in lost clinical hours must be completed before the end of the semester and at the convenience of the preceptor. If an emergency arises and a student believes he or she will not be able to complete the clinical hours, the student is to contact the DNP (P/MH) Clinical Coordinator immediately and the situation will be reviewed with the Associate Dean for Research and Graduate Education. Travel to Clinical Sites

MSU has an extensive policy on student travel (which includes travel to sites in the town where the student lives). The DNP Psych/Mental Health Clinical Coordinator is required to:  Maintain a list of emergency contacts for each student  Have a copy of each student’s clinical schedule for each semester Link to full policy: http://www.montana.edu/policy/student_trips/ Professional Behavior and Professional Dress    

Students present themselves as ambassadors of Montana State University, the College of Nursing and the graduate program. Students are expected to be respectful to preceptors, faculty, staff, patients and their families. Reports of unprofessional behavior will result in the student being counseled and are subject to review by the College of Nursing Associate Dean for Research and Graduate Education. Refer to College of Nursing (CON) Policy D-6 (http://www.montana.edu/nursing/documents/pdf/D6.pdf). Students should be dressed professionally (clinical site-specific attire) and wear a student nametag that meets State Board of Nursing requirements (provided at new graduate student orientation). It is suggested that students send his or her preceptor/s a thank you note at the completion of each clinical rotation as being a preceptor is a big undertaking. Many students also will give a small token of appreciation, but this is not required. Clinical Placement

Preparation 1. Students are expected to have full knowledge of agency requirements for the clinical practicum (orientation, dress, location, schedule, etc.) before scheduling the first clinical day. 2. The student is responsible for contacting human resources or office managers where applicable to find out what additional paperwork may be needed and to obtain access to the electronic medical record.

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The student can engage in computer or facility orientation prior to the start of the semester, but cannot have any patient interactions until the start of the semester. 3. On the first clinical day discuss further questions about orientation, computer access, the procedure for co-signing documents, communication with other disciplines, eating, parking arrangements, etc. 4. Learn something about the preceptor, when possible, in order to acknowledge the preceptor’s background and broaden the student’s educational experience. Placement Process 1. Meet with the DNP (P/MH) Clinical Coordinator (Rebecca Bourret) in the fall or early spring at least one semester before taking your first clinical course; this may be in person or on teleconference. Review your goals, strengths and weaknesses that you may anticipate in the clinical rotations. Discuss your ideas for clinical sites and potential preceptors. Complete the DNP (P/MH) Graduate Student Clinical Placement Plan on page 20 and return to the DNP (P/MH) Clinical Coordinator by February 15 th, 2018. This form will likely be completed with guidance from the Clinical Coordinator who can help you identify your personal clinical rotation plan. This plan is unlikely to finalize your clinical rotations, but is anticipated to be a rough draft of your clinical rotation plan. 2. You will then discuss the preceptor/placement that you have identified for the first clinical rotation with the Clinical Coordinator. The Clinical Coordinator will determine if the sites and preceptors you have identified meet the criteria for the clinical education component of the course and give you permission to continue to pursue this clinical education site. 

Note: you may identify the first preceptor/placement after discussing with the Clinical Coordinator prior to completing the Clinical Placement Plan (page 20).

3. Contact the potential preceptor by phone or letter of introduction. You will need to know: a. When the course begins and ends b. How many clinical hours you will be spending with the preceptor c. Days/hours that you are NOT available (e.g., class days, holidays, work) 4. When you have received verbal confirmation from a preceptor, request that the preceptor fill out a preceptor vita short form (page 23). You will fill out a preceptor information sheet (page 24) and send both documents together to the DNP (P/MH) Clinical Coordinator, Rebecca Bourret, MS, APRN, CPN, PMHNP-BC by email ([email protected]) by the specified date. The first deadline will be February 28, 2018. 5. Current HIPAA form submitted each semester into the correct external document folder in Typhon prior to starting the clinical rotation (page 22). 6. The preceptor packet will be prepared by the DNP (P/MH) Clinical Coordinator and sent directly to the student and preceptor via email. The preceptor packet contains an introductory letter, agency agreement (when applicable) signed by the College of Nursing dean, course description/objectives, student evaluation forms and a courtesy affiliate appointment form.

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7. The student is responsible to see that the preceptor packet is received via email and the agency agreement is signed and returned to the DNP (P/MH) Coordinator preferably by email, but may also be mailed (address to Rebecca Bourret, MS, APRN, CPN, PMHNP-BC, MSU College of Nursing, Anna Pearl Sherrick Hall, Bozeman, MT 59717) by the established deadline.  The agency agreement must be in the Clinical Coordinator’s hands prior to the start of a clinical rotation.  Students without a preceptor in place by the established deadline will be asked to withdraw from the course.  The College of Nursing has ongoing contracts with most major hospitals and large clinical organizations such as Community Medical Center, Billings Clinic and the VA. Check with DNP (P/MH) Clinical Coordinator to see if a contract is already in place. 8. Out-Of-State – if a clinical site is located outside the state of Montana it may be necessary for the College of Nursing to hire a short-term surrogate employee to perform at least one clinical site visit on behalf of the college’s clinical faculty member. The student, clinical faculty member, and DNP (P/MH) Clinical Coordinator work together to identify a qualified local person. Once recommended by the Clinical Coordinator, the Clinical Coordinator sends the surrogate clinical faculty’s name, employment address, work telephone number, and cv along with the student’s name to the Associate Dean for Research and Graduate Education. The information must be provided at least 1 month prior to the beginning of the semester so that a hiring interview and paperwork can be completed. The Associate Dean will inform the College of Nursing clinical faculty member once hiring is approved. Compliance with College of Nursing Policies Graduate students are required to remain in compliance with College of Nursing policies focused on communicable disease, standard precautions, background checks, substance screening, and CPR (Policies A32, A33, A-34, A-36, and A-38 at http://www.montana.edu/nursing/facstaff/policies.html). The Associate Dean’s office uses a software program called CastleBranch to track compliance documentation. Each graduate student is required to create an account with CastleBranch upon entering the graduate program and to remain in compliance while a graduate student in the College of Nursing. The Associate Dean’s office monitors student compliance via CastleBranch. If a graduate student falls out of compliance with College of Nursing policies, the student will be contacted directly. If the student is out of compliance during or just prior to a clinical course, the student will not be allowed into the clinical setting until the expired compliance documentation is renewed and on file in the office of the Associate Dean for Research and Graduate Education (via CastleBranch). IMPORTANT:  No student will be allowed to attend clinical until the preceptor vita is on file, the signed Agency Agreement has been returned to the DNP (P/MH) Clinical Coordinator, and the student is in compliance with College of Nursing policies via CastleBranch.  Students without a preceptor in place by the first week of classes for NRSG 631, NRSG 632, NRSG 633, & NRSG 634 will be asked to withdraw from the course.  If compliance documentation expires during a clinical course semester, the student will not be allowed to return to the clinical site until the expired document is renewed. 11

Documentation of Clinical Hours – Time Logs and Case Logs (Using Typhon) MSU CON uses a software program, NPST for Advanced Practice Nursing by Typhon Group, to track graduate student documentation of patient encounter logs and reports, clinical attendance and hours, and various evaluations and reports in an electronic computer system. All preceptors are entered into this system and the student will log clinical hours within this system. Students are expected to input information on each patient encounter into Typhon via the Case Log. Students also need to keep track of all their hours via the Time Log. At the end of the semester, preceptors complete an evaluation of the student via Typhon. Preceptors are sent log on information to complete this. For those preceptors that do not wish to use Typhon, students are expected to print out the evaluation forms and clinical log. Students obtain the preceptor signatures and then upload these as external documents into Typhon. There is a separate manual specific to the use of Typhon that will be provided to each student by the clinical coordinator. Record of the DNP (P/MH) Student’s Clinical Hours Documentation of clinical hours is required for: 1. Satisfactory completion of each clinical course 2. Certification as an advanced practice nurse 3. Preceptor recertification It is the student’s responsibility to maintain documentation of clinical hours and to obtain the preceptor’s signature (or “review” time stamp) at the appropriate time. All clinical paperwork is to be uploaded into Typhon, which is our clinical management system. If your preceptor does not use Typhon then you will need to fill out the clinical hours record found on page 22 and have it signed by your preceptor and also have it signed by the clinical faculty. This would negate the following two requirements. You are responsible to upload that document into Typhon to external documents once signed by the preceptor and clinical faculty. 

Time Log: total direct clinical hours, you should not include time spent that is not direct clinical hours such as lunch or EMR training in this time log (or anything outside of what is outlined below). In order for this to be accurate only input direct clinical hours, which may be different from the total time spent in a clinical setting each day. Most students spend their entire clinical day in qualifying direct clinical care, however, if this is not the case the following should be done in the time log. This is reviewed by the student and preceptor. o Example: clocked in at 0800, clocked out at 11 at which time the student worked on a project for another course until noon, at which time the student had lunch and then began to engage in the clinical setting again at 1300. The student then engaged in direct clinical hours from 13001500 before leaving for the day. In the time log the student would need to put two different time logs for that clinical day as follows: 0800-1100 and then 1300-1500 for total of 5 clinical hours.

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Case Log: total log of time and type of time spent with each patient, reviewed by clinical faculty and student at the end of the semester. Should be input weekly in order to not fall behind. This includes filling out all required components for every patient encounter.

Direct Clinical Hours Things that count: • Direct patient face to face time • Face to face time with patient’s family • Chart review pertaining directly to the patient • Interaction review with preceptor/staff on that direct patient • Charting completed on that specific patient • Hands on case studies in a simulation setting Things that do not count: • Logging hours in Typhon • Review of material not associated with a specific patient encounter • Writing up a case study as a requirement of the course on a specific patient encounter Preceptor Evaluation of the DNP (P/MH) Student College of Nursing clinical faculty assign the grade for student performance in clinical courses. Preceptors provide valuable input into student performance. It is important for students to review the evaluation form at the beginning of each semester. Course and individual student learning objectives also should be reviewed at this time to provide the student and preceptor an opportunity to discuss expectations and responsibilities. The preceptor provides the student with two types of evaluation: formative and summative. 1. Formative evaluation is the ongoing evaluation provided over the course of the semester. Formative evaluation is valuable to students, because feedback can build the student’s confidence, as well as identify areas needing improvement. 2. Summative evaluation is the final evaluation of the student’s performance at the end of clinical practicum. The preceptor will document the summative evaluation in Typhon and this will be reviewed by both the student and preceptor. A time stamp will be given to the evaluation once both parties review it and this is considered the “signature.” If the preceptor will not use Typhon then the student is responsible for having the preceptor complete the paper evaluation and uploading it into Typhon. See http://www.montana.edu/nursing/student/graduate.html for evaluation forms. Purposes of Preceptor Feedback/Evaluation     

To improve and enhance performance. To enable the student to complete course objectives successfully. To mentor the student in role and professional development. To provide ongoing and final evaluation. To assist clinical supervisor in evaluation of student performance. 13

Student Evaluation of the Preceptor For accreditation and credentialing purposes, students are required to evaluate preceptors. Evaluations are completed at the end of the clinical practicum via Typhon. Clinical Faculty Evaluation of the DNP (P/MH) Student Course and individual student learning objectives should be reviewed prior to the start of each clinical rotation. The clinical faculty grades each student and provides the student with two types of evaluation: formative and summative. 1. Formative evaluation is the ongoing evaluation provided over the course of the semester. This will be in the form of what is required to fulfull these expectations as outlined in the syllabus for each Advanced Clinical course. i. At least one clinical site visit per semester: The clinical faculty will come to the student’s clinical site and spend between 1-4 hours with the student, preceptor and patients. The goal of this visit is to interact with the student and preceptor together in the clinical setting. Time will be spent discussing the clinical rotation with both the student and preceptor. Time also will be spent observing the student providing direct patient care. This will be set up each semester between the clinical faculty, the student and the preceptor. 2. Summative evaluation is the final evaluation of the student’s performance at the end of clinical practicum. The clinical faculty will document the summative in Typhon at the end of the semester. This needs to be reviewed by the student and the time stamp will be considered the “signature” that the student has reviewed this evaluation. DNP (P/MH) Program Forms See http://www.montana.edu/nursing/student/graduate.html for various and current graduate program forms including evaluations. Copies of the DNP (P/MH) Graduate Student Clinical Placement Plan (page 20), Clinical Hours Record (page 21), the Clinical Reference Guide (page 18), Clinical Nursing Course Confidentiality Agreement (HIPAA) (page 22), Preceptor Vita Short Form (page 23) and the Preceptor Information Sheet (page 24) are included in this manual for your reference. List of Required Documentation at the End of the Semester, completed by the Friday of the last week of classes or as required by the provided deadline by the clinical faculty: To be completed in Typhon for Clinical Faculty review  Record of DNP (P/MH) Student’s Clinical Hours – time log in Typhon (reviewed/time stamped/signed by preceptor)  Preceptor’s Evaluation of DNP (P/MH) Student (reviewed/time stamped/signed by student after completed by preceptor)  Student’s Evaluation of Clinical Preceptor  Clinical Faculty’s Evaluation of DNP (P/MH) Student (reviewed/time stamped/signed by student after completed by faculty)  Case Log- clinical patient log in Typhon (reviewed/time stamped/signed by student and faculty) 14

To be completed in Typhon and emailed to the Clinical Coordinator (Rebecca Bourret)  Case log totals (graphical) o Tracking hours spent with each age group each semester  Case log totals (graphical) o Tracking hours spent with each age group for the entire clinical experience at MSU o Not required in NRSG 631, your first advanced clinical course

Montana Area Health Education Centers Montana State University has established a statewide system of regional Area Health Education Centers (AHEC). The Program Office is located on the Montana State University Campus, directed by Kristin Juliar. The purpose of the regional centers is to connect health professions education to rural and underserved communities. Programs developed at the center focus on creating a link between health professions students (such as DNP and WWAMI students) and clinical rotations in rural communities. For more information contact Kristin Juliar, (406)-994-6001, [email protected] or go to: http://healthinfo.montana.edu. Looking For a Clinical Site? Go Rural Rural health clinics, public health department clinics, critical access hospitals or hospital-affiliated primary care practices, managed care networks, prisons, U.S. Immigration, Customs & Enforcement, and Indian Health Clinics provide rich clinical experiences. Most of these sites are defined as Health Professional Shortage Areas and some offer housing for students traveling to clinical. Students are often employed in these areas after graduation and are eligible for loan repayment. For more information on the loan repayment plan go to: http://www.hrsa.gov/loanscholarships/index.html

Certification Examinations Certification is available for DNP (P/MH) graduates through American Nurses Credentialing Center (ANCC). Nurses who pass the ANCC certification are recognized for licensure by the Board of Nursing. The exam is computerized and upon completion will give the candidate a “pass/fail” result. To save time in the application process, students should request that official transcripts be sent directly from the university to ANCC. Students can submit an official transcript with work to date if applying before the end of the semester of program completion. Automatic notification of local state board of nursing can be requested for eligibility to take the examination and for passing the examination. Basic eligibility requirements 1. Hold a current, active, unrestricted professional RN license in the United States or its territories. 2. Hold a master’s or higher degree in nursing. 3. Have successfully completed formal education and training in the same role and specialty area of practice in which you are applying for certification through a DNP program. 4. Have graduated from a program offered by an accredited institution granting graduate-level academic credit for all course work that includes both didactic and clinical components and a 15

minimum of 500 hours of supervised clinical practice in the specialty area and role and includes core content in: a. advanced health assessment b. pharmacology c. pathophysiology d. health promotion and disease prevention, and e. differential diagnosis and disease management. 5. Show proof of diagnosis and medication management of psychiatric illness. 6. Received supervised clinical training at the graduate or post graduate level in at least two of the following modalities: a. Individual b. Family c. Milieu d. Group e. Expressive therapies f. Play therapy g. Other psychotherapeutic treatment modality ANCC Certification ANCC is the largest nursing credentialing organization in the United States. Computer-based exams are available year-round at more than 300 test sites. Testing sites in Montana include Billings and Helena. ANCC certification examinations are also fully accredited by the National Commission for Certifying Agencies (NCCA) and are recognized by the National Council of State Boards of Nursing. The DNP Psychiatric/Mental Health Clinical Coordinator must review an education validation form to be included with your application. The education validation form will then be signed by the Associate Dean for Research and Graduate Education. It often takes up to 8 weeks to receive your admission ticket to take the examination. The website has study guides, sample questions, and an outline of the examination. Credential awarded is APRN, BC (Advanced Practice Registered Nurse, Board Certified) For more information see http://www.nursecredentialing.org/certification.aspx

References American Academy of Nurse Practitioners website http://www.aanp.org/AANPCMS2 American Nurses Credentialing Center website http://www.nursecredentialing.org/ Manual adapted from: Dumas, M.A. Ed. (2000). Partners in NP Education: A Preceptor Manual for NP Programs, Faculty, Preceptors, & Students. Washington, DC: The National Organization of Nurse Practitioner Faculties.

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Clinical Reference Guide Student Responsibilities 1. Identify a preceptor and submit Preceptor Information Sheet (page 24) and Vita Short Form (page 23) 2 to 3 months prior to the start of each clinical rotation to the DNP (P/MH) Clinical Coordinator (Rebecca Bourret) who will specify the exact date each semester this will be due. 2. Current HIPAA form submitted each semester into the correct external document folder in Typhon 3. Preceptor packet is sent directly to student and preceptor via email. Student is responsible to confirm preceptor received packet 4. Student returns signed Agency Agreement to the DNP (P/MH) Clinical Coordinator or assures the preceptor has emailed to Clinical Coordinator before being allowed to start clinical. Once all paperwork has been received, the DNP (P/MH) Clinical Coordinator will announce that the student is cleared to begin clinical. Students are not to start clinical until they have verification from the Coordinator. 5. Student to monitor clinical hours 6. Complete any assignments designated by the clinical faculty or course instructor each semester 7. Student to turn in via Typhon all paperwork to clinical faculty by last Friday of week before finals at end of the clinical rotation or when clinical faculty requires. Paperwork to include:  Clinical case log (reviewed by student and clinical faculty)  Student evaluation of preceptor  Reviewed preceptor evaluation of student (reviewed by student and preceptor)  Reviewed time log (reviewed by student and preceptor) 8. Send a thank you to preceptor/agency. Some students often include a small token of appreciation, but this is not required. Electronic Preceptor Packet Contains:  Cover letter introducing student and clinical faculty; preceptor responsibilities; duration of course and required clinical hours  The One Minute Preceptor  Courtesy affiliate appointment and library access form (if desired)  Specific Advanced Clinical course description  Typhon use instructions  Agency Agreement (if applicable) Clinical Faculty Responsibilities  Maintain contact with students throughout the semester.  Conduct clinical seminars monthly to review notes & case studies and to discuss clinical & role issues.  Maintain monthly contact with preceptor  ½ day site visit during semester (more if needed)  Provide a grade for each student of unsatisfactory or satisfactory performance at semester end.  Confirm all completed paperwork is completed in Typhon and notify the DNP (P/MH) Clinical Coordinator at semester end. This includes: o Clinical faculty evaluation of student, student hours/time log/case log, preceptor evaluation of student, student evaluation of preceptor 17

DNP (P/MH) Graduate Student Clinical Placement Plan Student Name

Academic Year

Timeline

Course

Spring semester before NRSG 631 (deadline February 28th)

NRGS Adults 631 Advanced Clinical I Peds (Summer 2017)

Adults

By MidSummer semester or before NRSG 632 (deadline June 15th)

NRSG Adults 632 Advanced Clinical II Peds (Fall, 2017)

Adults

In Spring semester before NRSG 633 (deadline February 28th)

Preceptor

Agency

Anticipated hours

Agency Agreement (AA) Signed and returned by May 1st

Peds

Signed and returned by July 15th

Peds

Ind. Therapy

Ind. Therapy

Group Therapy

Group Therapy

NRSG Adults 633 Advanced Clinical III Peds (Summer 2018) Family Therapy

Adults

Peds Family Therapy

Couples Therapy

Couples Therapy

18

Signed and returned by May 1st

In Fall semester before NRSG 634 (deadline November 1st)

NRSG Adults 634 Advanced Clinical IV (Spring Peds 2019)

Adults

Peds

Signed and returned by December 15th

Please describe the setting you hope to work in upon graduation (ie, with children/adolescents/adults, inpatient, outpatient, etc.):____________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Five Steps to Clinical Step 1 Step 2 Submit Clinical packet is Preceptor sent to student Information and preceptor Sheet and via email Short Vita to DNP (P/MH) Coordinator

Step 3 Student ensures preceptor received and reviewed email. Appropriate agency representative signs.

Step 4 Signed agency agreement returned to DNP/FNP clinical coordinator

19

Step 5 HIPAA form uploaded to Typhon

Begin Clinical!!!

MONTANA STATE UNIVERSITY DNP Psychiatric/Mental Health Clinical Hours Record Student Name:

Clinical Site:

Course Number and Title:

Semester/Year:

Preceptor’s Name:

Faculty Name:

Total Number of Clinical Hours Needed:

Total Clinical Hours Achieved:

Documentation of Hours Date

Clinical Site(s)

Hours

# of Clients Seen

Types of Clients Seen (e.g. Age and DSM-IV-TR diagnosis)

Preceptor’s Signature:_____________________________________________________ Date:_________________________ Clinical Faculty’s Signature:_____________________________________________

Date:_________________________

Student’s Signature:_______________________________________________________ Date:_________________________

20

MONTANA STATE UNIVERSITY – BOZEMAN College of Nursing Clinical Nursing Course Confidentiality Agreement (HIPAA)

Students enrolled in the College of Nursing recognize the importance of protection of confidential information about patients and their families and of the operations of agencies where students are placed for clinical experiences. It is the obligation of every student to protect and maintain this confidentiality. All patient information stored via paper or computer system is considered confidential. It is the ethical and legal responsibility of all students to maintain and comply with all confidentiality requirements of the agencies used for clinical experiences. As a student at Montana State University Bozeman College of Nursing, I agree to the following: 1. 2. 3. 4.

5. 6.

I will protect the confidentiality of all patients, family and clinical agency information. I will not release unauthorized information to any source. I will not access or attempt to access information other than that information which I have authorized access to and need to know in order to complete my assignment as a student. I will report breaches of this confidentiality agreement by others to my clinical instructor and/or the course coordinator of NRSG ______. I understand that failure to report breaches is an ethical violation and subjects me to disciplinary action. I will not put patient/family/clinical agency identifying information on any written work completed for any assignment. I will not put patient/family/clinical agency identifying information on any stored information (disk or hard drive) on my own personal computer or on any other public or private computer.

______________________________________________________________________ Date Signature ________________________________ Print Name This form will be placed in my academic file; I was given a copy of this agreement for my records.

21

MONTANA STATE UNIVERSITY DNP Psychiatric/Mental Health

Preceptor Vita Short Form Name & Title: Agency Name: Agency Address:

Telephone: (

)

E-mail address:

Today’s Date:

Number of years of experience in current role:

year(s)

Higher Education Degree/s and dates of degree:

Number of hours of continuing education in the last two years: Board Certified:

YES

NO

Certifying Body: Certification Number:

Date of Expiration:

Montana State License (Type and Number): State License Number:

Date of Expiration:

For APRN Preceptors

Do You Have Prescriptive Authority?

YES

NO

Do You Have a DEA Number?

YES

NO

22

MONTANA STATE UNIVERSITY DNP Psychiatric/Mental Health Graduate Student Clinical Placement Request Form

Preceptor Information Sheet Student Name:________________ Course/Semester:_______________ SITE/PRECEPTOR 1: Names/Email addresses (Agency and Preceptor, no abbreviations):

Complete Agency Address:

Focus of Practice: (APRN, if therapist-type of therapy, age/population seen)

SITE/PRECEPTOR 2: Names/Email addresses:

Complete Agency Address:

Focus of Practice: (APRN, if therapist-type of therapy, age/population seen)

SITE/PRECEPTOR 3 (with special permission): Names/Email addresses:

Complete Agency Address:

Focus of Practice: (APRN, if therapist-type of therapy, age/population seen)

23

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