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GUIDELINES FOR THE CLINICAL PAPER (counts 20% of grade)   Cases may be selected from vSIM and/or from the Standardized Patient experience

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GUIDELINES FOR THE CLINICAL PAPER (counts 20% of grade)

 

Cases may be selected from vSIM and/or from the Standardized Patient experience. Students are to consider  therapeutic communication, review the psychosocial assessment (or complete this if needed), complete the mental status exam (MSE), review the psychiatric diagnoses, and review medications.  A clinical paper template is provided on Blackboard to download, which contains each part of the MSE assessment, tables, and structure for the paper.  Refer to the most current APA guidelines for your writing and referencing.  Refer to the grading rubrics for specific point distribution.  Students are reminded to adhere to confidentiality policies of the facility, in addition to state and federal regulations such as HIPAA.  

 

A template for your paper is available on Blackboard.

 

Part I: Patient Cases 1 & 2

The purpose of Part I of the clinical paper is to demonstrate proficiency in the following: completion of the mental status exam; identification and statement of the nursing diagnoses; and treatment planning by writing about two different cases in succession over the first several weeks of clinical (meaning do not do all of your cases at once).  Each of these cases has a specific due date which is noted on your schedule. Ideally, feedback from your instructor on the first case will be helpful in completing the second case. Both cases will be graded and are part of the final clinical paper grade.  It is recommended that each case represents a different primary psychiatric diagnosis, such as one mood disorder (i.e., Major Depressive Disorder), one psychotic disorder (i.e., Schizophrenia), and one substance use disorder (i.e., Alcohol Use Disorder). Cases may be selected from vSIM and/or from the Standardized Patient experience.

 

For each case, use the clinical paper template in the course manual to relay the following:

 

1.  General description of the patient/client; for example, this patient/client is an adult who was admitted to the acute care unit for suicidal ideation. Please refrain from providing specifics in the clinical paper that would potentially identify patients/clients (i.e., names, initials, ages, etc.).   
2. History of present illness (HPI)
3. Mental status examination
4. Psychiatric and medical diagnoses
5. List nursing diagnoses
6. Select the two top priority mental health related nursing diagnoses (ND). For these two ND, write out the complete ND including the problem, "related to"… "as evidenced by"….  Devise a treatment plan for each (using text or care plan book) and include two interventions with rationale (i.e., cite your text or care plan book with page number).
7. Complete the medication table
8. Respond to the communication reflection as prompted on the clinical paper template. 

As the cases are completed, compile them into Part I of the clinical paper, which will be submitted as one final document. 

 

 

 

Part II: Literature Review

Part II is an opportunity to explore the current literature and examine the latest evidence about treatment interventions for one nursing diagnosis/ problem of your choice that was encountered when completing cases in Part I.  Using the PICO (Patient/population/problem, Intervention, Comparison, Outcomes) approach to clinical inquiry, ask a clinical question. You may click on this link to the Well Built Clinical Question for a quick review of PICO or consider consulting your materials from your research course.  There are additional helpful references, which follow guidelines to each part of this paper.  Identify a patient or population and problem (i.e., patients/clients with suicidal ideation who are hospitalized) from one of your completed treatment plans in Part I.  Select one of the corresponding interventions that you have indicated in the treatment plan and the desired outcome.  The question may seek to support the intervention with evidence or may compare the existing intervention with another. Examples of each type of question are the following:

 

Without a comparison - In adult patients with depression who are hospitalized and have suicidal ideation, do verbal contracts for safety contribute to the patient being free of self harm?

 

With a comparison- In adult patients with depression who are hospitalized and have suicidal ideation, how do verbal contracts for safety affect the patient being free of self harm as compared to written contracts for safety?

 

            Then, examine the current literature (within the past five years; if literature is truly scant on the topic, ask your clinical instructor for permission to search older literature as far back as 10 years) to answer your question.   Locate two intervention-focused research articles (level of evidence I, II, or III) that address your PICO question.  Keep in mind the ND/problem, patient population and setting of care (i.e., acute inpatient), intervention, and desired outcome.  Both articles must be from a peer-reviewed journal, one of which is a nursing journal.  Use the literature table provided in the appendix of the clinical paper template (fill this out and include in the paper as an appendix, as it is presented in the template) to describe the studies.  Also, use the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal checklist (your answers to these questions) to write up a narrative discussion of the articles' quality, which will be used to support your answer to the clinical question.  Address the strength of the study design, the study results, study conclusions, and pertinent study findings, using this as a guide.  Submit your completed checklist and articles.  Length of the narrative writing for Part II should be at most 3 pages.  Additional pages may be omitted from the grading process (e.g., the instructor may stop reading and grading at the end of the third page, which may jeopardize your grade).

 

 

 

 

 

 

 

 

 

Part III: Reflection

Briefly (about one page) respond to the following reflection questions:

 

1. What did you learn about yourself during this course, and how will that influence your approach to nursing care?
2. How did the knowledge gained about mental health nursing contribute to your understanding of the role of the CNL in planning evidence-based care?
3. Whether you plan to work in psych or not, what psych-specific skills and knowledge can you apply to patient care in medical units?

 

Submitting the Paper

Be mindful that the paper is due by 7 a.m. on the specified clinical due date (on the day of your clinical).  Students are expected to submit the Part II and III of the paper to SafeAssign via BlackBoard and print the report generated by SafeAssign, which does indicate the time submitted.  Submit this report to the clinical instructor on or before the date/time due along with the final paper.  The clinical instructor will determine whether electronic or hard copy is expected.  Please, refer to the syllabus for policy regarding late submission of assigned work.

 

A draft SafeAssign submission area will be available for you as a helpful tool.  This is optional, but an excellent way to check your paper for matching, which gives you an opportunity to catch unintentional matches before submitting your final work. The paper submitted to clinical faculty to grading must match the final SafeAssign submission through Blackboard.

 

 

Your final graded paper will be submitted by the instructor to the Course Director after you have reviewed your graded work.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clinical Paper: Part I Feedback and Grading Rubric Used for Each Case Submission

 

Student:

 

Case # 1:

 

Date Submitted:

Elements of the assignment	Points possible	Points earned
General description of the patient   Example: This patient is an adult who was admitted to the acute care unit for suicidal ideation.	.5
HPI	0.75
MSE (template)	2.5
Psychiatric/Medical Diagnoses	.5
Nursing Diagnosis (ND) list all appropriate	1
Selection of 2 priority ND	1
Treatment plan for each of the 2 priority ND, including at minimal 2 interventions per ND	2.5
Completed medication table (template)	1
All parts of the case template are complete, grammar and spelling are accurate	0.25
APA, spelling, grammar, sentence structure	2
Total	12
Additional Comments:

 

 

 

Clinical Paper: Part I Feedback and Grading Rubric Used for Each Case Submission

 

Student:

 

Case # 2:

 

Date Submitted:

Elements of the assignment	Points possible	Points earned
General description of the patient	1
HPI	1.5
MSE (template)	5
Psychiatric/ Medical Diagnosis	1
Nursing Diagnosis (ND) list all appropriate	2
Selection of 2 priority ND	2
Treatment plan for each of the 2 priority ND, including at minimal 2 interventions per ND	5
Completed medication table (template)	2
All parts of the case template are complete, grammar and spelling are accurate	0.5
APA, spelling, grammar, sentence structure	2
Total	22
Additional Comments:

 

 

 

 

 

 

Clinical Paper: Part II & III Feedback Rubric and Clinical Paper Sum Total

 

Student:

Date/Time Submitted:

Elements of the Assignment: Part II	Points possible	Points earned
Selection of nursing diagnosis/problem, intervention, and outcome	2
Clinical question developed from PICO (considers the patient population and clinical setting) 1	4
Selection of a peer-reviewed research article from a nursing journal that applies to the question2	4
Selection of a peer-reviewed research article that applies to the question2	4
Accurate completion of the literature table which includes determination of the level and quality of evidence using the Evidence Rating Scale	5
Narrative discussion addressing points from the JHEBP Research Evidence Appraisal checklist (2 articles) to discuss the strength of the study, study results, and study conclusions. Completed checklist is provided with paper.	20
Demonstration of critical thinking: 1)   Conclusions are made based on the appraisal of the literature, the level of evidence, and the quality of the literature.       2)   Answers the clinical question based on the literature discussed.	10   5
Proper use of the most current referencing and citation using APA format, including correct grammar and spelling.	2
Total points for Part II	56
Elements of the Assignment: Part III
Summarizes the work done and how it contributes to understanding of the 1)  role of the mental health nurse;  and	4
2)  understanding of the role of nursing in planning EB care;	4
Describes how these experiences contributed to you as a nurse.	2
Total points for Part III	10
Additional Overall Comments:
Clinical Paper Grade Summary
Part I Total for Case 1	12
Part I Total for Case 2	22
Part II Total	56
Part III total	10
TOTAL	100

^1,2 If you do not submit your PICO question /articles before the deadline you will receive a zero for that section. You cannot change your PICO/articles once they have been approved.

The paper that you submit to your clinical instructor must match your SafeAssign submission. Any late SafeAssign submissions (after 7am) or submissions not matching copy given to the clinical instructor will be subject to a late penalty.

*Excessive quoting results in presenting someone else's work rather than your own ideas, which may result in zero points for that section of the paper.