you will share your experience (see below for experience) and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.

350 word discussion. At least 2 References ( I have attached some to utilize) within last 5 years and cited in discussion. Apa format

-Review the Resources (I attached articles) and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan. 

-This is the experience: Treatment is limited for patient with stage 4 cancer and they are considering going on hospice to have better quality life. (you can include any details you would like)

-Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/. 

Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic. Type in ‘hospice’

Try to use this link to take you right to the hospice link on that site

https://www.healthwise.net/ohridecisionaid/Content/StdDocument.aspx?DOCHWID=tu1430

The discussion:

-Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. 

-Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. 

-Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.-you have to reference and use the decision aid site listed above.

  

Here are references attached

Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x

Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396

Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186

  

Assignment 2: Week 6 Practicum Journal: Reimbursement Rates

Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses. As a PMHNP, you will be faced with varying rates that may be different than other health care providers you may work with.

In this Practicum Journal Assignment, you will analyze reimbursement rates for mental health treatments you will likely use in your practice and compare those rates to other provider rates.

Learning Objectives

Students will:

· Analyze reimbursement rates for mental health treatments

To prepare for this Practicum Journal:

· Research reimbursement rates for various treatment modalities.

· Compare NP rates to other provider rates.

For this Practicum Journal:

Complete the Reimbursement Rate Template in your Learning Resources using the five types of services you are likely to use in your practice.

NURS 6670 

Reimbursement Rate Template

  

Type of Service

eg. -New office visit

-Established office visit

-Inpatient hospital

-individual psychotherapy

-group psychotherapy (see examples below)

CPT code

Private insurer reimbursement rate for PMHNP

Private insurer reimbursement rate for physicians

Medicare

reimbursement rate for PMHNP

Medicare

reimbursement rate for physician

 

 

 

 

 

As the PMHNP becomes proficient in diagnosing and treating, it is also important to learn how to bill for your time. The CMS sets up codes to identify the type of service you are providing. You will generally complete this task at the end of the visit as you are documenting the visit with the client. Here are examples of the codes to know: 

CPT Codes for Psychiatric and Psychological Procedures

HMSA recognizes the following service codes for the reporting of psychiatric and psychological services. (See Code Books for information on how to obtain the books.)

  

CPT   Code 

Footnote(s) 

Description 

 

90791

1

Psychiatric   diagnostic evaluation

 

90792

1,3

Psychiatric diagnostic evaluation with medical services

 

90832

2

Psychotherapy, 30 minutes with patient and/or family member

 

90833

2,3

Psychotherapy, 30 minutes with patient and/or family member when   performed with an evaluation and management service

 

90834

4

Psychotherapy, 45 minutes with patient and/or family member

 

90836

3,4

Psychotherapy, 45 minutes with patient and/or family member when   performed with an evaluation and management service

 

90837

6

Psychotherapy,   60 minutes with patient and/or family member

 

90838

3,6

Psychotherapy, 60 minutes with patient and/or family member when   performed with an evaluation and management service

 

90839

6

Psychotherapy for crisis; first 60 minutes

 

90840

2

each additional 30 minutes

 

90846

4

Family psychotherapy (without the patient present)

 

90847

4

Family psychotherapy (conjoint psychotherapy) (with patient   present)

 

90849

4

Multiple-family group psychotherapy

 

90853

4

Group psychotherapy (other than of a multiple-family group)

 

90870

1, 5

Electroconvulsive therapy (includes necessary monitoring)

 

96101

1

Psychological   testing (includes psychodiagnostic assessment of personality,   psychopathology, emotionality, intellectual abilities, e.g., WAIS-R,   Rorschach, MMPI) with interpretation and report, per hour.

Note: All hours   of psychological testing done on a single day will be counted as one visit   (either inpatient or outpatient as appropriate) toward the patient’s   inpatient or outpatient visit maximum. However, payment will be made to the   participating provider on a per-hour basis.

 

96118

1

Neuropsychological   testing battery (e.g., Halstead-Reitan, Luria, WAIS-R) with interpretation   and report, per hour

Note: All hours   of psychological testing done on a single day will be counted as one visit   (either inpatient or outpatient as appropriate) toward the patient’s   inpatient or outpatient visit maximum. However, payment will be made to the   participating provider on a per-hour basis.

Links to websites that discuss this:

https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement

http://www.mb-guide.org/medical-coding-guidelines.html

 

Assignment:

Evidence-Based Practice Model and Change Model

Create a PowerPoint presentation that addresses each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with at least three (3) sources using APA citations throughout your presentation. Make sure to cite the sources using the APA writing style for the presentation. Include a slide for your references at the end. Follow best practices for PowerPoint presentations related to text size, color, images, effects, wordiness, and multimedia enhancements. Review the rubric criteria for this assignment.

Part 1: Choose and explain one Evidence Based Practice Model from Chapter 13 of the textbook (Melnyk and Fineout-Overholt, 2015). Then, related to your research topic from Mod 1, describe in detail how you would utilize the model to implement an evidence-based practice change in your personal clinical practice environment. Models to choose from include: Stetler Model of EBP, Iowa Model of EBP, A Model for EBP Change, ARCC Model, PARIHS, Clinical Scholar Model, John Hopkins Nursing EBP, ACE Star Model of Knowledge Transformation

Part 2: Choose one Change Model/Theory from Chapter 14 of the textbook (Melnyk and Fineout-Overholt, 2015). Then, related to your research topic from Mod 1, describe in detail how you would utilize the model/theory to implement an evidence-based practice change in your personal clinical practice environment. Models/theories to choose from include: Change Curve, Kotter and Cohen’s, Roger’s Theory of Diffusion of Innovations, The Transtheoretical Module of Health Behavioral Change

• Title Slide (1 slide)
• Objective Slide (1 slide)
• Choose and explain one Evidence Based Practice Model from Chapter 13 of the textbook (Melnyk and Fineout-Overholt, 2015). (1-2 slides)
• Related to your research topic from Mod 1, describe in detail how you would utilize the model to implement an evidence-based practice change in your personal clinical practice environment (2-3 slides)
• Choose one Change Model/Theory from Chapter 14 of the textbook (Melnyk and Fineout-Overholt, 2015). (1-2 slides)
• Related to your research topic from Mod 1, describe in detail how you would utilize the model/theory to implement an evidence-based practice change in your personal clinical practice environment. (2-3 slides)
• References (1 slide)

Assignment Expectations:

Length: 9-13 slides
Structure: Include a title slide, objective slide, content slides, reference slide in APA format. Title/Objective/Reference slides do not count towards the minimum slide count for this assignment.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required for this assignment.

 

Choose a current issue/trend topic from the following list:

1. Technology in health care
2. Collective bargaining
3. The impaired nurse
4. The global nurse workforce
5. Mentoring and coaching in nursing
6. The trimodal model of 21st-century effective nurse leaders
7. Other instructor-approved topic

Create a 6- to 8-page paper in APA format including a minimum of 4 to 5 references. Explain how you would lobby your legislators or local government for funds to support your issue or trend. Include the following elements in your paper: share why you chose the specific topic, the current relevance of material, how it is integrated into clinical practice, and how the information is used in clinical setting.

To prepare for this discussion, read the case study below:

Case Study

Then, answer the following questions:

• Describe the information       the nurse should seek in order to provide culturally competent care for       this client.
• How might the family’s       traditional medicine be incorporated into the treatment she receives at       the hospital?
• What steps are necessary       for the client’s safety regardless of culture?

Cause Study:   

PRN 1555 – Case Study odule 02 DiscussionE.S. is a 23-year-old female from El Salvador who migrated to the United States with her sister (now 17) in 2011. They fled El Salvador due to crime and gang violence. E.S is being admitted to the hospital on a 72-hour-hold.

E.S. was referred to a psychiatrist by her primary physician for an evaluation of possible Post Traumatic Stress Disorder (PTSD). The symptoms she was experiencing at the time included: trouble falling asleep, frequent awakening, nightmares, awakening in cold sweats, and crying out in the middle of the night that someone was trying to kill her. Her appointment was set for next month. Since the referral, she has become increasingly agitated. She was brought to the ER after trying to run in front of a car. She is accompanied by her sister and 25-year-old boyfriend.

Her boyfriend speaks and interprets for the sisters. E.S. and her sister do not speak English. Her brother reports that E.S. has had frequent lapses of memory, that she does not “make sense”, that the house is a mess and that she has wandered off and gotten lost three times in the last few months. The brother says that he feels that E.S. should be taken care of by his family when he leaves the hospital. 

In the first 24 hours of hospitalizations, E.S. is pacing the room frequently and often looks out the window. Bruises were noted on her back and arms. When meals are served, E.S. will ignore it or throw the tray on the floor. She refuses to take any medications. She has had three incidents of self-injurious behavior. Her boyfriend would like her restrained during visits and meals for safety. Her boyfriend has requested that she be discharged to the care of an espirista and her boyfriend’s family tomorrow.