NURS 6600 Capstone Synthesis Practicum Essays and Assignments

NURS 6600 Capstone Synthesis Practicum Essays and Assignments
NURS 6600 Capstone Synthesis Practicum Essays and Assignments

Walden University
School of
Nursing
Practicum
Manual
Master of Science in Nursing (MSN)
Nurse Practitioner Specializations:
 Adult Gerontology Acute Care Nurse Practitioner
 Adult Gerontology Primary Care Nurse Practitioner
Family Nurse Practitioner
 Psychiatric-Mental Health Nurse Practitioner

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page ii

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page iii
Walden University
100 Washington Avenue South, Suite 900
Minneapolis, MN 55401
1-800-925-3368
Walden University is accredited by The Higher Learning Commission, www.hlcommission.org..
Walden University practices a policy of nondiscrimination in admission to, access to, and employment in
its programs and activities. Walden does not discriminate on the basis of race, color, sex, age, religion or
creed, marital status, disability, national or ethnic origin, socioeconomic status, sexual orientation, or
other legally protected status.
Walden is committed to providing barrier-free access to its educational services and makes appropriate
and reasonable accommodations when necessary. Students requesting accommodations per the
Americans with Disabilities Act (ADA) must contact the Office of Disability Services at
[email protected].
This publication represents current curricula, educational plans, offerings, requirements, tuition, and
fees. These may be modified or discontinued from time to time in the university’s sole discretion to carry
out the university’s purposes and objectives. Neither the provisions of this document nor the acceptance
of students through registration and enrollment in the university constitutes a contract or an offer of a
contract.
Find information on costs, occupation types, completion rates, and median loan debt for this program at
http://programdata.laureate.net/walden/master-of-science-in-nursing.html.
Walden University is a registered trademark of Walden University, LLC.
© 2017 Walden University, LLC
http://www.hlcommission.org/
mailto:[email protected]
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MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page iv
Contents Section 1. Introduction ………………………………………………………………………………………………………………… 1
Purpose of This Manual ……………………………………………………………………………………………………………. 1
Walden University ……………………………………………………………………………………………………………………. 1
Vision ………………………………………………………………………………………………………………………………….. 1
Mission ……………………………………………………………………………………………………………………………….. 1
Social Change ………………………………………………………………………………………………………………………. 2
School of Nursing …………………………………………………………………………………………………………………….. 2
Vision ………………………………………………………………………………………………………………………………….. 2
Mission ……………………………………………………………………………………………………………………………….. 2
Goals ………………………………………………………………………………………………………………………………….. 2
MSN Program Outcomes ………………………………………………………………………………………………………….. 2
Nurse Practitioner Licensure ……………………………………………………………………………………………………… 3
Note on Certification …………………………………………………………………………………………………………….. 3
Note on Licensure, Authorization, Endorsement, or Other State Credentials Necessary to Practice as
a Nurse Practitioner ……………………………………………………………………………………………………………… 4
Field Experience Terms …………………………………………………………………………………………………………….. 4
Practicum ……………………………………………………………………………………………………………………………. 4
Practicum Site ……………………………………………………………………………………………………………………… 5
Primary Care………………………………………………………………………………………………………………………… 5
Acute Care …………………………………………………………………………………………………………………………… 6
Supervision ………………………………………………………………………………………………………………………….. 6
Field Experience Roles ……………………………………………………………………………………………………………… 6
Preceptors …………………………………………………………………………………………………………………………… 6
Students ……………………………………………………………………………………………………………………………… 6
Practicum Course Faculty Members ……………………………………………………………………………………….. 8

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page v
Clinical Instructors ………………………………………………………………………………………………………………… 8
Specialization Coordinators …………………………………………………………………………………………………… 9
Program Director …………………………………………………………………………………………………………………. 9
Field Education Coordinators …………………………………………………………………………………………………. 9
Working Together ………………………………………………………………………………………………………………… 9
Field Experience Regulatory Requirements ……………………………………………………………………………….. 10
State Requirements ……………………………………………………………………………………………………………. 10
State Board Requirements …………………………………………………………………………………………………… 11
Non-U.S.-Based Student Requirements …………………………………………………………………………………. 11
Licensure Review………………………………………………………………………………………………………………… 11
Section 2. NP Practicum Program ………………………………………………………………………………………………… 13
Specializations Overview…………………………………………………………………………………………………………. 13
Required Activities …………………………………………………………………………………………………………………. 14
Individualized Learning Objectives ……………………………………………………………………………………….. 16
Conference Call ………………………………………………………………………………………………………………….. 16
Journal and Time Log ………………………………………………………………………………………………………….. 17
Performance Evaluation ………………………………………………………………………………………………………. 19
Formal Preceptor and Student Feedback ………………………………………………………………………………. 19
Course-Specific Guidance………………………………………………………………………………………………………… 19
Section 3. Getting Started …………………………………………………………………………………………………………… 26
Finding Practicum Sites and Preceptors …………………………………………………………………………………….. 26
Tips for Practicum Site and Preceptor Search…………………………………………………………………………. 26
Choosing a Site …………………………………………………………………………………………………………………… 27
Choosing a Preceptor ………………………………………………………………………………………………………….. 27
Change of Preceptor …………………………………………………………………………………………………………… 29
Affiliation Agreements With Practicum Sites ………………………………………………………………………….. 30

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page vi
Completing and Submitting the Practicum Application ……………………………………………………………….. 31
Policy on Electronic Signatures …………………………………………………………………………………………….. 31
Verification Documents ………………………………………………………………………………………………………. 32
Obtaining the Required Information …………………………………………………………………………………….. 33
Application Deadlines …………………………………………………………………………………………………………. 35
Field Site Onboarding Requirements ………………………………………………………………………………………… 37
Practicum Approval and Start ………………………………………………………………………………………………….. 38
Application Approval …………………………………………………………………………………………………………… 38
Practicum Course Registration ……………………………………………………………………………………………… 38
Application Steps ……………………………………………………………………………………………………………….. 39
Section 4. Practicum Policies ………………………………………………………………………………………………………. 41
Student Conduct and Responsibilities ………………………………………………………………………………………. 41
Academic Standing …………………………………………………………………………………………………………………. 41
Student Professional Competence Policy ………………………………………………………………………………….. 42
Problem Behaviors ……………………………………………………………………………………………………………… 42
Inappropriate and/or Unprofessional Conduct ………………………………………………………………………. 42
Critical Behaviors ……………………………………………………………………………………………………………….. 43
Nondiscrimination and Sexual Harassment Policies ……………………………………………………………………. 43
Nondiscrimination ………………………………………………………………………………………………………………. 43
Sexual Harassment ……………………………………………………………………………………………………………… 44
Problem Resolution and Process ……………………………………………………………………………………………… 45
Section 5. Frequently Asked Questions ………………………………………………………………………………………… 48
Section 6. Contact Information ……………………………………………………………………………………………………. 51
School of Nursing …………………………………………………………………………………………………………………… 51
Other Important Resources …………………………………………………………………………………………………….. 52
Field Education Resource Links …………………………………………………………………………………………….. 52

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page vii
Academic Advising Team …………………………………………………………………………………………………….. 52
Office of Disability Services ………………………………………………………………………………………………….. 52
Section 7. Programs of Study ………………………………………………………………………………………………………. 53
MSN Core Courses …………………………………………………………………………………………………………………. 53
MSN NP Specialty Track Courses ……………………………………………………………………………………………… 53
Course Descriptions ……………………………………………………………………………………………………………….. 56

Section 1. Introduction
Purpose of This Manual
Welcome to the field experience component of Walden University’s Master of Science in Nursing (MSN)
program. This manual describes the structure and timing of the classroom-based and on-site practicum
experiences and the policies students must follow to be successful in the nurse practitioner (NP)
specialties. For more information about the nursing programs, students should refer to the School of
Nursing Handbook.
This manual is intended to provide MSN-NP students with information they need related to practicum
policies and procedures as well as to serve as a reference for practicum preceptors and other practicum
personnel.
This manual refers to the Walden University Catalog and the Walden University Student Handbook for
specific information on university policies and courses. These resources can be accessed at
catalog.WaldenU.edu.
Note: Walden University reserves the right to make program changes as needed to help ensure the
highest quality program.
Walden University
The MSN program at Walden University is designed to promote Walden University’s vision, mission, and
ongoing commitment to social change. These guiding principles serve as a framework for the program
curriculum and outcomes and are included here as a reference.
Vision
Walden University envisions a distinctively different 21st-century learning community where knowledge
is judged worthy to the degree that it can be applied by its graduates to the immediate solutions of
critical societal challenges, thereby advancing the greater global good.
Mission
Walden University provides a diverse community of career professionals with the opportunity to
transform themselves as scholar-practitioners so that they can effect positive social change.
http://academicguides.waldenu.edu/fieldexperience/son/formsanddocuments
http://academicguides.waldenu.edu/fieldexperience/son/formsanddocuments
http://catalog.waldenu.edu/
http://catalog.waldenu.edu/
http://catalog.waldenu.edu/

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 2
Social Change
Walden University defines positive social change as a deliberate process of creating and applying ideas,
strategies, and actions to promote the worth, dignity, and development of individuals, communities,
organizations, institutions, cultures, and societies. Positive social change results in the improvement of
human and social conditions.
School of Nursing
Vision
The School of Nursing envisions recognition as a preeminent 21st-century school of nursing in which the
contributions of nursing, health, and related sciences will transform the provision of nursing services
along the continuum of care and across the human lifespan to meet the needs of individuals and local
and global communities.
Mission
The School of Nursing provides academically rigorous and culturally and contextually relevant
educational programs, based on the scholar-practitioner model, for a diverse array of nursing
professionals seeking enhancement of critical-thinking skills, abilities to select and implement evidence-
based practices, and core and specialty nursing knowledge in order to transform society.
Goals
The goals of the School of Nursing at Walden are to:
1. Empower nursing professionals through academic advancement that enhances personal growth,
professional development, and academic achievement.
2. Create an educational environment where learners are able to build on their existing
transformational and professional nursing knowledge, skills, and integrative abilities.
3. Educate nursing professionals with consideration for the complex needs of the diverse learner while
upholding professional nursing standards.
4. Encourage learners to integrate biopsychosocial, nursing and health theories, research, and
evidence-based practice that exemplify professional nursing standards.
5. Prepare professional nursing leaders who are empowered to promote social change for individuals,
groups, and organizations locally, nationally, and globally.
MSN Program Outcomes
At the end of the MSN program, students will be able to:

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 3
1. Synthesize organizational/systems leadership for cost-effective specialist nursing practice that
contributes to high-quality healthcare delivery, advancement of the nursing profession, and social
change.
2. Critique evidence-based literature drawing from diverse theoretical perspectives and pertinent
research to guide decision making that demonstrates best practices for specialist nursing practice in
a global society.
3. Integratively assess, diagnose, plan, implement, and evaluate cost-effective healthcare strategies
that reduce health disparities by patient/population advocacy for access to specialist nursing care.
4. Demonstrate the ability to effectively communicate using audience-specific oral, written, and
information technology for professional delivery of specialist nursing care.
5. Evaluate health needs of diverse populations for necessary teaching/coaching functions based on
specialist nursing knowledge to restore/promote health and prevent illness/injury.
6. Exhibit ongoing commitment to professional development and value of nursing theories/ethical
principles (altruism, autonomy, human dignity, integrity, social justice) in accordance with ethically
responsible, legally accountable, specialist nursing practice.
7. Implement specialist nursing roles to promote quality improvement of patient-centered care in
accordance with professional practice standards that transform health outcomes for diverse
populations.
Nurse Practitioner Licensure
Note on Certification
The MSN-NP specializations are designed to prepare graduates to qualify to sit for national NP
certification exams, which are required for practice as an NP in most states. Because no university
program can guarantee that graduates will be permitted to practice as an NP upon graduation,
Walden encourages students to consult with the appropriate Board of Nursing or state agency to
determine specific certification exam requirements. Walden enrollment advisors can provide
information relating to national certification exams; however, it remains the individual’s
responsibility to understand, evaluate, and comply with all requirements relating to national
certification exams for the state in which he or she intends to practice as requirements vary widely.
Walden makes no representations or guarantee that completion of Walden coursework or
programs will permit an individual to obtain national certification. For more information about NP
certification exams, students should visit the American Academy of Nurse Practitioners at
www.aanpcertification.org, the American Nurses Credentialing Center at
www.nursecredentialing.org, and the American Association of Critical Care Nurses at www.aacn.org.
file:///C:/Users/spotler/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/ZK3VPQH1/www.aanpcertification.org
file:///C:/Users/spotler/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/ZK3VPQH1/www.nursecredentialing.org
file:///C:/Users/spotler/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/ZK3VPQH1/www.aacn.org

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 4
Note on Licensure, Authorization, Endorsement, or Other State
Credentials Necessary to Practice as a Nurse Practitioner
The MSN-NP specializations are designed to prepare graduates with an active registered nurse (RN)
license to practice as NPs. However, each state Board of Nursing has its own academic and
certification requirements and issues its own credential for an RN to be permitted to practice as a
NP in that state. Because no university program can guarantee that graduates will be permitted to
practice as NPs upon graduation, Walden encourages students to consult with the appropriate
Board of Nursing or state agency to determine specific requirements in the state in which they wish
to practice. Walden enrollment advisors can provide guidance relating to the state-by-state
requirements for practice as a NP; however, it remains the individual’s responsibility to understand,
evaluate, and comply with all requirements relating to the practice as a NP in the state in which he
or she intends to practice as requirements vary widely. Walden makes no representations or
guarantee that completion of Walden coursework or programs will permit an individual to obtain
state licensure, authorization, endorsement, or other state credential. For more information about
the requirements to practice as a NP, students should contact the appropriate Board of Nursing or
state agency. After graduation, all certification, credentialing, and licensure forms and requests
must be sent to Nursing Licensure at [email protected].
Field Experience Terms
For the purposes of this manual, the following terms are defined in this way:
Practicum
A practicum is a distinctly defined supervised on-site experience in which students develop applied skills
and integrate professional knowledge in the provision of advanced practice nursing care. All NP
students must complete four practicum courses, with a minimum of 576 hours of supervised clinical
experience (144 hours in each course). The didactic (classroom) and clinical components of the courses
are integrated. The courses vary by specialization:
 Students in the Adult Gerontology Acute Care Nurse Practitioner (AGACNP) specialization must complete NURS 6531, 6540, 6550, and 6560.
 Students in the Adult Gerontology Primary Care Nurse Practitioner (AGPCNP) specialization must complete NURS 6531, 6540, 6551, and 6565.
 Students in the Family Nurse Practitioner (FNP) specialization must complete NURS 6531, 6541, 6551, and 6565.
 Students in the Psychiatric-Mental Health Nurse Practitioner (PMHNP) specialization must complete NURS 6640, 6650, 6660, and 6670.
mailto:[email protected]

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 5
Practicum Site
A practicum site is a health agency or other appropriate setting at which students have supervised,
applied practice experiences that are consistent with their education and training. Officials at practicum
sites enter into an affiliation agreement with Walden, stating they will provide appropriate support and
supervision for students during the practicum experience. Virtual sites are not allowed for practicum
courses.
In general, students must spend the majority of their clinical experience time in general primary care
settings seeing a good overall mix of age groups over the lifespan (FNP) or with adolescents and adults
(AGACNP, AGPCNP) with a broad range of health promotion, disease prevention, and acute and chronic
health problem assessment and management needs. Appropriate practicum sites for the AGPCNP/FNP
specializations can include physician’s offices (family practice, pediatric practice, women’s health, or
internal medicine); clinics that provide primary care, such as health departments; and hospital-based
primary care clinics. AGACNP students may use some of these sites in NURS 6531 and 6540 and acute
care facilities for NURS 6550 and 6560.
Psychiatric-mental health nurse practitioners will have practicum experiences in a wide range of setting
with children, adolescents, adults, and older adults. NURS 6640 and NURS 6650 focus on psychotherapy
practice where NURS 6660 and NURS 6670 are integrative experiences (psychopharmacology coupled
with psychotherapy).
Primary Care
A primary care practice serves as the patient’s first point of entry into the healthcare system and as the
continuing focal point for all needed healthcare services. Primary care practices provide patients with
ready access to their own personal physician. These practices provide health promotion, disease
prevention, health maintenance, counseling, patient education, diagnosis, and treatment of acute and
chronic illnesses in a variety of healthcare settings. These practices are organized to meet the needs of
patients with undifferentiated problems, with the vast majority of patient concerns and needs being
cared for in the primary care practice itself. Primary care practices are generally located in the
community of the patients, thereby facilitating access to healthcare while maintaining a wide variety of
specialty and institutional consultative and referral relationships for specific care needs. The structure of
the primary care practice may include a team of physicians and non-physician health professionals.
Appropriate settings for primary care should be in outpatient primary care settings.
All students in NP specializations require primary care experiences. FNP students must complete all
clinical hours in primary care settings, AGPCNP students may complete clinical hours both in primary
care and specialty care settings, and AGACNP and PMHNP students may complete clinical hours in

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 6
primary care, specialty care, and acute care settings.
Acute Care
Acute care refers to a level of specialty care focused on the management of severe injuries, urgent
medical conditions, exacerbation of chronic illnesses, and/or recovery after surgical procedures. Acute
care settings provide patients with secondary healthcare services that address active healthcare
problems. Acute care practices provide access to healthcare teams that span the gamut of nursing,
medical, and surgical specialties. Acute care practitioners perform assessments, order and interpret
diagnostic tests, formulate diagnoses, perform procedures, and develop and/or implement treatment
plans. The quintessential acute care setting is the in-patient hospital, but acute care is also provided in
emergency rooms, urgent care centers, or surgery centers. Essentially, comprehensive care of patients
with acute, critical, and/or exacerbated, complex, chronic conditions falls under the realm of the acute
care provider regardless of the practice setting. The acute care provider is specialized in addressing the
needs of high acuity patients along the illness-to-wellness spectrum.
Supervision
Supervision by a preceptor is composed of a tutorial and mentoring form of instruction in which
practicum preceptors monitor students’ activities in the practicum during the provision of primary care
and facilitate learning and skill-development experiences. Preceptors guide students and provide
feedback on their practicum work.
Field Experience Roles
Preceptors
Preceptors are qualified practitioners within a clinical site who are responsible for guiding students’
practicum experiences (see Preceptor Requirements in Section 3). Preceptors must be employed at the
field site. Walden expects preceptors to be accessible to students and to provide guidance and feedback
that promotes growth of knowledge, skills, and competencies consistent with Walden’s educational
goals as well as with best nursing practices. Preceptors provide mentoring and guidance appropriate to
students’ roles in their clinical sites, including ongoing feedback about the students’ progress in meeting
clinical goals.
Students
Students at Walden are considered to be adult learners who are capable of seeking educational
opportunities to meet their personal and professional goals. Walden expects students to collaborate
with faculty members and be self-directed to meet educational requirements. Students work with
faculty members, clinical instructors, and preceptors to ensure they obtain a well-rounded educational
experience.

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 7
Students are expected to complete adhere to the following:
 Develop a learning contract to meet course objectives and outcomes for the practicum.
 Adhere to the learning contract as established by the student, clinical instructor, and preceptor.
 Comply with the policies and protocols established by the practicum site.
 Seek direct and indirect supervision from the clinical instructor and preceptor.
 Be appropriately prepared for each laboratory and clinical experience.
 Incorporate theory and research into clinical practice to provide evidence-based care to patients.
 Provide safe, competent, and quality care under the supervision of the clinical instructor and preceptor.
 Maintain an ethical and professional manner at all times.
 Use acquired knowledge and clinical skills for appropriate clinical setting.
 Use various educational resources to provide evidence-based care to patients.
 Be on time and be prepared for each clinical session.
 Develop a clear and concise plan to meet course outcomes.
 Be respectful and professional.
 Participate in regular conferences with the clinical instructor.
 Seek regular feedback from the clinical instructor and preceptor about progress in the clinical setting.
 Adhere to Health Insurance Portability and Accountability Act (HIPAA) guidelines at all times.
 Maintain a clinical journal, time logs, patient logs, and other pertinent clinical records as required by the clinical instructor and/or preceptor.
 Be adaptable and flexible learners.
 Evaluate the course, clinical experience, and preceptor.
 Develop long-term and short-term goals during the program.
 Participate in group and individual conferences.
 Complete the required hours needed for the didactic and clinical portions of the courses.
 Complete all course assignments satisfactorily.
 Contact the clinical instructor and practicum site if unable to attend a clinical experience.
 Use critical-thinking skills and sound clinical judgment in providing patient care.
Students With Disabilities
The School of Nursing at Walden will not discriminate on the basis of disability and is committed to
providing all qualified students with disabilities equal access to its programs, services, and activities in
accordance with the Americans with Disabilities Act and section 504 of the Rehabilitation Act of 1973.

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 8
In postsecondary education, it is the students’ responsibility to self-identify disability status and register
with the Office of Disability Services prior to requesting accommodations. To register, students should
submit documentation of disability along with Walden’s Accommodation Request form to
[email protected].
The process and form are available from the Office of Disability Services. Students with disabilities
requesting accommodations to access field experiences, such as a practicum and/or internship, should
register with the Office of Disability Services prior to registering for those field experiences and clarify
their specific accommodation needs. In most cases, field experience sites have their own systems for
ensuring equal access for employees/interns with disabilities. The Office of Disability Services will help
address any gaps in those systems.
Practicum Course Faculty Members
Walden nursing faculty members, who are doctorally prepared, teach the didactic portion of the courses
and communicate with clinical instructors and preceptors regarding the students’ successful mastery of
all competencies prior to recording the final course grades. Practicum course faculty members
collaborate with students and clinical instructors and inform specialization coordinators about any
difficulties that arise during the practicum experience. Didactic faculty members may also serve as
clinical faculty.
Clinical Instructors
Clinical instructors are a critical element of the NP student practicum experience. These instructors
monitor and assess appropriate learning experiences to facilitate students’ achievement as it relates to
the practicum course objectives. The clinical instructors are NPs responsible and accountable for
assuring that students meet the course objectives at a specific practicum site and work closely with
preceptors.
Clinical instructors communicate on a regular basis with NP students and their preceptors regarding
student progress and learning needs; they are also available to resolve problems that may arise. Clinical
faculty make practicum site visits (virtually and/or physically) to review students’ experiences and the
appropriateness of the setting. Clinical instructors are responsible for evaluating the students’ clinical
work.
Specific clinical instructor responsibilities include the following activities:
 Providing guidance to students in formulating the learning contract.
 Conferring with students individually and in groups.
mailto:[email protected]
http://ecampus.waldenu.edu/c/Student_Faculty/StudentFaculty_436.htm

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 9
 Assigning student grades following review of the learning outcome measures identified in the course and the learning contract.
 Completing final student evaluations in Meditrek.
 Forwarding all evaluation forms to the specialization coordinator.
The clinical instructors and their assigned students should touch base very early in the quarter and
arrange date(s) for the site visit(s). Students should turn in their subjective, objective, assessment, plan
(SOAP) notes and their journal entries to their clinical instructors and maintain their time logs within
Meditrek. The clinical instructors are the students’ primary resource regarding any problems or issues
that arise related to the practicum experience.
Specialization Coordinators
Specialization coordinators are doctorally-prepared Walden faculty members whose primary role
regarding the MSN practicum is to oversee the experience for a given MSN specialization (i.e., AGACNP,
AGPCNP, PMHNP, or FNP). The specialization coordinators are an important resource for students
during the program, especially if any problems arise during the practicum.
Program Director
The program director (PD) is a doctorally-prepared full-time academic administrator who reports to the
dean and supervises the specialization coordinators and faculty. The PD’s primary role is to maintain the
quality and integrity of the degree program and oversee day-to-day program management. While
working with specialization coordinators, the PD supports students throughout the MSN-NP program,
including during the practicum experience.
Field Education Coordinators
Field education coordinators are Walden employees who help students understand the practicum
policies and procedures. They answer questions about the practicum application process, review
materials to ensure that students have completed all required application and documentation steps, and
work collaboratively with the specialization coordinators and the PD throughout the approval process.
Once practicum applications have been approved, the field education coordinators ensure that students
are enrolled in their appropriate practicum course. Field education coordinators are assigned to
students by region and are available to students via e-mail, phone, or appointment. Students can find
their field education coordinator online at
http://academicguides.waldenu.edu/fieldexperience/son/contactus.
Working Together
Walden’s program directors, director of field placement, specialization coordinators, field education
coordinators, practicum course faculty members, and clinical instructors are committed to working
collaboratively with students and preceptors to support the successful completion of practicum
experiences.
http://academicguides.waldenu.edu/fieldexperience/son/contactus

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 10
Process for Mentoring and Evaluation of Students
The practicum process is collegial, with the recognition that NP students are adult learners who are
capable of critical self-reflection, open to constructive feedback, and responsible for their own learning.
Expectations for clinical practica performance correlate with the stage of the students’ learning; i.e.,
greater clinical practicum expertise is anticipated as students’ progress through the program.
Once students enroll in a practicum course, they are mentored and evaluated by their preceptor and a
Walden clinical instructor who is assigned to them at the beginning of the quarter. Preceptors provide
the experie


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NURS 6670
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 The American Medical Association (AMA) developed Current Procedural Terminology (CPT) a medical code system that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations. The CPT is a numerical coding methodology that accurately identifies the professional services provided by qualified healthcare professionals and to report those services in a way that can be universally understood by institutions, private and government payers, researchers, and others interested parties. The CPT is the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. (Dotson, 2013). CPT codes are an integral part of the billing process. CPT codes tell the insurance payer what procedures the health care provider would like to be reimbursed for It is used to track important health data and measure performance and efficiency reimbursement rates for mental health treatments sample essays.
CPT code is five characters long and may be numeric or alphanumeric, depending on which category the CPT code is in. (Detorie, Mahesh, Hevezi, 2016).
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The difference between
CPT codes and ICD codes are that CPT codes are related to procedures and ICD codes are related to diagnoses. ICD codes the ‘category’ refers to the first three characters of the code, which describe the injury or disease documented by the healthcare provider.
 
The relationship between ICD-10 codes and CPT is important because the ICD- 10 codes identifying the diagnosis support the necessity of the procedure completed. This allows the procedure to be covered and the provider to be reimbursed (Thorwarth, 2008)
 
Type of Service eg. -New Office Visit-Established Office Visit-Inpatient hospital-individual psychotherapy-group psychotherapy (see examples below)
CPT code The private insurer reimbursement rate for PMHNP
The private insurer reimbursement rate for physicians Medicare the reimbursement rate for PMHNP Medicare the reimbursement rate for physician Psychiatric
Diagnostic Evaluation
90791
$118.54
$138.26
$119.99
$159.0
Psychiatric Diagnostic Evaluation with Medical Services
90792
$125.13
$159.74
$116.58
$130.0
Psychotherapy, 30 minutes with patient and or family member
90832
$67.22
$96.52
$64.61
$76.10
Psychotherapy, 45 minutes with Patient and/or family member
90834
$89.88
$115.63
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86.16
94.89
Psychotherapy for crisis; first 60 minutes
90839
140.66
$164.28
135.08
143.54
State of Maryland Department of Health and Mental Hygiene (2018) Reimbursement Rates Retrieved from;
https://mmcp.health.maryland.gov/Documents/physicianfeeJCRfinal1

14.pdf.
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 psych diagnostic 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
Reference
Dotson, P. (2013). CPT
®
Codes: What Are They, Why Are They Necessary, and How Are They Developed?
Advances in Wound Care
,
2
(10), 583

http://doi.org/10.1089/wound.2013.0483

Detorie, N, Mahesh, M, Hevezi, J (2016). CPT®
Code 77370 Journal of American College of Radiology,
5 (8),
937

93
Thorwarth, W.T. Jr.(2008). CPT®: An Open System That Describes All That You Do
.
J Am Coll Radiol
.
5:555

560.Retrieved from:
https://www.jacr.org/article/S1546

1440(08)00226

3/references
State of Maryland Department of Health and Mental Hygiene (2018) Reimbursement Rates Retrieved from reimbursement rates for mental health treatments sample essays;
https://mmcp.health.maryland.gov/Documents/physicianfe
eJCRfinal1

14.pdf.
9 / 9
Assignment 2-WK6DUWK7- Reimbursement Rates

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 reimbursement rates for mental health treatments sample essays

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.
 
Practicum Journal: Reimbursement Rates
                                Analyze reimbursement rates for mental health treatments
The Healthcare Common Procedure Coding System (HCPCS), built up in 1978, is an institutionalized framework to portray explicit things and administrations gave in health services conveyance, (IBHP, 2019). This coding framework was produced to guarantee that claims for Medicare, Medicaid, and other medical coverage programs are prepared reliably reimbursement rates for mental health treatments sample essays. At first, utilization of the codes was willful, however with the approach of HIPAA in 1996 (Health Insurance Portability and Accountability Act of 1996), the codes wound up required (IBHP,2019). This paper will break down repayment rates for mental wellness treatment and repayment rates for different treatment modalities and looks at NP rates to other supplier rates.
The outlook of reimbursement rates for various treatment modalities.
The Center for Health Care Solutions has developed Billing and Financial Worksheets for each state that identify current billing opportunities for services in integrated settings. The most frequently used code by the psychiatrists can be found in psychiatry subsection of the medicine section of the CPT manual (codes 90785-90899). In 2005–2006, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA), with guidance from the Centers for Medicare & Medicaid Services (CMS),(2018), jointly sponsored a study to identify the barriers to, and possible solutions for, reimbursement of mental health services provided in primary care settings (Danna et., al 2008). Significant changes to the psychiatry codes were seen in the year 2013 whereby refinement was made between an initial evaluation with medical services carried out by a doctor 90792 and a first assessment done by a non-physician 90791.There’s one major difference between 90791 and 90792: the use of medical services. Whereas both codes are used for psychiatric diagnostic evaluations, 90791 can’t include medical services and 90792 can reimbursement rates for mental health treatments sample essays.
Contrasting NP reimbursement rates to other provider rates.
In contrasting NP repayment rates with other supplier rates, it is perfect to see how to legitimately bill and code for services given by NPPs is basic to running a savvy and effective medical practice. Outlining and documentation necessities must be met. Most importantly, states set their own rates at which they repay suppliers, where you practice is taken cognizance of and my affect the outcome. In a few states, suppliers remain to benefit most by treating patients protected through Medicare reimbursement rates for mental health treatments sample essays. In different states, treating patients guaranteed through Medicaid designs produces the most income, (IBHP,2019).
Directions fluctuate by insurance agencies and states, so both the doctor and the NPP’s must remain current with training rules and progressing changes. Nurse Practitioners and Physician Assistants have progressively turned into a staple in most medical practices. NPs are nurses who hold a graduate degree or Doctor of Nursing Practice (DNP). PAs are affirmed (PA-C), generally holding a graduate degree also. There are a few reasons that therapeutic practices use these mid-level suppliers: reduced Salary expenses (as compared to a physician); lower overhead costs; higher patient volumes; and reduced insurance and liability costs (Tufts Health Plan, 2018) reimbursement rates for mental health treatments sample essays.
 Psychiatric Business Template
Reimbursement Rate Template

Type of Service
 
CPT code
Private insurer reimbursement rate for PMHNP
Private insurer reimbursement rate for physicians
Medicare
reimbursement rate for PMHNP
Medicare
reimbursement rate for physician

Psychiatric diagnosis evaluation
90791
$135.42
$159.32
$117.76
 $138.54

Psychiatric diagnostic evaluation with medical services
 90792
$135.42
$159.32
$117.76
 $138.54

Electroconvulsive therapy (includes necessary monitoring)
90870
$155.10
$182.47
$97.25
$114.41

Psychological testing, interpretation and reporting per hour by a psychologist
96101
$83.24
$97.93
$72.38
$85.16

Neuropsychological testing, interpretation and reporting by a psychologist
 
96118
$98.15
$115.47
$85.35
$100.41

Various minutes are allotted to each evaluation to attract the stipulated amount of money.
 
 
Reference
Centers for Medicare and Medicaid Services (CMS), (2018). Physician Fee Schedule. Retrieved from                 https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/ reimbursement rates for mental health treatments sample essays
Danna Mauch,D., Kautz, C.,Smith, S. (2008). Reimbursement of Mental Health Services in Primary Care Settings. Retrieved from      https://www.integration.samhsa.gov/Reimbursement_of_Mental_Health_Services_in_Primary_                Care_Settings.pdf
Integrated Behavioral Health Partner IHBP (2019). Billing, Reimbursement and Financing. Retrieved from

Billing, Reimbursement And Financing


Tufts Health Plan. (2018). Nurse Practitioner and Physician Assistant Professional Payment Policy              Retrieved from https://tuftshealthplan.com/documents/providers/payment-policies/np-pa-    comm
Quintero-Howard, C. (2019). Child and Adult Psychiatry Business Plan Template. Townson, MD reimbursement rates for mental health treatments sample essays.
NURS 6670
Reimbursement Rate Template
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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
reimbursement rates for mental health treatments sample essays
Medicare
reimbursement rate for physician

 
Psychiatric diagnostic evaluation
 
90791

 
Psychiatric diagnostic evaluation with medical services
 
90792

 
Electroconvulsive therapy (includes necessary monitoring)
 
90870

 
Psychological testing
 
96101

reimbursement rates for mental health treatments sample essays

 
Neuropsychological testing battery
 
96118

 
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: reimbursement rates for mental health treatments sample essays.
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.) reimbursement rates for mental health treatments sample essays.
 

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 reimbursement rates for mental health treatments sample essays

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. reimbursement rates for mental health treatments sample essays
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 reimbursement rates for mental health treatments sample essays.

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
reimbursement rates for mental health treatments sample essays


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