PICOT is an acronym used to help develop clinical research questions and guide you in your search for evidence:

P = Patient population

I = Intervention or issue of interest

C = Comparison of interventions or comparison of interests

O = Outcome

T = Time frame

For example, you may wish to research the effects of interrupted sleep on cognition of ICU patients 65 or older.

Using this PICOT model,

In _________(P), how does __________ (I) compared to _________ (C) influence _________ (O) over ________ (T)?

In ICU patients who are 65 or older, how does interrupted sleep (awakened one time or more in four hours) as compared to uninterrupted sleep influence the patient’s cognitive ability over 5 days?

Assignment Directions

Begin by selecting a topic in nursing or medicine that is of interest to you. Next, use PICOT to format possible research questions about that topic. Provide 3 possible PICOT research questions.

Include the following:

• Title page
• Provide a brief description of the topic and background information.
• Explain the significance of the topic to nursing practice.
• Provide 3 clearly stated PICOT questions.

Your paper should:

• Be 2–3 pages (not including the title page and reference page)
• Use current APA format to style your paper and to cite your sources.

Review the rubric for further information on how your assignment will be graded.

Practicum Journal

Continue documenting your Practicum Experiences in your Practicum Journal. Reflect on your Practicum Experiences and relate them to your Professional Goals and Self-Assessment of Clinical Skills that you identified in Week 1.

WRITE ON THIS DIAGNOSIS BELOW AND ELABORATE:

Otitis Media with effusion

Use at least 2 references (From 2015 and UP)

Primary health Plan focused on preventive services.

Title:  Diabetes prevention in elderly population of my community.

APA style, 10 pages long, not including references and presentation page.

Identify a health problem in your community, in which you can develop a preventive program. (I choose Obesity prevention in adolescents of my community).

Create a clinical question using the PICOT (problem/patient/or population, intervention/indicator, comparison, outcome, and time element or type of study).

Objectives of the presentation

· Define preventive services commonly offered to different types of communities, using Healthy People 2020.

· Explain how to develop and write a practical policy for preventive services

· Define the steps to develop Primary Health Plan.

· Explain the evaluation criteria of a primary health plan.

· Explain the commonly used methods for evaluating a preventive health program.

· Identify a health problem in which it is important to develop a preventive health program.

Introduction.

Abstract

Literature that support the project

Description of the proposed solution.

Theory of change.

Problem identification, intended participant, Setting selection.

Objective and goals.

Intervention

Community involvement.

Develop materials and activities

Implementation and monitoring the intervention.

Choose one of the four overarching goals to work on the project:

· Attain high quality, longer lives free of preventable disease, disability, injury, and premature death.

· Achieve health equity, eliminate disparities, and improve the health of all groups.

· Create social and physical environments that promote good health for all.

· Promote quality of life, healthy development, and healthy behaviors across all life stages.

Evaluation.

Practice.

Conclusion.

References.

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this assignment.

1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.

2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).

3. The PICOT question will provide a framework for your capstone project.

4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles.  Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

RUBRICS: A clinical issue is thoroughly described. The issue relates to nursing practice. A PICOT question is clearly presented. The PICOT question format is applied accurately and presents an answerable and researchable question. Article citations and permalinks are presented. Article citations are accurately presented in APA format. Each article clearly relates to the PICOT question. The articles provide strong support for the PICOT question. Six research articles are presented. Each article meets the assignment criteria for a quantitative, qualitative, or mixed study. An ability to identify the different types of research design used in a study is consistently demonstrated. Purpose statements are accurate and clearly summarized. Research questions are accurate and capture the fundamental question posed by the researchers in each study. Research outcomes are accurate and described in detail for each article. The setting in which the researcher conducted the study is detailed and accurate for each article. The sample is indicated and accurate for each article. A thorough discussion on the method of study for each article is presented. Discussion of study results, including findings and implications for nursing practice, is thorough with relevant details and extensive explanation. Researcher recommendations accurate are thoroughly described for each article. Writer is clearly in command of standard, written, academic English. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

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