Master Resource Outline

Course Title: NRSG 691-002 – Psychiatric Case Formulation

Credits: 3 (2 didactic, 1 lab)

Semester Offered: Fall

Prerequisites: NRSG 601, NRSG 602

Degree: DNP

AACN Core Competencies for Advanced-level Nursing Education: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10

Course Description

This graduate nursing course establishes the foundation for the assessment, diagnosis, and treatment of psychiatric conditions. Focus will be on conceptual and clinical approaches to advanced-level assessment techniques and diagnostic reasoning in psychiatric/psychosocial disorders. Synthesizes knowledge from psychosocial nursing and multiple allied fields to enhance learners’ cognizance of principles for establishing accurate and comprehensive diagnoses and sound multifaceted psychiatric/psychosocial formulations.

Catalog Description

Foundation for assessment, diagnosis, and treatment of psychiatric conditions with focus on conceptual and clinical approaches to advanced-level assessment techniques and diagnostic reasoning in psychiatric/psychosocial disorders. Synthesizes knowledge from psychosocial nursing and allied fields for comprehensive diagnoses and case formulations.

Course Learning Outcomes: Upon completing this course the student will be able to: 

1. Link comprehensive case formulation with evidence-based treatments including psychopharmacology, various psychotherapies, and alternative modalities.

2. Assess elements pertinent to provision of psychiatric evaluations incorporating the time, setting, therapeutic assessment process, and other factors following current standards of care.

3. Evaluate issues of data validity and current screening and diagnostic tools.

4. Evaluate the use of DSM and other nosological systems for diagnosing.

5. Utilizes interdisciplinary resources to collaborate or refer for diagnostic process.

6. Examine the scope of practice for the PMHNP APRN in diagnostic reasoning.

7. Distinguish diagnostic case formulation differences throughout the lifespan incorporating cultural differences.

8. Evaluate barriers in psychiatric case formulation and self-reporting.

Exemplars of Course Learning Outcomes

1. Create a comprehensive case formulation based on chief complaint(s). [CLO 1-8]

2. Analyze the necessary components of psychiatric assessment based on chief complaint and review of psychiatric systems while considering the implication of medical conditions. [CLO 2, 3, 4, 5]

3. Integrate diagnostic tests used in ruling in/out a differential diagnosis. [CLO 3, 4, 5, 6, 7]

4. Formulates a list of two to three differential diagnoses based on chief complaint, review of systems, and assessment. [CLO 3, 4, 5, 6]

5. Evaluate validity of information from others, family, records, etc. [CLO 3, 5, 7, 8]

6. Recognize the importance of physical health rule outs, ex. Thyroid, vitamin D, what to do with results. [CLO 1, 2, 3]

7. Evaluate the consequences, legal, and ethical implications of assigning diagnostic labels. [CLO 3, 6, 7, 8,]

8. Incorporate self-reflection of personal biases into diagnostic process. [CLO 6, 8] 2

9. Acquire epidemiological thinking with diagnostic reasoning. [CLO 2, 3]

AACN Level 2 Competencies 

This course introduces:

1.1e-g

1.1e Translate evidence from nursing science as well as other sciences into practice.

1.1f Demonstrate the application of nursing science to practice.

1.1g Integrate an understanding of nursing history in advancing nursing’s influence in health care. Demonstrate the application of nursing science to practice.

1.2f-j

1.2f Synthesize knowledge from nursing and other disciplines to inform education, practice, and research.

1.2g Apply a systematic and defendable approach to nursing practice decisions.

1.2h Employ ethical decision making to assess, intervene, and evaluate nursing care.

1.2i Demonstrate socially responsible leadership.

1.2j Translate theories from nursing and other disciplines to practice.

1.3d-f

1.3d Integrate foundational and advanced specialty knowledge into clinical reasoning.

1.3e Synthesize current and emerging evidence to Influence practice.

1.3f Analyze decision models from nursing and other knowledge domains to improve clinical judgment.

2.1d-e

2.1d Promote caring relationships to effect positive outcomes.

2.1e Foster caring relationships.

2.2g-j

2.2g Demonstrate advanced communication skills and techniques using a variety of modalities with diverse audiences.

2.2h Design evidence-based, person-centered engagement materials.

2.2i Apply individualized information, such as genetic/genomic, pharmacogenetic, and environmental exposure information in the delivery of personalized health care.

2.2j Facilitate difficult conversations and disclosure of sensitive information.

2.3h Demonstrate that one’s practice is informed by a comprehensive assessment appropriate to the functional area of advanced nursing practice.
2.4f-g

2.4f Employ context driven, advanced reasoning to the diagnostic and decisionmaking process.

2.4g Integrate advanced scientific knowledge to guide decision making.

2.5h-k

2.5h Lead and collaborate with an interprofessional team to develop a comprehensive plan of care.

2.5i Prioritize risk mitigation strategies to prevent or reduce adverse outcomes.

2.5j Develop evidence-based interventions to improve outcomes and safety.

2.5k Incorporate innovations into practice when evidence is not available.

2.6e-j

2.6e Model best care practices to the team.

2.6f Monitor aggregate metrics to assure accountability for care outcomes.

2.6g Promote delivery of care that supports practice at the full scope of education.

2.6h Contribute to the development of policies and processes that promote transparency and accountability.

2.6i Apply current and emerging evidence to the development of care guidelines/tools.

2.6j Ensure accountability throughout transitions of care across the health continuum.

2.7d-f

2.7d Analyze data to identify gaps and inequities in care and monitor trends in outcomes.

2.7e Monitor epidemiological and system-level aggregate data to determine healthcare outcomes and trends.

2.7f Synthesize outcome data to inform evidence-based practice, guidelines, and policies.

2.8f-j

2.8f Develop strategies that promote self-care management.

2.8g Incorporate the use of current and emerging technologies to support selfcare management.

2.8h Employ counseling techniques, including motivational interviewing, to advance wellness and self-care management.

2.8i Evaluate adequacy of resources available to support self-care management.

2.8j Foster partnerships with community organizations to support self-care management.

2.9f-i

2.9f Evaluate communication pathways among providers and others across settings, systems, and communities.

2.9g Develop strategies to optimize care coordination and transitions of care.

2.9h Guide the coordination of care across health systems.

2.9i Analyze system-level and public policy influence on care coordination.

2.9j Participate in system-level change to improve care coordination across settings.

3.3c-f

3.3c Analyze cost-benefits of selected population-based interventions.

3.3d Collaborate with partners to secure and leverage resources necessary for effective, sustainable interventions.

3.3e Advocate for interventions that maximize cost effective, accessible, and equitable resources for populations.

3.3f Incorporate ethical principles in resource allocation in achieving equitable health.

3.6h-j

3.6h Collaborate with interdisciplinary teams to lead preparedness and mitigation efforts to protect population health with attention to the most vulnerable populations.

3.6i Coordinate the implementation of evidence-based infection control measures and proper use of personal protective equipment.

3.6j Contribute to system-level planning, decision making, and evaluation for disasters and public health emergencies.

4.1h-k

4.1h Apply and critically evaluate advanced knowledge in a defined area of nursing practice.

4.1i Engage in scholarship to advance health.

4.1j Discern appropriate applications of quality improvement, research, and evaluation methodologies.

4.1k Collaborate to advance one’s scholarship.

4.2i-k

Collaborate in the development of new/revised policy or regulation in the light of new evidence.

4.2 j Articulate inconsistencies between practice policies and best evidence.

4.2k Evaluate outcomes and impact of new practices based on the evidence

5.2i-j

5.2i Design evidence-based interventions to mitigate risk.

5.2j Evaluate emergency preparedness system-level plans to protect safety.

5.3e-h

5.3e Advocate for structures, policies, and processes that promote a culture of safety and prevent workplace risks and injury.

5.3f Foster a just culture reflecting civility and respect.

5.3g Create a safe and transparent culture for reporting incidents.

5.3h Role model and lead well-being and resiliency for self and team.

6.1h-l

6.1h Facilitate improvements in interprofessional communications of individual information (e.g. EHR).

6.1i Role model respect for diversity, equity, and inclusion in team-based communications.

6.1j Communicate nursing’s unique disciplinary knowledge to strengthen interprofessional partnerships.

6.1k Provide expert consultation for other members of the healthcare team in one’s area of practice.

6.1l Demonstrate capacity to resolve interprofessional conflict.

6.2g-h

6.2g Integrate evidence-based strategies and processes to improve team effectiveness and outcomes.

6.2h Evaluate the impact of team dynamics and performance on desired outcomes.

6.2j

6.2j Foster positive team dynamics to strengthen desired outcomes.

6.3d

6.3d Direct interprofessional activities and initiatives.

6.4e-i

6.4e Practice self-assessment to mitigate conscious and implicit biases toward other team members.

6.4f Foster an environment that supports the constructive sharing of multiple perspectives and enhances interprofessional learning.

6.4g Integrate diversity, equity, and inclusion into team practices.

6.4h Manage disagreements, conflicts, and challenging conversations among team members.

6.4i Promote an environment that advances interprofessional learning.

7.2g,h,k,l

7.2g Analyze relevant internal and external factors that drive healthcare costs and reimbursement.

7.2h Design practices that enhance value, access, quality, and cost-effectiveness.

7.2k Recommend system-wide strategies that improve cost- effectiveness considering structure, leadership, and workforce needs.

7.2l Evaluate health policies based on an ethical framework considering costeffectiveness, health equity, and care outcomes.

8.1g

8.1g Identify best evidence and practices for the application of information and communication technologies to support care.

8.2h

8.2h Use standardized data to evaluate decision making and outcomes across all systems levels.

8.2i Clarify how the collection of standardized data advances the practice, understanding, and value of nursing and supports care.

8.3g

8.3g Evaluate the use of information and communication technology to address needs, gaps, and inefficiencies in care.

8.3i

8.3i Appraise the role of information and communication technologies in engaging the patient and supporting the nurse-patient relationship.

8.3k

8.3k Pose strategies to reduce inequities in digital access to data and information.

8.4f

8.4f Employ electronic health, mobile health, and telehealth systems to enable quality, ethical, and efficient patient care.

8.5g-l

8.5g Apply risk mitigation and security strategies to reduce misuse of information and communication technology.

8.5h Assess potential ethical and legal issues associated with the use of information and communication technology.

8.5i Recommend strategies to protect health information when using communication and information technology.

8.5j Promote patient engagement with their personal health data.

8.5k Advocate for policies and regulations that support the appropriate use of technologies impacting health care.

8.5l Analyze the impact of federal and state policies and regulation on health data and technology in care settings.

9.1i-k

9.1i Model ethical behaviors in practice and leadership roles.

9.1j Suggest solutions when unethical behaviors are observed.

9.1k Assume accountability for working to resolve ethical dilemmas.

9.2h-l

9.2h Foster opportunities for intentional presence in practice.

9.2i Identify innovative and evidence-based practices that promote personcentered care.

9.2j Advocate for practices that advance diversity, equity, and inclusion.

9.2k Model professional expectations for therapeutic relationships.

9.2l Facilitate communication that promotes a participatory approach.

9.3i-k

9.3i Advocate for nursing’s professional responsibility for ensuring optimal care outcomes

9.3j Demonstrate leadership skills when participating in professional activities and/or organizations.

9.3k Address actual or potential hazards and/or errors.

9.3m

9.3m Advocate for policies/practices that promote social justice and health equity.

9.4d

9.4d Advocate for policies that enable nurses to practice to the full extent of their education.

9.4e Assess the interaction between regulatory agency requirements and quality, fiscal, and value-based indicators.

9.4f Evaluate the effect of legal and regulatory policies on nursing practice and healthcare outcomes.

9.4g Analyze efforts to change legal and regulatory policies that improve nursing practice and health outcomes.

9.5f-i

9.5f Articulate nursing’s unique professional identity to other interprofessional team members and the public.

9.5g Evaluate practice environment to ensure that nursing core values are demonstrated.

9.5h Identify opportunities to lead with moral courage to influence team decisionmaking.

9.5i Engage in professional organizations that reflect nursing’s values and identity

9.6d-i

9.6d Model respect for diversity, equity, and inclusion for all team members.

9.6e Critique one’s personal and professional practices in the context of nursing’s core values.

9.6f Analyze the impact of structural and cultural influences on nursing’s professional identity.

9.6g Ensure that care provided by self and others is reflective of nursing’s core values.

9.6h Structure the practice environment to facilitate care that is culturally and linguistically appropriate.

9.6i Ensure self and others are accountable in upholding moral, legal, and humanistic principles related to health.

10.1c

10.1c Contribute to an environment that promotes self-care, personal health, and well-being.

10.2g-j

10.2g Demonstrate cognitive flexibility in managing change within complex environments.

10.2h Mentor others in the development of their professional growth and accountability.

10.2i Foster activities that support a culture of lifelong learning.

10.2j Expand leadership skills through professional service.

10.3j

10.3j Provide leadership to advance the nursing profession.

10.3n

10.3n Participate in the evaluation of other members of the care team.

10.3p

10.3p Advocate for the promotion of social justice and eradication of structural racism and systematic inequity in nursing and society.

10.3q Advocate for the nursing profession in a manner that is consistent, positive, relevant, accurate, and distinctive issues

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Approved by GAAC: 5/1/2023

Approved by Faculty: 5/10/2023