Reflections on Evidence-Based Practice, Clinical Practice Guidelines, and Standards of Care
Reflections on Evidence-Based Practice, Clinical Practice Guidelines, and Standards of Care
As an advanced practice provider, you may encounter situations where your clinical judgment differs from your colleagues. For this reflective assignment, you will begin to gain experience in recognizing Clinical Practice Guidelines (CPG) for Standards of Care from evidence-based practices. You will critically evaluate a treatment plan you feel your preceptor may have deviated from Clinical Practice Guidelines and develop your own clinical reasoning skills. This assignment will begin to prepare you for next quarter’s implementation of treatment planning and interventions in patient cases. Keep what you learned from this assignment in your critical thinking processes for future Practicum Experiences.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCE
To Prepare
Identify a Case:
Choose a patient case from your clinical experience where you and your preceptor approached the treatment plan differently.
Research evidence-based information pertinent to your chosen patient for treatment Clinical Practice Guidelines and Standards of Care.
Submission Requirements:
Length: 3-4 pages, double-spaced, APA format.
Cite at least 3 peer-reviewed sources to support your analysis.
Evaluation Criteria:
Clarity and completeness of the case summary.
Depth of analysis and comparison between treatment plans.
Use of evidence-based rationale for your alternative plan.
Reflection on learning and future application.
Proper use of APA formatting and references.
Assignment
Write a paper:
Briefly summarize:
The patient case, including all relevant information: the patient’s history, assessment findings, medications, any pertinent testing, presenting symptoms, and the final diagnosis (ensure patient confidentiality).
Compare Treatment Plans:
Describe your preceptor’s recommended treatment plan and interventions.
Explain the alternative treatment plan you would have recommended as a nurse practitioner based upon Clinical Practice Guidelines and Standards of Care.
Justify Your Approach:
Use evidence-based guidelines, clinical research, and relevant literature to support your alternative plan.
Discuss why you believe your approach would be effective, considering the patient’s history, condition, and individual needs.
Reflect on Differences:
Analyze the differences between your plan and your preceptor’s.
Consider factors such as clinical experience, knowledge, patient-centered care, and the influence of evidence-based practice in decision-making.
Lessons Learned:
Reflect on how this experience has influenced your clinical practice and approach to treatment planning.
Discuss how you can apply what you learned to future patient care.
How might you approach another provider professionally in the future when you find treatment plans differing during collaboration on the patient case?
This is the patient i want to write
Dates 6/13/2025
Course Psychopathophysiology Diagnostic Reasoning
Clinical Faculty Melissa Virnig
Approved Preceptor Nicole Queen
Total Time 8
Notes/Comments LJ is a 62-year-old African American male who presented today, 06/13/2025, with increased irritability and expressed anger, stating, “That mother fucker put me out because I said it’s too cold in here.” LJ is currently unstably housed, staying intermittently with relatives; he was recently staying with his cousin but is now temporarily with his sister, who reports he cannot remain there long-term. He has a well-documented psychiatric history with prior hospitalizations for medication management and has had legal system involvement in the past.LJ has a complex medical profile, including hypertension and end-stage renal disease, and currently undergoes dialysis three times per week. He is in recovery from heroin use and reports occasional alcohol use in the past. He recently separated from his wife due to her continued substance use, and he maintains some connection with his son and adult stepchildren. Despite his challenges, LJ demonstrates strengths including an interest in music, a desire to help others, and enjoyment of community events. He completed the 11th grade and supports himself through odd jobs. Given his psychiatric history, medical comorbidities, recent housing instability, and psychosocial stressors, LJ may benefit from a comprehensive mental health evaluation, medication review, and linkage to social services, including housing support and continued substance use recovery resources. His presentation today highlights the need for trauma-informed, person-centered care with attention to his psychiatric stabilization and social determinants of health.LJ is currently prescribed the following medications: Lamivudine 100 mg PO daily – Antiretroviral for HIV management, Abacavir 300 mg PO daily – Antiretroviral for HIV management
Prezista (Darunavir) 800 mg PO daily – Antiretroviral for HIV management
Risperdal Consta 25 mg/2 mL IM every 2 weeks – Long-acting antipsychotic for psychiatric stabilization. Nifedipine 40 mg PO daily – Calcium channel blocker for hypertension
Pravastatin 80 mg PO daily – Statin for hyperlipidemia management
Aspirin 81 mg PO daily – Antiplatelet for cardiovascular protection. Ranitidine 150 mg PO daily – H2 blocker for gastrointestinal symptoms. Vitamin B complex, Vitamin C, and Folic Acid 0.8 mg PO daily – Nutritional supplementation.This regimen reflects management of multiple chronic conditions, including HIV, hypertension, hyperlipidemia, and psychiatric illness, and underscores the importance of integrated care coordination for medical, psychiatric, and social needs.
Date6/13/2025
Course Psychopathophysiology Diagnostic Reasoning
Clinical Faculty Melissa Virnig
Approved Preceptor Nicole Queen
Patient Number 20
Client Information LJ
Visit Information Shadowing
Practice Management Individual Counseling
Diagnosis: Schizoaffective disorder, Bipolar
Student Notes—LJ is a 62-year-old African American male AOX4 who presented on 06/13/2025 Making statement such as “ That mother Fucker put me out because I said its to cold in there’’. He presents with increased irritability and verbal aggression. He is currently experiencing housing instability, staying intermittently with relatives. He most recently resided with his cousin and is now temporarily living with his sister, who reports he cannot stay there long-term. LJ has a significant psychiatric history, including previous hospitalizations for medication management, and has had involvement with the legal system. Medically, he presents with multiple chronic conditions, including hypertension and end-stage renal disease requiring hemodialysis three times per week. He is also living with HIV and is managed on antiretroviral therapy. LJ is in recovery from heroin use and reports past occasional alcohol use. He recently separated from his wife due to her ongoing substance use and maintains some contact with his biological son and adult stepchildren. Despite his psychosocial and medical challenges, LJ demonstrates personal strengths such as a passion for music, a desire to assist others, and participation in community events. He completed the 11th grade and supports himself through various odd jobs. Given his psychiatric history, comorbid medical conditions, and current housing and psychosocial stressors, LJ would benefit from a comprehensive psychiatric evaluation, medication review, and connection to supportive services, including housing resources and continued substance use recovery support. A trauma-informed, person-centered approach is essential in planning his care, with attention to both psychiatric stabilization and his broader social determinants of health. Medications are as follows. Lamivudine 100 mg PO daily – Antiretroviral therapy (HIV)Abacavir 300 mg PO daily – Antiretroviral therapy (HIV)Prezista (Darunavir) 800 mg PO daily – Antiretroviral therapy (HIV)Risperdal Consta 25 mg/2 mL IM every 2 weeks – Long-acting antipsychoticNifedipine 40 mg PO daily – For hypertension Pravastatin 80 mg PO daily – For hyperlipidemia Aspirin 81 mg PO daily – For cardiovascular protectionRanitidine 150 mg PO daily – For GI symptoms, Vitamin B Complex, Vitamin C, and Folic Acid 0.8 mg PO daily – Nutritional support
This complex medication regimen reflects the need for ongoing, multidisciplinary care coordination that addresses LJ’s psychiatric, medical, and social needs
Reference.
Addington DE, Pantelis C, Dineen M, Benattia I, Romano SJ. Efficacy and tolerability of ziprasidone versus risperidone in patients with acute exacerbation of schizophrenia or schizoaffective disorder: an 8-week, double-blind, multicenter trial. J Clin Psychiatry. 2004 Dec;65(12):1624-33. [PubMed]
Vieta E. Developing an individualized treatment plan for patients with schizoaffective disorder: from pharmacotherapy to psychoeducation. J Clin Psychiatry. 2010;71 Suppl 2:14-9. [PubMed]
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