MN 569 Unit 6 Assignment grading rubric. Referrals
Instructors: Enter total available points in cell H2, and values
Content Rubric
Introductory - Not
submitted or largely
incomplete. Work may
indicate very little if
any comprehension of
content.
Emergent - Work
shows some
comprehension but
errors indicating
miscomprehension
may be present.
0 - 1.9
2 - 2.9
Referral Request
Referral request omits more
than 4 essential elements or
is not submitted.
Consultation Request
Consultation request omits
Consultation request omits
more than 4 essential
3-4 essential elements.
elements or is not submitted.
Referral request omits 3-4
essential elements.
(Do Not Change
criteria below)
Writing Deduction
Rubric (everyone
starts with 4's =
no deductions)
Introductory
Emergent
0-1
2
Grammar &
Punctuation
Spelling
The overall meaning of the
paper is difficult to
understand. Sentence
structure, subject verb
agreement errors, missing
prepositions, and missing
punctuation make finding
meaning difficult.
Several confusing
sentences, or 1 to 2
confusing paragraphs make
understanding parts of the
paper difficult, but the
overall paper meaning is
clear. Many subject verb
agreement errors, run-on
sentences, etc. cause
confusion.
Many typos, misspelled
The many misspelled words
words, or the use of
and incorrect words choices
incorrect words making
significantly interfere with the
understanding difficult in a
readability.
few places.
The order of information is
confusing in several places
Paper has some good
and this organization
information or research, but it interferes with the meaning
does not follow assignment
or intent of the paper.
Order of Ideas &
However, the paper has a
Length Requirement directions and is lacking in
overall organization and
generally discernible
content.
purpose and follows
assignment directions
overall.
APA
This is an attempt use APA
formatting and citing. There
There is some attempt at
are both in-text citations
APA formatting and citing.
and reference listings.
There are one or more
Citation information may be
missing parts such as the
missing or incorrect (i.e.
cover page or references list. Websites listed as in-text or
Citation information may be reference citations). There
missing. Citation mistakes
is an attempt to cite all
make authorship unclear.
outside sources in at least
one place. Authorship is
generally clear.
Feedback:
ubric. Referrals
nts in cell H2, and values between 0 and 4 in the yellow
Total available points =
Practiced - Work
indicates overall
progress toward
comprehension. Minor
errors may present.
Proficient/Mastered Work is complete and
indicates full
comprehension of
content.
3 - 3.9
4
Referral request omits 1-2
essential elements.
Complete referral request
written to provider for the current
complaint. Includes all essential
elements, including patient
identification, referring provider
information, reason for referral,
treatments patient has
undergone to date, evaluation
and management codes.
Complete consultation request
written to provider for current
complaint. Includes all essential
elements, including, patient
identification, reason for the
Consultation request omits 1consult, consulting provider’s
2 essential elements.
information, current evaluation
and recommendations or
treatments and correct CPT
code for consult.
Score
Weight
Final Score
4
50%
2,00
4
50%
2,00
Content
Score
Practiced
Proficient/Mastered
3
4
10
Score
Weight
10
Final Score
A few confusing sentences
make it difficult to
understand a small portion
of the paper. However, the
overall meaning of a
paragraph and the paper
are intact. There may be a
few subject verb agreement
errors or some missing
punctuation.
There are one or two confusing
sentences, but the overall
sentence and paragraph
meanings are clear. There are a
few minor punctuation errors
such as comma splices or runon sentences.
4
35%
1,40
Some misspelled words or
the misuse of words such as
confusing then/than.
However, intent is still clear.
A few misspelled words
normally caught by
spellcheckers are present but
do not significantly interfere with
the overall readability of the
paper.
4
35%
1,40
The overall order of the
information is clear and
The order of information is contributes to the meaning of
confusing in a few places
assignment. There is one
and the lack of organization paragraph or a sentence or two
interferes with the meaning that are out of place or other
or intent of the paper in a
minor organizational issues. A
minor way.
few sentences may be long and
hard to understand. Meets
length requirements.
4
20%
0,80
There is an overall attempt
at APA formatting and
citation style. All sources
appear to have some form
of citation both in the text
and on a reference list.
There are some formatting
and citation errors. Citations
generally make authorship
clear.
4
10%
0,40
There is a strong attempt to cite
all sources using APA style.
Minor paper formatting errors
such as a misplaced running
head or margins may occur.
Minor in-text citation errors such
as a missing page number or a
misplaced date may occur.
Quotation marks and citations
make authorship clear.
Writing 0
Deduction
Final Score
Percentage
10
100%
Unit 6: Assignment: Consultation and Referral
Writing Assignment: Consult: Write up a consult request and include all key elements.
Ms. Perez has been referred to Ms. Wilson FNP-C, APRN, MSN for consultation regarding
eczema unresponsive to treatment in the past six months.
Document the evaluation and recommendations for how Ms. Wilson FNP-C, APRN, MSN
should deal with the consultation request and bill a consultation code.
CONSULTATION FORM:
Patient: MS. PEREZ
DOB: 01/01/1970
Procedure Code: 99213
An established office patient with Eczema ICD-10: L30.9: Dermatitis, unspecified.
CC: “lesions in my neck and forearms.”
Interval History: Patient with known Eczema lesions over the neck and bilateral forearm, which
had been previously treated with Montelukast, Burrow's solution, Colloidal baths, and Benadryl
for the past 6 months. Now states that the lesions are severe and are not responding to treatment.
Patient was referred for a consultation visit.
ROS: Integumentary –Positive for papulovesicular lesions in around the neck and bilateral
anterior and posterior forearm, along with pigmentary changes, and intense pruritus.
Physical Exam: Moderate to severe swelling of the neck, positive to eczema lesion, some of
them infected and oozing. Bilateral forearm skin lesions with severe dryness in surrounding skin.
Some pain over the affected areas, described as 5/10.
Assessment: Chronic eczema with exacerbation, Suspected secondary bacterial infection.
Plan:
1.
2.
3.
4.
5.
Culture and sensitivity of infected lesions.
Start Prednisone 20 mg PO BID x 7 days, because of oozing lesions.
Blood work: CBC, Specific IgE, IgA, IgG, lipid profile.
Consider after blood work results: cyclosporine A or Imuran therapy.
Stop Benadryl and consider starting Sinequan 75mg PO q HS to control severe pruritus
during the night.
6. Continue with Montelukast 10mg PO q HS.
7. If lesions continue, consider skin biopsy.
8. Return visit as needed if no improvement.
Writing Assignment: Referral: Write up a referral request and include all key elements.
As an NP and Ms. Perez primary care provider, you decide to refer her to Dr. Owens a
dermatologist for evaluation and treatment regarding eczema unresponsive to treatment in the
past six months.
1. Document your referral to Dr. Owens
2. Document the evaluation and recommendations for how Dr. Owens should deal with the
referral and bill a referral code.
REFERAL ORDER:
Patient: MS. PEREZ
DOB: 01/01/1970
To: DR. OWENS
1234 SW 56 STREET
MIAMI, FL 33030
Phone: (305) 999-9999
Fax: (305) 999-9990
From: Lola Resario, ARNP
1234 NW 56 STREET
MIAMI, FL 33032
Diagnosis: Eczema ICD-10: L30.9: Dermatitis, unspecified
Order Name: Eczema ICD-10: L30.9: Dermatitis, unspecified; DERMATOLOGY REFERRAL
Schedule Within: STAT
Note to Provider: This patient is being followed regarding eczema unresponsive to treatment in
the past six months. The patient still has severe lesions that do not respond to usual treatment
with Montelukast, Burrow's solution, Colloidal baths, and Benadryl. He is referred for evaluation
to rule out an atopic disease and because of the need of a more aggressive treatment. Attached
are full encounters summaries, please send me copy of your findings and plan within 1 week of
the visit. Thank you.
Urgency: High
Reason for Referral: Evaluation and Management of Eczema
Appointment Date: 02/15/2018
Appointment Time: 10:30 AM
End Date: 05/13/2018
Notes to Patient: Please bring insurance card and photo ID
Prior Authorization #: 01234
Procedure Code: 99242
Start Date: 02/13/2018
Visits Approved: 3
Prior CT, MRI or X-ray Studies? N
Attached Full Encounters Summary.
Height / Weight / BMI / BP Height 5 ft 7 in 01/30/2018 Weight 150 lbs 01/30/2018 BMI 23.5
01/30/2018 Blood Pressure 110 / 75 01/30/2018
Problems:
1. History of asthma - Onset: 06/01/1990
2. Eczema - Onset: 01/30/2018
3. Allergic rhinitis – Onset 02/02/2000
Surgical History: NONE
Medications:
1. Benadryl 25 mg capsule: Take 2 capsule(s) every day by oral route at bedtime for 10
days., start 09/01/2017
2. Burrow's Solution Topical: Apply as a compress for 20-30 min 4-6 times per day over the
lesions., start 09/01/2017
3. Colloidal oatmeal 43 % bath packet: Dissolve 1 packet into the tub or container and soak
affected area for 15 to 30 minutes. Repeat for up to 7 days., start 09/01/2017
4. Montelukast 10 mg tablet: Take 1 tablet(s) every day by oral route at bedtime for 30
days., start 09/01/2017
Vaccines: UP TO DATE
Allergies / Adverse Reactions: HOUSE DUST MITE: Itching (Mild to moderate)
Reference
Dunphy, L. M. H., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary Care:
The Art and Science of Advanced Practice Nursing. Philadelphia: F.A. Davis Company.
Unit 6: Assignment: Consultation and Referral
Writing Assignment: Consult: Write up a consult request and include all key elements.
Ms. Perez has been referred to Ms. Wilson FNP-C, APRN, MSN for consultation regarding
eczema unresponsive to treatment in the past six months.
Document the evaluation and recommendations for how Ms. Wilson FNP-C, APRN, MSN
should deal with the consultation request and bill a consultation code.
CONSULTATION FORM:
Patient: MS. PEREZ
DOB: 01/01/1970
Procedure Code: 99213
An established office patient with Eczema ICD-10: L30.9: Dermatitis, unspecified.
CC: “lesions in my neck and forearms.”
Interval History: Patient with known Eczema lesions over the neck and bilateral forearm, which
had been previously treated with Montelukast, Burrow's solution, Colloidal baths, and Benadryl
for the past 6 months. Now states that the lesions are severe and are not responding to treatment.
Patient was referred for a consultation visit.
ROS: Integumentary –Positive for papulovesicular lesions in around the neck and bilateral
anterior and posterior forearm, along with pigmentary changes, and intense pruritus.
Physical Exam: Moderate to severe swelling of the neck, positive to eczema lesion, some of
them infected and oozing. Bilateral forearm skin lesions with severe dryness in surrounding skin.
Some pain over the affected areas, described as 5/10.
Assessment: Chronic eczema with exacerbation, Suspected secondary bacterial infection.
Plan:
1.
2.
3.
4.
5.
Culture and sensitivity of infected lesions.
Start Prednisone 20 mg PO BID x 7 days, because of oozing lesions.
Blood work: CBC, Specific IgE, IgA, IgG, lipid profile.
Consider after blood work results: cyclosporine A or Imuran therapy.
Stop Benadryl and consider starting Sinequan 75mg PO q HS to control severe pruritus
during the night.
6. Continue with Montelukast 10mg PO q HS.
7. If lesions continue, consider skin biopsy.
8. Return visit as needed if no improvement.
Writing Assignment: Referral: Write up a referral request and include all key elements.
As an NP and Ms. Perez primary care provider, you decide to refer her to Dr. Owens a
dermatologist for evaluation and treatment regarding eczema unresponsive to treatment in the
past six months.
1. Document your referral to Dr. Owens
2. Document the evaluation and recommendations for how Dr. Owens should deal with the
referral and bill a referral code.
REFERAL ORDER:
Patient: MS. PEREZ
DOB: 01/01/1970
To: DR. OWENS
1234 SW 56 STREET
MIAMI, FL 33030
Phone: (305) 999-9999
Fax: (305) 999-9990
From: Lola Resario, ARNP
1234 NW 56 STREET
MIAMI, FL 33032
Diagnosis: Eczema ICD-10: L30.9: Dermatitis, unspecified
Order Name: Eczema ICD-10: L30.9: Dermatitis, unspecified; DERMATOLOGY REFERRAL
Schedule Within: STAT
Note to Provider: This patient is being followed regarding eczema unresponsive to treatment in
the past six months. The patient still has severe lesions that do not respond to usual treatment
with Montelukast, Burrow's solution, Colloidal baths, and Benadryl. He is referred for evaluation
to rule out an atopic disease and because of the need of a more aggressive treatment. Attached
are full encounters summaries, please send me copy of your findings and plan within 1 week of
the visit. Thank you.
Urgency: High
Reason for Referral: Evaluation and Management of Eczema
Appointment Date: 02/15/2018
Appointment Time: 10:30 AM
End Date: 05/13/2018
Notes to Patient: Please bring insurance card and photo ID
Prior Authorization #: 01234
Procedure Code: 99242
Start Date: 02/13/2018
Visits Approved: 3
Prior CT, MRI or X-ray Studies? N
Attached Full Encounters Summary.
Height / Weight / BMI / BP Height 5 ft 7 in 01/30/2018 Weight 150 lbs 01/30/2018 BMI 23.5
01/30/2018 Blood Pressure 110 / 75 01/30/2018
Problems:
1. History of asthma - Onset: 06/01/1990
2. Eczema - Onset: 01/30/2018
3. Allergic rhinitis – Onset 02/02/2000
Surgical History: NONE
Medications:
1. Benadryl 25 mg capsule: Take 2 capsule(s) every day by oral route at bedtime for 10
days., start 09/01/2017
2. Burrow's Solution Topical: Apply as a compress for 20-30 min 4-6 times per day over the
lesions., start 09/01/2017
3. Colloidal oatmeal 43 % bath packet: Dissolve 1 packet into the tub or container and soak
affected area for 15 to 30 minutes. Repeat for up to 7 days., start 09/01/2017
4. Montelukast 10 mg tablet: Take 1 tablet(s) every day by oral route at bedtime for 30
days., start 09/01/2017
Vaccines: UP TO DATE
Allergies / Adverse Reactions: HOUSE DUST MITE: Itching (Mild to moderate)
Reference
Dunphy, L. M. H., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary Care:
The Art and Science of Advanced Practice Nursing. Philadelphia: F.A. Davis Company.
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