22 Soap notes rubric and sample attached

butterflyl
TyphonSoapNoteRubric.docx

Florida National University

PMHNP PGC

Typhon Soap Note Rubric

Criterion

Description

Present

Not Present

Subjective

Client identifying information.

5 points

age, marital status, general appearance, reliability, ethnicity (state at end of scenario, in case formulation).  

Chief Complaint

5 points

“in patient’s own words” reason for visit-restate in case formulation.  

e.g. R presents in this initial outpatient appointment alone, for evaluation and management of:

(insomnia).

History of Present Illness

5 points

(Why present now/precipitants/stressors? When it started? How long it lasts/frequency? What is it like? Impact on life)

Neurovegetative Symptoms:

Sleep

Appetite and weight

Energy

Concentration

Anhedonia

Mood

Diurnal variation of mood

SI/HI

Anxiety-all disorders

Mania

Psychosis

Sexual interest/performance

Must include chronological timeline of development of current problem, what they have tried to help the problem,

assessment of strengths and usual coping strategies. Include any medications tried with responses.

Risk assessment: suicide/violence

5 points

Ask about any homicidal ideation – and first experience of suicidal ideation, and any history of attempts. Assess if ever had feelings of hopelessness

Psychiatric History

5 points

Ask at what age first saw a counselor or psychiatrist. 

Ask about first time taking psychotropic medications, and obtain chronological history with medications, duration and response – helpful or side effects, with reason for discontinuation. 

Substance Use History

5 points

This section contains any history or current use of caffeine, nicotine, illicit substance (including marijuana), and alcohol. Include the daily amount of use and last known use. Include type of use such as inhales, snorts, IV, etc. Include any histories of withdrawal complications from tremors, Delirium Tremens, or seizures.

For reporting

substance use, include age of first use, date of last use, frequency, amount and method.

of use

Past Medical History:

5 points

Does patient obtain primary care?

Date/name of provider and last visit. 

List any chronic illness.

with date of dx and treatment regimen.

Allergies.

Current medications.

Family History:

5 points

Inquire about family history of any psychiatric problems – depression, anxiety, substance use disorders, psychiatric hospitalizations, suicide attempts. 

Prompt to inquire about parents, grandparents, aunts or uncles, siblings and their children if applicable. 

Personal History

5 points

Place of birth:

As a child: (family structure, parents’ occupations, relationship with parents, siblings, friends, abuse)

As a teen: (friends, relationships, school, activities, sex, trouble, relationship with parents)

As an adult: (work, finances, education, relationships, family, goals for future, trends in functioning)

Psychosocial

5 points

History: Inquire about religion/spiritual beliefs, sexuality, living situation, education, employment.

history of incarceration, current support systems, hobbies, activities of interest, talents

Education

5 points

No formal education

 Elementary school completed.

Some high school-did not graduate.

High school graduate

College graduate

Employment:

5 points

Unemployed

Employed

on Disability

Developmental

5 points

History: Inquire about mother’s pregnancy and delivery, childhood with attainment of milestones, any learning disabilities or academic problems. 

Psychiatric Review of Systems:

5 points

Has patient ever experienced depression, anxiety, mania, ADHD, OCD, eating disorder, psychosis, trauma, personality disorder ?

Medical Review of Systems: especially history of seizure or head trauma  

Objective

Mental Status Examination:

5 Points

Appearance 

Behavior 

Speech 

Mood(inquired)

Affect (observed)

Thought process (observed)

Thought content (inquired)

 Cognition (inquired – include memory/ recall)

 Insight/Judgment (Some areas are observed, and some are inquired – describe all areas observed in Case Formulation)

Assets/strengths

Liabilities

Do full MMSE if memory concerns or over age 65 (score 1-30)

Assessment

Impression formulation

5 Points

e.g. The patient is a 36-year-old Caucasian male with a long history of depression and attention deficits. Hyperactivity criteria are essentially absent. Although medications have been somewhat efficacious, he has residual symptoms that are quite troublesome

Diagnosis

10 Points

Diagnoses

Medical diagnoses

Differential diagnoses: (generally is the medical causes of the symptoms, such as hypothyroidism or brain tumor, for example)

Rule out diagnoses: (generally refers to DSM 5 diagnoses that you suspect and will continue to evaluate for; e.g. if someone has MDD, then one R/O is Bipolar II Disorder, Most Recent Episode Depressed)

DSM-5 criteria: (what criteria are met, what criteria are not met at this time; how arrived at decision re the diagnosis)

Plan

Plan

10 Points

Labs/ Diagnostic Tests/ Screening Tools

Medications

Dosage & directions

Why this med?

Neurochemistry & MOA

Side effects

Expected benefits

Contraindications

Black Box Warnings

Therapy prescription

Type(s), duration, etc

Why this therapy?

Expected benefits

Therapy goals

Teaching plan

Safety plan

Diet and exercise

Sleep

Stress management/set goals/ homework

Health promotion

Relationship issues

Resources (bibliotherapy, websites, etc)Teach about meds, side effects, caution

Other

Referrals and consultations

PCP for physical exam or other follow up for symptoms

Psychoneurological assessment (eg. child with learning disorder)

Outpatient substance abuse treatment, etc

Inpatient hospitalization

Follow up

Time frame for next appointment based on assessment, safety