ANCC PMHNP EXAM CHPT 4 QUESTIONS AND ANSWERS

The nurse practitioner is educated to lead interdisciplinary treatment teams - ANS The nurse practitioner is educated to lead interdisciplinary treatment teams * Acts as full partner in health care * Designs, implements, evaluates, and advocates to redesign the U.S. healthcare system * Translates research into practice Team leadership model - ANS Team leadership model Decision 1: Should the leader monitor the team or take action? * Seek out information to understand the team * Analyze information * Interpret the information and decide how to act Decision 2: Should the leader intervene to meet the task or relational need? * Performance functions * Task functions Decision 3: Should the leader intervene internally or externally? Assess for conflicts between group members—action to maintain group performance * Assess for unclear goals * Assess for proper support (Northouse, 2007, pp. 209-234) Reflective Practice - ANS Reflective Practice * Reflection uses a model or framework to systematically "make sense of experience" (Sherwood & Horton-Deutsch, 2012, p. 4). * Process to tell a story about self and others to gain insight into practice * Enhances critical thinking to problem-solve and enhance clinical reasoning and decision-making * Link theory to practice Conflict Resolution, Negotiation, Mediation, and Professional Civility - ANS Conflict Resolution, Negotiation, Mediation, and Professional Civility * Conflict: occurs when a person believes his or her needs, interests, or values are incompatible with others' * Conflict resolution: directed by a neutral third party who facilitates a "win-win" situation * Negotiation: discussion among two or more people with the goal of reaching an agreement * Mediation: voluntary and confidential process in which a third party facilitates discussion to reach an agreement * Arbitration: process in which a third party reviews evidence from both sides and makes a decision to settle the case * Professional civility: behavior that shows respect toward another person Critical Thinking - ANS Critical Thinking * Defined as the acquisition of knowledge with an attitude of deliberate inquiry * Making clinical decisions based on evidence-based practice ** Decreases the difficulty of choosing from conflicting or multiple recommendations when diagnosing and treating clients * Develops self-awareness though a metacognitive process to gain new insights about self, and in relation to others Research utilization - ANS Research utilization: Process of synthesizing, disseminating, and using research-generated knowledge to make a change in practices; a subset of the broader evidence based practice Evidence-based practice: - ANS Evidence-based practice: The integration of best research evidence with clinical expertise and client values and needs. PMHNPs need to know the effectiveness of evidence-based interventions and select the intervention to meet the client need (Perese, 2012, p. 29). Research utilization and evidence-based practice are two models for reducing the gap between research findings and application to practice - ANS Research utilization and evidence-based practice are two models for reducing the gap between research findings and application to practice Research utilization process * Critique research * Synthesize the findings * Apply the findings * Measure the outcomes PICO - ANS Develop a clinical question using the PICO method P = patient, population of patients, problem I = intervention C = comparison (another treatment or therapy, placebo) O = outcome Systematically search for relevant research evidence - ANS Systematically search for relevant research evidence * Critique the research evidence Quanitative hierarchy (Fineout-Overholt, Melnyk, & Schultz, 2005) 1. Randomized controlled trials (RCT), meta-analysis, or systematic review 2. Evidence-based guidelines based on systematic review 3. Evidence from RCT without randomization 4. Evidence from systemic review of descriptive and qualitative studies 5. Evidence from expert opinion or committee reports * Qualtitative hierarchy (Fineout-Overholt, Melnyk, & Schultz, 2005) 1. Evidence from systematic reviews of descriptive and qualitative studies 2. Evidence from a single descriptive or qualitative study 3. Evidence from expert opinion or committee 4. Evidence-based guideline based on systematic review of RCTs 5. Evidence from well-designed controlled trials without randomization 6. Systematic reviews or meta-analysis 7. Evidence from at least one well-designed RCT Make an evidence-based decision regarding implementation Implement the change, depending on the above decision Evaluate the change Dissemination - ANS Dissemination * Present at local, regional, and national conferences * Publish in peer-reviewed journals * Publish in professional newsletters (Melnyk, Fineout-Overholt, Stillwell, & Williamson, 2010) Internal validity - ANS The independent variable (the treatment) caused a change in the dependent variable (the outcome) External validity - ANS The sample is representative of the population and the results can be generalized Descriptive statistics - ANS Used to describe the basic features of the data in the study; numerical values that summarize, organize, and describe observations; can be generated by either quantitative or qualitative studies