ANCC PMHNP Role and Scope of practice exam questions and answers

State Legislative Statutes: What do they do? (law created by the state) -They are the Nurse Practice Act -Provides Title protection, -Grants legal authority; -Define Scope of Practice , -Defines advanced practice, -Puts restrictions on practice, -Sets credentialing requirements, -Sets grounds for disciplinary actions, -May require a Collaborative agreement Statutory Law (written law created by legislative body) -rules and regulations differ per state -may further define scope of practice requirements -may provide restrictions unique to each state Licensure The state grants permission to practice Credentialing ensuring minimum level of competence Certification -Is a credential that provides title protection, -Determine scope of practice -Process as to how ANCC certifies that NP has met specified standards; -Assures mastery and skills; -ANA is the only certifying body for psych nursing Scope of Practice -Define NP roles and actions -Identify competencies Standard of Practice -Provides a way to judge the nature of care -Reflex the expectation for the care -May include precise protocols or general guidelines What is HIPAA? -Privacy Protection Act -Garante 4 rights: 1. To be educated about privacy 2. Have access to their own med. record 3. Request amendments to their med record to which they object 4. Permission to disclose their records What is Health Information Technology for Economic And Clinical Health Act (HITECH)? -Provide intensive payment for sharing electronic medical record (EHR) data -Meaningful use incentive Exceptions to guaranteed confidentiality -The need for information outweigh confidentiality -Intent to harm self or others, -attorney involved in litigation -records released to insurance companies, -answering court orders, subpoenas, or summons -mandatory reporting of diseases, -Child or elder abuse -duty to warn potential victims (Tarasoff principle, 1976) Informed Consent -Communication between the patient and provider that results in patient accepting or rejecting the proposed treatment. -Explanation of relevant information that enables the client to make an informed decision. -Right of all adults and emancipated minors (person <18 who is married or live independently of parents) Elements of Informed Consent Nature and purpose of treatment Risks / Benefits of doing treatment Risks / Benefits of not doing it Alternatives treatments Diagnosis and prognosis Theoretical Approaches to Ethical Decision Making include the following theory: Deontological Theory Teleological Theory Virtue Ethics Deontological Theory Action is good or bad based on the act itself, regardless of the concsequences Theological Theory Action good or bad based on consequences or outcomes Virtue Ethics Action is chosen based on moral virtures (honesty, courage, compassion, wisdome...) or the character of the person making the decision Justice Doing what is fair, fairness in all aspects of care Beneficence Promoting well-being and doing good. Nonmaleficence Doing no harm Fidelity Being true and loyal Autonomy Doing for self Veracity Telling the truth Respect Treating everyone with equal respect What are the 4 Elements of Negligence to Prove Malpractice 1. Duty: to provide reasonable care 2.Breach of Duty: violation of standards 3. Proximate Cause: relationship between the breach of standard and patient's injuries 4. Damages: permanent and substantial What is Reflective Practice? -A model to systemically "make sense of practice" -Process to tell a story to gain insight into practice -Enhance critical thinking and problem-solve Primary Prevention -Decrease incidence or onset (# of new cases) -Help pts avoid deseases, stressors, or cope better -Ex: stress mgmt. classes, smoking prevention classes, immunizations Secondary Prevention -Decrease prevalence (# of existing cases) -Early case-finding, -Screening, (pop smear, BP) -Fast/effective treatment -Ex: hotlines, crisis intervention, disaster response, Tertiary Prevention -Decrease disability and severity -Rehab, avoid complications -Ex: day tx, case mgmt. for needs, social skills training Types of Risk factors predisposing a person to develop a disorder -Biological -Psychological: -Social Biological Risk factors Hx of mental illness, poor nutrition, poor general health Psychological Risk factors Poor self-concept, external locus of control, poor ego defenses Social Risk Factors stressful occupation, low socioeconomic class, poor level of social integration Types of Preventative factors (Oposite of risk factors) -Biological -Psychological -Social ADVANCE DIRECTIVES Include: -Living Will -Durable POA for Health Care -Verries from state to state Living Will Client makes the will when while competent to be used if becomes incompetent Durable POA = Health Care Proxy -Designates agent to act for pt if pt can no longer make health decisions -Not limited to terminal illness; includes financial during illness -It is part of relapse planning for chronic psych pts Culture-bound Syndromes -Behaviors related to pts. culture and not linked to a psych disorders -Disorders found only in particular cultures RESEARCH include: Evidence-based Practice Research Utilization What does Evidence Based Practice Include? Best evidence clinical expertise pt values/needs Research Utilization -Subset of evidence-based practice 1. Critique research 2. Synthesize the findings 3. Apply the findings 4. Measure the outcomes What is the mnemonic used for Developing Clinical Question? -PICO -P: Pt, population of patients, problem -I: Intervention (Independent variable) -C: Comparison (to another tx, therapy, placebo) -O: Outcome (dependent variable) What does PICO do? -Develop a clinical question -Critique the research evidence -Make evidence-based decision regarding implementation and evaluation of change