PMHNP ANCC IQ DOMAIN 5 EXAM QUESTIONS AND ANSWERS VERIFED FOR ACCURACY

Americans with Disabilities Act of 1990 -prevents employers from discriminating against individuals with mental health disorders in employment decisions -Reasonable accomodations need to be made for that individual Best Example for Continuous Quality Improvement One that directly serves the needs (peer review process of charts with another provider) A patient asks to refill for nonpsychiatric med, what do you do? State that your certification is for psychiatric care only and refer him back to his GP Requesting admitting priviliges at a local hospital Persuade the appropriate hospital decision maker, through facts, figures, presentation of projected benefits to the hospital and of the need to change policy to allow NP privileges Psychotherapy notes as defined by HIPAA; refers to what? Notes recorded in any medium by a mental health professional documenting or analyzing the contents of conversation during a private session- HIPAA does requires SEPARATE authorization from patient to release or even provide some info about these notes Advocating Includes advocating for things to reduce barriers to health such as safe and inexpensive housing What research design is best used to compare treatments? Randomized control trials- where patients are randomly allocated to control treatment groups Competent elderly with signs of abuse refusing to consent for the provider to report abuse suspicions Do not report. Respect patient's decisions if the patient is competent. State mandates vary on elder and domestic abuse statutes Veracity or Truthfulness Includes giving patients information about health needs to facilitate autonomous decision making IRBs (institutional review boards) Ensure informed consent is obtained and documented Ensure adverse events are reported and benefits/risk evaluated Ensure risks to participants are minimized Scope and Standards 5A PMHNP provides leadership in coordination of care for patients using interdisciplinary approach to care delivery Best solution for practitioners who cant afford EHR Process notes and patient records in secure electronic system with a template for patient information and interactions, supporting quick access within your network Rural hospitals receive financial help for EHRs Incentives are provided for having EHRs Incident Reports Part of organizational reporting mechanism for RISK MANAGEMENT, not included in medical record What is included in the medical record? Format: 1. Reason for encounter and relevant hx 2. Physical exam findings and prior dx tests 3. Assessment, clinical impression or dx 4. Plan of care 5. Legible identity of provider Additionally if not already documented: Reason for diagnostic and ancillary services ordered Past and present dx should be accessible to treating and/or consulting provider Health risks identified Response to tx and changes in tx Revision of dx What should the progress note reflect? The type of services and dx codes reflected on the billing statement CPT codes for service provided ICD 10 and or DSM V Codes Social Justice Bringing care or access to those who have the least means of getting care but need the care the most HIPAA 1996 Federal law intended to protect employed Americans by decreasing the chance of losing existing health insurance coverage, facilitating purchase of individual or family health insurance coverage if coverage is lost from an employer's plan or no other health insurance is available Preceptor’s Responsibility Gaining permission from the patient for the student to perform evaluation and to ensure quality of evaluation; preceptor uses judgment if task is appropriate based on student's capability Phone Interactions with Patients Must be documented fully at all times LACE Consensus Model for APRNS 2015 PMHNP FAMILY POPULATION AARP 2009 Pamphlet Identified nurses as "paraprofessionals" trained to assist professionals Preceptor Role Contracted defined role with goals. Teaching is completed through: Observed performance Examples Role Modeling When is chaste hug allowed? The pt and Np know each other well Not psychiatrically inapproptiate The patient agrees Confidence Intervals Reflect a range of values where one can be confident that the true value is situated wider confidence interval Usually based on smaller sample sizes Fewer number of outcome events Less precision in estimate of effect Collaborating Providers Not held legally responsible in legal lawsuits It is the NPs sole liability The Stark Law states that Providers can't refer patients to practitioners with whom they have a financial relationship. Or any family member Federal Law 42 CFR separate release of information for chemical dependcy Who governs the state’s APRN legislation The state governs what APRNs can do in that state The state's HHS dept will have documentation on laws defining what the law means and how laws are interpreted Muslims Same gender provider Males need to be present with wife during treatment Avoid: Shellfish All cloven-hoofed animals and its products (e.g. gelatin) except camels All fanged predatory animals Blood products Alcohol and alcohol-based vanilla Universal Bill of Rights for Mental Health Patients (Mental Health Systems Act of 1980) 1. Right to be given reasonable explanation explanation of general mental and physical condition, objectives of treatment, possible adverse effects of recommended treatment 2. The right to freedom from restraint or seclusion, other than as mode of tx during an emergency situation. Treatment in the least restrictive environment 3. Right to ongoing participation in planning of mental health services in a manner appropriate to capabilities Factors Increasing Validity of Research Randomization Outcome measure Sample size Confounder variable Variable that disrupts a causal relationship; distorts the true relationship of interest by virtue if also being related to the outcome of interest Often unequally distributed among groups being compared