Ch 2 Psychiatric Mental Health Nurse Practitioner Role, Scope of Practice, and Regulatory Process Questions And Answers Rated A+ Assured Satisfaction.

Who established psychiatric nursing? - correct answer June Mellow and Hildegard Peplau What are nurse practitioner core competencies? - correct answer Scientific foundations, leadership, quality, practice inquiry, technology and information literacy, policy, health delivery system, ethics, and independent practice. Who introduced the NP role and when? - correct answer Loretta C. Ford EdD and Henry K Silver MD at U of Colorado in 1965 What are the 4 NP roles? - correct answer rCRNA, CNM, CNS, CNP What are state legislative statutes? - correct answer They grant legal authority for NP practice. There is a Nurse Practice Act (statutory law) for every state which: provides title protection, defines advanced practice, defines scope of practice, places restrictions, sets credentialing requirements, states grounds for disciplinary action, and can require a collaborative agreement between an NP and a physician. What is licensure? - correct answer A process by which an agency of state government grants permission to persons to engage in the practice of that profession. It also prohibits all others from legally doing protected practice. What is credentialing? - correct answer A process used to protect the public by ensuring minimum level of professional competence. What is certification? - correct answer A credential that provides title protection and determines scope of practice. It is the process by which a professional organization or association (ANCC for PMHNPs) certifies that a person licensed to practice as a professional has met certain predetermined standards specified by that profession for specialty practice, assures the public that a person has mastery of a specified body of knowledge, and assures that the person has acquired the skills necessary to function in a particular specialty. What is scope of practice? - correct answerVaries broadly from state to state- defines NP ROLES and ACTIONS and identifies competencies assumed to be held by all NPs who function in a particular role. What are standards of practice? - correct answerAuthoritative statements regarding the quality and type of practice that should be provided, they reflect professional agreement focused on the minimum levels of acceptable performance. They can be precise protocols or more general guidelines that recommend actions. They can be used to legally describe the standard of care that must be met by a provider. What are NP professional role responsibilities? - correct answerConfidentiality, HIPAA, Health Information Technology for Economic and Clinical Health Act (HITECH), Telehealth, Exceptions to guaranteed confidentiality, Informed consent, and Ethics. What is confidentiality? - correct answerClient can assume that information given to the HCP will not be disclosed. Protected un the Medical Record Confidentiality Act. Requires that signed medication authorization and consent to release medical records when requested by the client or another HCP. What is HIPAA? - correct answerThe first national comprehensive privacy protection act which guarantees: 1- to be educated about HIPAA 2- access to their own medical records 3- request amendment of their health information if they object 4- require permission for disclosure of their personal information. What is HITECH? - correct answerHealth Information Technology for Economic and Clinical Health Act. Provides incentive payments for sharing specified EHR data. Meant to improve individual and population based health outcomes. Using EHR can improve quality, safety, efficiency, effectiveness, and outcomes. What is telehealth? - correct answerUse of telephone or video tools to deliver mental health care to rural areas or those who may not be able to access care. The same standards as care delivered in person and must assure that HIPAA is followed. When are there exceptions to guaranteed confidentiality? - correct answerWhen the need for information outweighs the principle of confidentiality- -intent to harm self or others -information given to attorneys in litigation -releasing records to insurance companies -court orders or subpoenas -state mandatory reporting for diseases or conditions -Tarasoff principal (warn potential victim of imminent danger or homicidal clients) -child or elder abuse What is informed consent? - correct answerCommunication between client and provider / explanation that enables the client to accept or reject treatment, making an appropriate and informed decision. It is a right of all competent adults and emancipated minors (under 18 married, parents, self sufficient away from family domicile). It must be documented and the PMHNP is responsible for ensuring that the client is cognitively capable. What does informed consent include? - correct answer-The nature and purpose of proposed treatment or procedure -Risks or discomforts and benefits of treatment -Risks and benefits of not undergoing treatment -Alternative procedure or treatments -Diagnosis and prognosis What is ethics? - correct answerPart of the NP role that deals with moral duties, obligations, and responsibilities- what is right vs what is wrong. What are the ETHICAL PRINCIPLES that provide foundation and direction for complex decisions? - correct answer-JUSTICE: doing what is fair, fairness in all aspects of care -BENEFICENCE: promoting well-being and doing good -NONMALEFICENCE: doing no harm -FIDELITY: being loyal and true -AUTONOMY: doing for self -VERACITY: telling the truth -RESPECT: treating everyone with equal respect What is the ANA's Code of Ethics for Nurses with Interpretive Statements? - correct answerA statement that lists 9 provisions of ethical nurse behavior. What are some ethical principles specific to psychiatry? - correct answer-Clients involved in decision making to their full capacity -Client right to treatment in the least restrictive setting -Client right to refuse treatment unless a mandatory court order. What are the theoretical approaches to ethical decision making? - correct answer- DEONTOLOGICAL Theory: action judged as good or bad based on the act itself and not its consequences -TELEOLOGICAL Theory: action judged as good or bad based on consequence or outcome -VIRTUE ETHICS: actions chosen based on moral virtues (honesty, courage, compassion, wisdom, gratitude, self respect) or the character of the person making the decision. What are some considerations re: Disclosure of Disability regarding Employment? - correct answerEmployees are protected by the American Disabilities Act (ADA) to prevent discrimination by employers with 15 or more employees. There are risks and benefits to disclosure. What are ethics of disclosure? - correct answerClient has a right to now when the NP has made a mistake and may pursue compensation. What is malpractice insurance? - correct answerIt provides financial protection against malpractice claims- recommended for all NPs, coverage for negligent acts, doesn't protect NPs practicing outside their scope. What are the 4 elements of negligence to prove malpractice? - correct answer1. Duty: NP had a duty to exercise reasonable care 2. Breach of duty: NP violated the standard of care in treating the client's condition 3. Proximate cause: there is a causal relationship between breach of care and the client's injuries 4. Damages: client experiences permanent and substantial damages as a result of the breach in standard of care. What is COMPETENCY? - correct answerA LEGAL concept (not medical) which is a determination that the client can make reasonable judgements and decisions regarding treatment. A person is considered competent UNTIL A COURT RULES THE PERSON INCOMPETENT. If incompetent, the court appoints a guardian to make health related decisions for that person. What is a COMMITMENT? - correct answerThe process of forcing a person to receive involuntary evaluation and treatment, which differs from state to state. What are the 4 basic criteria for being "committed"? - correct answer1- person has a diagnosed psychiatric disorder 2- person is harmful to self or others as a consequence of the disorder 3- person is unaware or unwilling to accept the nature and severity of the disorder 4- treatment is likely to improve functioning What is "involuntary admission"? - correct answerAdmission to a hospital or treatment facility against a person's will, they maintain all civil liberties except the ability to come and go as they please. Time allowed for involuntary admission varies from state to state. What a "voluntary admission"? - correct answerAdmission to a hospital or treatment facility that a person agrees to or desires, maintains all civil liberties, they consent to potential confinement within the structure of the hospital setting. What are the roles of a PMHNP? - correct answer-Scholarly activities -Mentoring -Client advocacy -ANA, APNA, ISPN -Health policy -Case management: overall goal is to promote quality, cost-effective outcomes -Risk assessment: continuous monitoring for high-risk situations -Risk management: appropriate interventions, reduce subsequent claims against healthcare providers -Advance directives -Durable power of attorney for health care / healthcare proxy- designates an agent to act on behalf of a person should he or she become unable to make healthcare decisions, legally binding in all 50 states -Living will- document prepared while client is mentally competent to designate preferences for care if a client becomes incompetent or terminally ill, not legally binding in all states What is culturally competent care? - correct answerTreating clients from diverse cultures, viewing each client as a unique person, and noting a potential relationship between clients' cultural experiences and their symptom presentation and perceptions. More comprehensive health care can be provided.