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PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
All nurse practitioners upon graduation are expected to meet - correct answer ✅NURSE PRACTITIONER ADVANCED PRACTICE CORE CONTENT a set of core competencies Specialty competencies, such as the Psychiatric-Mental Health Nurse Practitioner Competencies, are then built upon these core competencies (NONPF, 2013). Nurse Practitioner Core Competencies are based on "THE Q SLIPP" - correct answer ✅*Technology and Information Literacy *Health Delivery System *Ethics *Quality
- Scientific Foundations *Leadership *Practice Inquiry *Independent Practice *Policy What are the 3) MHNP Leadership Competencies - correct answer ✅Leadership Competencies 1)Participates in and evaluate community/population-focused programs that:
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
promote mental health prevent or reduce risk of mental health problems 2)Advocates for complex client and family medicolegal rights and issues 3)Collaborates with colleagues about advocacy, policy to reduce health disparities and improve outcomes for populations Quality Competencies - correct answer ✅Quality Competencies Evaluates the appropriate uses of seclusion and restraints in the care process Policy Competencies - correct answer ✅Policy Competencies Employs opportunities to influence health policy to reduce the impact of stigma on services for prevention and treatment of mental health problems and psychiatric disorders Independent Practice Competencies - correct answer ✅Independent Practice Competencies
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
Safely prescribes pharmacologic agents Ensures client safety through the appropriate prescription of pharmacologic and nonpharmacologic interventions Explains the risks and benefits of treatment to client and family Identifies the role of PMHNP in risk mitigation strategies in areas of opiate use and substance abuse Seeks consultation Uses self-reflection to improve care Provides consultation to healthcare providers and others to enhance quality and cost Guides the client in evaluating the appropriate use of complementary and alternative treatment Uses individualized outcome measure to evaluate psychiatric care
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
Manages psychiatric emergencies Refers clients appropriately Facilitates the transition of clients across levels of care Uses outcomes to evaluate care Attends to the client-NP relationship as a vehicle for change Maintains a therapeutic relationship over time with individuals and groups Therapeutically concludes the client-NP relationship Demonstrates ability to address sexual and physical abuse, substance abuse, sexuality, and spiritual conflicts Applies therapeutic relationship strategies based on theory and research
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
examination, PMHNP-Life Span, with the American Nurses Credentialing Center (ANCC, 2015). All previous psychiatric-mental health advanced practice certification examinations have been retired as of December 2015 (ANCC, 2015). Proven competence brought an acceptance of the NP role in the healthcare system, with acceptance and recognition of the title and role by consumers and other health professionals. NP programs are accredited by one of two organizations to achieve standardization and control over quality: the Commission on Collegiate Nursing Education (CCNE, 2016) and the Accreditation Commission for Education in Nursing (ACEN, 2016). NPs are recognized providers under many third-party insurance coverage plans (e.g., Medicare, Medicaid, CHAMPUS, federal programs funding school-based clinics, U.S. military, Veterans Administra In ______ year the License, Accreditation, Certification, and Education (LACE) consensus model was finalized and adopted by many nursing organizations. The consensus model identified what four Advanced Practice Registered Nurse roles? - correct answer ✅ 2008 Certified Registered Nurse Anesthetist (CRNA), Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS), and Certified Nurse Practitioner (CNP) Growth of the NP Role - correct answer ✅Growth of the NP Role Facilitating factors for growth
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
*Consumer demand for services *Acceptance of the advanced practice nursing role *Emergence of the PMHNP role *Decreasing stigmatization *Emphasis on integrated healthcare services Constraining factors for growth *Growing competition in job market in general for NPs *Reimbursement struggles with Medicare and private insurance companies *Overlapping scope of practice with other NPs *Increased concerns over reimbursement fraud and abuse (e.g., issues of coding and billing for services) *Scope of practice and need for formal supervisory or collaborative relationships with physicians Regulatory and Statutory Dimensions of the NP Role State legislative statutes & The Nurse Practice Act - correct answer ✅Regulatory and Statutory Dimensions of the NP Role State legislative statutes
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
Regulatory and Statutory Dimensions of the NP Role Statutory law, Licensure, Credentialing, Certification - correct answer ✅Regulatory and Statutory Dimensions of the NP Role Statutory law
- Rules and regulations differ for each state
- May further define scope of practice and practice requirements
- May provide restrictions in practice unique to specific state Licensure
- A process by which an agency of state government grants permission to persons to engage in the practice of that profession
- Also prohibits all others from legally doing protected practice Credentialing
- Process used to protect the public by ensuring a minimum level of professional competence Certification
- A credential that provides title protection
- Determines scope of practice (i.e., whom NPs can see and what NPs can treat)
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
- The process by which a professional organization or association 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
- Assures that the person has acquired the skills necessary to function in a particular specialty
- The American Nurses Credentialing Center (ANCC), which is a subsidiary of the American Nurses Association, is the only certifying body for advanced practice psychiatric nursing. **Certification offered as a Psychiatric-Mental Health Nurse Practitioner-Life Span (ANCC, 2015) Regulatory and Statutory Dimensions of the NP Role Scope of Practice & Standards of Practice - correct answer ✅Regulatory and Statutory Dimensions of the NP Role Scope of practice
- Defines NP roles and actions
- Identifies competencies assumed to be held by all NPs who function in a particular role
- Varies broadly from state to state
- Advanced practice PMHNP standards are identified in Psychiatric-Mental Health Nursing: Scope and Standards of Practice (ANA, 2014).
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
- Pertains to verbal and written client information
- Requires that the provider discuss confidentiality issues with clients, establish consent, and clarify any questions about disclosure of information
- Requires that provider obtain a signed medical authorization and consent form to release medical records and information when requested by the client or another healthcare provider PROFESSIONAL ROLE RESPONSIBILITIES HIPAA - correct answer ✅PROFESSIONAL ROLE RESPONSIBILITIES HIPAA
- The first national comprehensive privacy protection act
- Guarantees clients four fundamental rights:
- To be educated about HIPAA privacy protection,
- To have access to their own medical records,
- To request amendment of their health information to which they object, and
- To require their permission for disclosure of their personal information. PROFESSIONAL ROLE RESPONSIBILITIES The Health Information Technology for Economic and Clinical Health Act (HITECH)
- correct answer ✅PROFESSIONAL ROLE RESPONSIBILITIES
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 (Health Resources and Services Administration [HRSA], 2013)
- Incentive payments for sharing specific electronic health record (EHR) data
- Meaningful use incentives
- Electronic health records can improve both individual and population-based health outcomes (Friedman, Parrish, & Ross, 2013).
- Electronic health records can improve quality, safety, efficiency, effectiveness, and outcomes (U.S. DHHS, Office for Civil Rights, 2013).
- E-prescribing
- Computerized physician order sets
- Tracking care and avoiding duplication of services PROFESSIONAL ROLE RESPONSIBILITIES Telehealth - correct answer ✅PROFESSIONAL ROLE RESPONSIBILITIES Telehealth
- The use of telephone or videoconferencing tools to deliver mental health care to clients who reside in rural areas or who may otherwise not be able to access care
- Must follow the same standards as care delivered in person
- Must be practiced in accordance with international, federal, and state regulatory agency standards
PSYCHIATRIC-MENTAL HEALTH NURSE
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Informed consent
- The communication process between the provider and the client that results in the client's acceptance or rejection of the proposed treatment
- An explanation of relevant information that enables the client to make an appropriate and informed decision
- The right of all competent adults or emancipated minors ** Emancipated minors: Persons younger than 18 years old who are married, parents, or self-sufficiently living away from the family domicile
- Elements of informed consent ** Nature and purpose of proposed treatment or procedure ** Risks or discomforts and benefits of treatment ** Risks and benefits of not undergoing treatment ** Alternative procedures or treatments ** Diagnosis and prognosis
- Provider must document in the medical record that informed consent has been
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
obtained from the client.
- PMHNP is responsible for ensuring that the client is cognitively capable of giving informed consent. PROFESSIONAL ROLE RESPONSIBILITIES Ethics - correct answer ✅PROFESSIONAL ROLE RESPONSIBILITIES Ethics
- Important aspect of the NP role that deals with moral duties, obligations, and responsibilities
- What is right versus what is wrong
- Ethical principles that provide foundation and direction for complex decisions: ** 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
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
- The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both PROFESSIONAL ROLE RESPONSIBILITIES Ethics 2 - correct answer ✅PROFESSIONAL ROLE RESPONSIBILITIES Ethics 2 Important ethical principles in psychiatry
- Clients must be involved in decision-making to the full extent of their capacity (mutual decision-making).
- Clients have a right to treatment in the least restrictive setting.
- Clients have a right to refuse treatment unless a legal process resulting in a mandatory court order for treatment has been obtained. Ethical dilemma
- Occurs in a situation in which there are two or more justifiable alternatives
- Occurs when the choice is made to promote good
- Which option sacrifices the fewest high-priority values (a harm reduction approach)?
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER ROLE, SCOPE OF
PRACTICE, AND REGULATORY
PROCESS exam review 2025
Theoretical approaches to ethical decision-making
- Deontological Theory: An action is judged as good or bad based on the act itself regardless of the consequences.
- Teleological Theory: An action is judged as good or bad based on the consequence or outcome.
- Virtue Ethics: Actions are chosen based on the moral virtues (e.g., honesty, courage, compassion, wisdom, gratitude, self-respect) or the character of the person making the decision. Ethics of Disclosure by Providers - correct answer ✅Ethics of Disclosure by Providers
- Clients have a right to know what is happening during the course of their treatment.
- Providers have an ethical responsibility to disclose medical errors, accidents, injuries, and negative results to clients.
- As a result of the disclosure, a client may have legal right to compensation for harm suffered due to medical misadventures (Sadock, Sadock, & Ruiz, 2015). Risk vs. Benefits of Disclosure of Disability Regarding Employment - correct answer ✅Risk vs. Benefits of Disclosure of Disability Regarding Employment
