Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
96 Cards in this Set
- Front
- Back
|
What two psychiatric nurses developed an established, recognized, subspeciality of nursing?
|
June Mellow and Hildegard Peplau in the 1950s
|
|
|
What does the emergence of the PMHNP roles reflect?
|
1. Growth of Adv. Practice
2. Acceptance of brain-based etiology 3. Awareness of holistic care care that does not separate mind and body |
|
|
What are the components of a psychiatric Assessment?
|
1. Physical and mental health assessment
2. Psychiatric eval including: a. Mental status evaluation b. Differentiating normal and abnormal symptomalogy c. family system assessment |
|
|
Professional Role of PMHNP?
|
1. Interdisciplinary collaboration
2. Consultation 3. Coordination of referrals 4. Participate in professional organizations 5. Research involvement and utilization 6. Use of ethical/legal standards |
|
|
How does the PMHNP manage and negotiate health care delivery systems?
|
1. Using ethical principles to advocate for clients
2. Participating in health policy |
|
|
How does the PMHNP monitor and ensure the quality of health care practice?
|
1. Consulting with others to improve quality of care.
2. Engaging in continuing education 3. Staying current with research |
|
|
When was the NP role introduced and by who?
|
1965 by Dr. Loretta Ford and Henry Silver, MD at University of Colorado
|
|
|
Who grants legal authority for NP practice and scope of practice?
|
State Legislative Statutes
|
|
|
What is a collaborative agreement?
|
Describes what types of drugs might be prescribed and defines some form of oversight board for NP practice
|
|
|
What might state legislative statues specifically require?
|
That an NP develop a collaborative agreement with a physician
|
|
|
Statutory Law?
|
1. Rules and regulations differ for each state.
2. May further define scope of practice and practice requirements 3. May provide restrictions in practice unique to specific state. |
|
|
What is a licensure?
|
A process by which an agency of state government grants permission to indivuduals accountable for the practice of a profession to engage in the practice of that profession
|
|
|
What prohibits all others from legally doing protected practice?
|
Licensure
|
|
|
What is credentialing?
|
Process used to protect the public by ensuring a minimum level of professional competence
|
|
|
What does certification determine?
|
The scope of practice (who NPs can see and what NPs can treat).
|
|
|
What does certification assure?
|
1. The public that an individual has mastery of the body of knowledge
2. That the individual has acquired the skills necessary to function in a particular specialty |
|
|
What is the primary certifying body for psychiatric nursing?
|
The American Nurses Association
|
|
|
What does the Scope of Practice define?
|
NP roles and actions
|
|
|
Where are advanced practice PMHNP standards identified?
|
Scope and Standards of Psychiatric-Mental Health Clinical Nursing Practice (ANA, 2000b).
|
|
|
Standards of Practice give authoritative statements regarding?
|
The quality and type of practice that should be provided
|
|
|
Standards of Practice reflects the...
|
1. Expectations for the care that should be provided to clients with various illnesses
2. Professional agreement focused on the minimum levels of acceptable performance |
|
|
How can the Standards of Practice be used legally?
|
To describe the standard of care that must be met by a provider
|
|
|
What is patient confidentiality protected by?
|
Federal statute through the Medical Record Confidentiality Act of 1996
|
|
|
What does HIPPA stand for?
|
Health Insurance Portability and Accountability Act
|
|
|
What is HIPPA?
|
1st national comprehensive privacy protection act
|
|
|
What 4 fundamental rights does HIPPA guarantee?
|
1. To be educated about HIPPA
2. Have access to their own medical records 3. Request amendment to aspects of their health info to which they object 4. Require their permission for disclosure of their personal information |
|
|
What is the exception to guaranteed confidentiality?
|
When appropriate individuals or organiaations determine that the need for information outweighs the principle of confidentiality
|
|
|
What are some examples of legally not maintaing confidentiality?
|
1. Reveals intent to harm self or others
2. To attorneys involved in litigation 3. Records released to insurance companies 4. When answering court orders, subpoenas, or summons 5. When meeting state requirements for mandatory reporting of disease 6. Cases of child abuse |
|
|
What principle is an exception to confidentiality?
|
Tarasoff principle (1976): duty to warn potential victim of imminent danger of homicidal clients
|
|
|
Informed consent is the right of all competent....
|
Adults or emancipated minors
|
|
|
What are emancipated minors?
|
Individuals ages 18 or younger who are married, parents, or self-sufficiently living away from the family domicile
|
|
|
What are the elements of Informed Consent?
|
1. Nature and purpose of treatment
2. Risk or discomforts and benefits of treatment and of not undergoing treatment 3. Alternative procedures or treatments 4. Diagnosis and prognosis |
|
|
Documentation of informed consent?
|
Providers must document in medical records that informed consent has been provided to client.
|
|
|
The PMHNP is responsible for ensuring that the client....
|
is cognitively capable of giving informed consent
|
|
|
What are ethics?
|
What is right vs what is wrong
Deals with moral duties, obligations, and responsibilities |
|
|
Principles of Ethics?
|
Justice
Beneficence Nonmalfeasance Fidelity Autonomy Veracity Respect |
|
|
What is justice?
|
doing what is fair; fairness in all aspects of care
|
|
|
What is beneficence?
|
promoting well-being and doing good
|
|
|
What is nonmalfeasance?
|
doing no harm
|
|
|
What is fidelity?
|
being true and loyal
|
|
|
What is autonomy?
|
doing for self
|
|
|
What is veracity?
|
telling the truth
|
|
|
What is respect?
|
treating everyone with equal respect
|
|
|
The Code of Ethics for Nurses, 2005 provides guidelines related to delivering care that preserves client's....
|
1. Dignity
2. Autonomy 3. Rights 4. Confidentiality |
|
|
What are some important ethical principles in psychiatry?
|
1. Clients must be involved in decision making
2. Clients have right to treatment in least restrictive setting 3. Right to refuse treatment unless it is court ordered |
|
|
What is the Deontological Theory?
|
An action is judged as good or bad based on the act itself regardless of consequences
|
|
|
What is the Teleological Theory?
|
An action is judged as good or bad based on the consequences or outcome
|
|
|
What is Virtue Ethics?
|
Actions are chosen based on the moral virtues (honesty, courage, compassion, wisdom, gratitude, self-respect) or the character of the person making the decision
|
|
|
What does malpractice Insurance provide insurance for?
|
1. Negligent professional acts
2. Coverage for highly technical or professional skills required by health professionals including NPs |
|
|
What are the 4 elements of negligence that must be established to prove malpractice?
|
1. Duty
2. Breach of duty 3. Proximate cause 4. Damages |
|
|
What is duty?
|
the NP has a duty to exercise reasonable care when undertaking and providing treatment to the client
|
|
|
What is breach of duty?
|
when the NP violated the applicable standard of care in treating the client's condition
|
|
|
What is proximate cause?
|
when there is a casual relationship between the breach in the standard of care and the client's injuries
|
|
|
What are damages?
|
damages to the client as a result of the breach in standards of care
|
|
|
What is competency?
|
A legal and not a medical concept
|
|
|
With an involuntary commitment a patient maintains all civil liberties except...?
|
the ability to come and go as they please
|
|
|
What is a voluntary admission?
|
client consents to potential confinement within the structure of a hospital setting
|
|
|
What is case management?
|
a system of controlled oversight and authorization of services and benefits provided to clients
|
|
|
What are the public health principles?
|
1. Primary prevention
2. Secondary prevention 3. Tertiary prevention |
|
|
What is primary prevention?
|
aimed at decreasing the incidence (number of new cases) of mental disorders
helping people avoid stressors or cope with them more adaptively |
|
|
Example of primary prevention?
|
Stress management classes
Smoking prevention classes |
|
|
What is secondary prevention?
|
aimed at decreasing the prevalence (number of existing cases) of mental disorders
|
|
|
What are examples of secondary preventions?
|
Telephone hotlines
Crisis intervention Disaster response |
|
|
What are tertiary prevention?
|
aimed at decreasing the disability and severity of a mental disorder
|
|
|
Example of tertiary prevention?
|
Day treatment programs
Social skills training Rehabilitative services |
|
|
What are psychological risk factors?
|
Poor self-concept
External locus of control Poor ego defenses |
|
|
What are social risk factors?
|
Stressful occupation
Low socioeconomic status Poor level of social integration |
|
|
What are biological prevention factors?
|
without a history of mental illness in the family, healthy nutritional status, good general health
|
|
|
What are psychological preventitive factors?
|
Good self-esteem or concept
Internal locus of control Healthy ego-defenses |
|
|
What are social preventative factors?
|
Low-stress occupation
Higher socioeconomic status Higher level of education |
|
|
Where are advanced directives legally binding?
|
All 50 states
|
|
|
What is a living will?
|
documents giving specific instructions while client is mentally competent that providers must follow if client becomes incompetent
|
|
|
What is durable power of attorney for health care?
|
should be considered as an aspect of relapse planning for clients with chronic psychiatric disorders
|
|
|
What is culture-bound syndromes?
|
specific behaviors related to a person's culture and not linked to a psychiatric disorder
|
|
|
What are some cultural influences?
|
1. Family
2. Ethnicity 3. Community 4. Environment |
|
|
What is research utilization?
|
process of synthesizing, disseminating, and using research-generated knowledge to make a change in practice
a subset of the broader evidence-based practice |
|
|
What is evidence-based practice?
|
the integration of best research evidence with clinical expertise and patient values and needs
|
|
|
What are research utilization and evidence-based practice two models used for?
|
reducing the gap between research findings and application to practice
|
|
|
What is the research utilization process?
|
1. Critique research
2. Synthesize the findings 3. Apply the findings 4. Measure the outcomes |
|
|
Evidence-Based Practice Model is used by developing what method?
|
P = patient, population,prob.
I = intervention C = comparison O = outcome |
|
|
What is internal validity?
|
When the independent variable (the treatment) caused a change in the dependent variable (the outcome).
|
|
|
What is external validity?
|
when the sample is representative of the population and the results can be geralized
|
|
|
What is descriptive statistics?
|
used to describe the basic features of the data in the study
|
|
|
What is standard deviation?
|
indication of the possible deviations from the mean
|
|
|
What is a variance?
|
how the values are dispersed around the mean; the larger the variance, the larger the dispersion of scores
|
|
|
Examples of descriptive statistics?
|
mean - average scores
standard deviation - indication of possible deviations from the mean variance - how the values are dispersed around the mean |
|
|
What are inferential statistics?
|
numerical values that enable one to reach conclusions that extend beyond the immediate data alone
|
|
|
What is inferential statistics generated by?
|
Quantitative research designs
|
|
|
t test?
|
assess whether the means of two groups are statistically different from each other
|
|
|
Analysis of variance (ANOVA)?
|
tests the difference among 3 or more groups
|
|
|
Pearson's r correlation?
|
tests the relationship between 2 variables
|
|
|
Probability?
|
likelihood of an event occurring; lies between 0 and 1; an impossible event has a probability of 0 and a certain event has a probabliity of 1
|
|
|
p Value?
|
AKA: level of significance; describes the probability of a particular result occurring by chance alone
(if p = 0.1, there is a 1% probability of obtaining a result by chance alone). |
|
|
What is the purpose of the American Nurses Associations Scope and Standards of practice?
|
Define the role and actions for the NP
|
|
|
The trend in legal rulings on cases involving mental illness over the past 25 years has been to:
|
Protect the individual's freedoms or rights when he or she is committed to a mental hospital
|
|
|
What does the Institutional review boards (IRBs) protect?
|
rights and welfare of human research participants and has the authority to approve, require modifications, or disapprove af any research activities
|
