Module 5 Part 2 Flashcards
What determines the scope of practice for nurse practitioners?
State legislative statute (State Board of Nursing)
The scope of practice defines the nurse practitioner’s roles and actions and identifies competencies assumed to be held by all nurse practitioners.
What is the primary role of the State Board of Nursing?
To define the scope of practice for nurse practitioners
The State Board of Nursing also sets the minimum requirements for nurse practitioners.
What does the acronym D.S.L.A.I.M. represent?
Determined, Scope, Legislation, Advocates, Interprofessional, Minimum
It summarizes key aspects of the scope of practice.
Who determines the standard of practice?
American Nurse Association (ANA)
The standard of practice provides a way to judge the nature of care provided.
What is the legal definition of the standard of care?
The quality of care that a provider must meet
It can be described through protocols or guidelines.
Where does the nurse practitioner code of ethics come from?
ANA or American Psychiatric Nurses Association (A.P.N.A.)
This varies depending on the specific role of the nurse practitioner.
What is the primary source for the most up-to-date information on state-specific scope of practice for N.P.s?
State Board of Nursing website
Professional associations and certification organizations do not supersede state regulations.
What is the patient’s right regarding confidentiality?
To assume that information given to the provider will not be disclosed
This requires signed medical authorization and consent forms for releasing medical records.
What does HIPAA prohibit regarding psychotherapy notes?
Disclosure without patient authorization
Two separate releases are required for psychiatric and chemical conditions.
What must be signed before any healthcare in the state?
Notice of Privacy Practices Statement
This informs individuals about how their protected health information may be used and disclosed.
What is the purpose of HIPAA?
To establish national standards for electronic healthcare transactions
It also provides a national ID for providers, health plans, and employers.
What does the acronym E.T.H.I.C.S. represent in terms of confidentiality exceptions?
Emergency, Threat, Hearing, Insurance, Conditions, Safety
It outlines situations where confidentiality may be breached.
What is the Tarasoff Principle?
Duty to warn potential victims of imminent danger from homicidal clients
Not every state enforces this principle.
What does the American Disability Act of 1990 aim to prevent?
Unfair treatment of people with disabilities
It covers employment, public accommodations, transportation, and government services.
What is the significance of the O’Connor vs. Donaldson case?
Mental illness alone cannot justify involuntary hospitalization
Patients cannot be confined against their will if they can survive outside.
What is required before a P.M.H.N.P. shares patient information with a family member?
Patient’s signed consent
This is necessary to comply with confidentiality laws.
What is informed consent?
The communication process between the provider and the patient
It results in the patient’s acceptance or rejection of treatment.
What does the acronym C.A.R.E. represent in informed consent?
Communication, Acceptance, Rights, Emancipated
It highlights the key elements of informed consent.
What is the right of every adult or emancipated minor regarding informed consent?
The right to consent and withdraw consent at any time
An emancipated minor is someone younger than 18 who is married, a parent, or self-sufficient.
What must a P.M.H.N.P. do if a patient expresses suicidal thoughts?
Report the thoughts to appropriate authorities
Duty to protect life supersedes confidentiality in such cases.
What does the least restrictive environment refer to?
Patient rights to receive care in the least restrictive setting possible
This principle is upheld in mental health law.
What is the significance of the Stark Law?
Prohibits self-referral for monetary gain
It addresses conflicts of interest in healthcare practices.
What is the definition of an emancipated minor?
An emancipated minor is a person below the age of majority who is legally granted the rights of an adult.
What is one key element of informed consent?
Patient’s right to confidentiality.
What can a patient do regarding informed consent?
The patient can consent and withdraw it at any time.
What does ‘least restricted environment’ refer to?
The right to receive treatment in the least restrictive setting appropriate to their needs.
What was established in the Rennie vs Klein case?
The right to refuse any treatment and the use of an appeal process.
What are the Ethical Principles in nursing?
- Justice: Doing what is fair
- Nonmaleficence: Doing no harm
- Beneficence: Promoting well-being
- Fidelity: Being true and loyal
- Veracity: Telling the truth
- Autonomy: Right to self-determination
- Respect: Treating everyone with equal rights
What ethical principle is violated if a patient is excluded from treatment for financial reasons?
Justice.
Fill in the blank: The PICO acronym stands for _______
[P]atient or population, [I]ntervention, [C]omparison, [O]utcome, [T]ime.
What is Level 1 evidence in research?
Evidence from systematic review or meta-analysis of R.C.T.
What is the purpose of a retrospective chart review?
To improve the system, decrease cost, and improve productivity.
What does the P.D.S.A. cycle stand for?
- Plan: Plan the change
- Do: Carry out the plan
- Study: Examine the results
- Act: Decide what actions will improve the process
What does patient advocacy ensure?
The patient’s autonomy and self-determination are respected.
What is a Just Culture?
An environment that encourages reporting mistakes to improve systems.
What is the role of a PMHNP when supporting a bill for mental health funding?
Advocate.
True or False: Nonmaleficence means doing good.
False. Nonmaleficence means doing no harm.
What is the initial action a PMHNP should take before implementing an E.B.P. project?
Identify potential barriers and facilitators that promote the patient’s values and expectations.
What is the focus of Patient-Centered Care (P.C.C.)?
Putting the patient at the heart of their healthcare experience.
What are the social determinants of mental health?
The social and economic factors that influence a person’s risk of developing mental illness and their ability to access and benefit from mental health care.
What is the mnemonic for the phases of policymaking?
P.R.E.P. F.I.E.
What ethical principle is concerned with fairness in care?
Justice.
Fill in the blank: The ethical principle that promotes well-being is _______.
[Beneficence].
What is the significance of cultural response to stressors in mental health?
An expected cultural response does NOT mean it is a mental health condition.
What should a PMHNP do if they become aware of colleagues using off-label medication?
Conduct a literature search to determine whether the data supports this practice.
What is the goal of quality improvement in healthcare?
To improve the system, decrease cost, and improve productivity.
What is reflective practice in nursing?
Learning from experience by linking theory to practice.
What does the ethical principle of veracity emphasize?
Telling the truth.
What is an example of a quality improvement process?
P.D.S.A. – Plan Do Study Act.
What is sociocultural competence?
Understanding and considering culture, economics, cultural status, health literacy level, family patterns, situations and traditions, communication, and language differences
Includes alternative medicine and folk remedies
What are the social determinants of mental health?
Social and economic factors that influence a person’s risk of developing mental illness and their ability to access and benefit from mental health care
Examples include poverty, housing instability, and discrimination
True or False: Social determinants of mental health only relate to individual behaviors.
False
They encompass broader societal issues like poverty and discrimination
List some examples of social determinants of mental health.
- Poverty
- Housing instability
- Exposure to violence or trauma
- Discrimination
- Racism
- Limited access to healthcare and education
- Social isolation
- Unemployment
Who is disproportionately impacted by social determinants of mental health?
People with lower socioeconomic status, racial and ethnic minorities, LGBTQ+ individuals, and people with disabilities
These groups are often more vulnerable
How do social determinants of mental health affect mental health outcomes?
They can create chronic stress, hopelessness, and lack of control, increasing the risk of depression and anxiety
These factors worsen mental health outcomes
Why is addressing social determinants of mental health crucial?
It promotes mental health by creating a more equitable and supportive environment
Tackling these issues can lead to better mental health for everyone
What role do multilevel social and structural factors play in mental and behavioral health?
They shape mental and behavioral health, including stigma, social networks, and policies on housing and criminal justice
Structural racism is also a significant factor
Fill in the blank: Risk factors for many common mental disorders are heavily associated with _______.
[social inequalities]
What is the relationship between social inequality and mental disorder risk?
The greater the inequality, the higher the inequality in risk
This highlights the impact of social conditions on mental health
What should a healthcare provider prioritize for a senior female immigrant struggling with English?
Address Health literacy
Ensuring equal care involves understanding her communication barriers
