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ANCC > Chap. 1 - role, scope, regulatory > Flashcards

Chap. 1 - role, scope, regulatory Flashcards

1
Q

Two seminal psych nurses (1950’s)

A

Hildegard Peplau

Jane Mellow

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2
Q

Maintenance of the nurse-client relationship (3 factors)

A

Trust and respect
Healthy boundaries
Therapeutic communication

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3
Q

Teaching and coaching roles (3)

A

Health promotion/disease prevention
Risk reduction
Coaching toward behavioral change

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4
Q

Participation in policy making
Negotiating legislation
Do we care about these?

A

Yes

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5
Q

Competencies (7)

A

Health promotion, health protection, disease prevention, and treatment
NP-Client relationship
Teaching/coaching
Professional role
Managing and negotiating health care delivery systems
Monitoring and ensuring quality
Cultural competence

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6
Q

Health promotion and protection, disease prevention, and treatment: the three competencies within

A

Assessment
Diagnosis of health status
Plan of care and implementation of treatment

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7
Q

Assessment (4 subsets)

A

Physical and mental health
Psych eval (including MSE)
Family system
Differentiation of normal/abnormal symptomology

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8
Q

Why conduct a physical assessment? (4 reasons)

A

Assess general health status
Differential dx
To screen for general/non-psych disorders
To identify the primary psych dx

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9
Q

Diagnosis of health status - 4 areas

A

Ordering/interpreting dx tests
Differential dx
Dx of psych disorders
Applying taxonomy

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10
Q

Taxonomy

A

The science of defining groups of biological organisms on the basis of shared characteristics and giving names to those groups.

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11
Q

6 taxonomies

A

International Classification of Diseases (ICD)
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Health Insurance Portability and Accountability Act (HIPAA) code sets
Nursing Interventions Classification (NIC)
Nursing Outcomes Classification (NOC)
North American Nursing Diagnosis Association (NANDA)

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12
Q

Plan of care is always….

A

Evidence based

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13
Q

Are collaboration, consultation, and coordination of referrals important?

A

Yes they are.

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14
Q

Should we stay involved in professional organizations and research?

A

Yes we should.

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15
Q

Are education, policy, and research important.

A

You betcha.

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16
Q

NP role was introduced when, where, and by whom?

A

1965
The University of Colorado
Dr Loretta C Ford and Henry K Silver, MD

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17
Q

Why are NP programs accredited?

A

To achieve standardization and quality control.

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18
Q

Who or what grants the legal authority for NP practice?

A

State legislative statutes

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19
Q

State legislative statutes governing nursing are called…

A

Nurse Practice Acts

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20
Q

Nurse Practice Acts define what? (6)

A

Title protection (who can be styled an NP)
Advance practice
Scope of practice (what an NP does)
Restrictions on practice
Credentialing requirements (education and certification)
Grounds for disciplinary action

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21
Q

Are all Nurse Practice Acts the same?

A

No, they vary from state to state

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22
Q

Collaborative Agreement

A

A protocol that describes what types of drugs might be prescribed and defines some form of oversight board for NP practice.

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23
Q

Licensure

A

A process by which an agency of state government grants permission to individuals accountable for the practice of a profession to engage in the practice of that profession.

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24
Q

Credentialing

A

Process used to protect the public by ensuring a minimum level of professional competence.

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25
Q

Certification

A

Determines scope of practice
Assurance that the licensee has met predetermined standards specified by the profession
Assures the public that the licensee has mastery of a body of knowledge

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26
Q

Primary certifying body of psych nursing

A

American Nurses Association

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27
Q

Scope of practice: defined at state or national level?

A

State level.

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28
Q

Scope of practice: what is it?

A

Defines NP roles and actions.

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29
Q

Standards of practice define what?

A

Minimum levels of acceptable performance
Legally, the standard of care that must be met by a provider
The quality and type of practice to be provided

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30
Q

In layman’s terms, scope is ______ and standards are ______

A

scope is what we do

standards are how we do it

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31
Q

Confidentiality is protected under what federal statute?

A

The Medical Record Confidentiality Act of 1996

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32
Q

HIPAA is the first national comprehensive ______ act

A

Privacy

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33
Q

HIPAA guarantees four rights:

A

To be educated about HIPAA
To have access to our own medical records
To request amendment to aspects of our health info to which we object
To require permission for disclosure of personal information

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34
Q

When does the need for information outweigh the principle of confidentiality? (7 categories)

A

Intent to harm self or others
Release to attorneys involved in litigation
Release to insurance companies
In response to court orders, summons, or subpoenas
Mandatory reporting of certain diseases or conditions
Child abuse/elder abuse
Tarasoff principle

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35
Q

What is the Tarasoff (1976) principle?

A

Duty to warn potential victim of imminent danger of homicidal clients

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36
Q

Informed consent

A

A right of all competent adults and emancipated minors. An explanation of the proposed treatment allowing the client to make an informed decision as to whether to accept or decline the treatment.

37
Q

Emancipated minors

A

Individuals aged 18 or under who are married, parents, or self-sufficiently living away from their family domicile

38
Q

Five elements of informed consent:

A 
Nature and purpose of proposed treatment
Risks and benefits treatment
Risks and benefits of non-treatment
Alternative procedures or treatments
Diagnosis and prognosis
39
Q

Must you document provision of informed consent?

A

Yes, you must

40
Q

Must you ensure that the client is cognitively capable of giving informed consent?

A

Yes, you must

41
Q

Justice

A

Doing what is fair; fairness in all aspects of care

42
Q

Beneficence

A

Promoting well-being and doing good

43
Q

Nonmalfeasance

A

Doing no harm

44
Q

Fidelity

A

Being true and loyal

45
Q

Autonomy

A

Doing for self

46
Q

Veracity

A

Telling the truth

47
Q

Respect

A

Treating all with equal respect

48
Q

Does the ANA have a policy statement on NP ethics?

A

Yes, the Code of Ethics for Nurses (2005)

49
Q

Three crucial client rights/ethical principles in psychiatry

A

Clients must be involved in decision making (to the full extent of their capacity)
The right to treatment in the least restrictive setting
The right to refuse treatment (unless court-ordered)

50
Q

An ethical dilemma involves ___ or more _____ ______

A

two or more justifiable alternatives

51
Q

Deontological theory

A

An action is judged as good or bad based on the act itself, regardless of consequences

52
Q

Teleological theory

A

And action is judged as good or bad based on the consequence or outcome

53
Q

Virtue ethics

A

Actions are chosen based on the moral virtues (honesty, courage, wisdom, compassion) or character of the person making the decision

54
Q

What does malpractice not cover?

A

Charges of practicing outside their legal scope of practice

55
Q

Four elements of negligence that must be established to prove malpractice

A

Duty
Breach of duty
Proximate cause
Damages

56
Q

Duty defined (as relates to negligence/malpractice)

A

The NP had a duty to exercise reasonable care when providing treatment

57
Q

Breach of duty defined (as relates to negligence/malpractice)

A

The NP violated the applicable standard of care in treating the client’s condition

58
Q

Proximate cause defined (as relates to negligence/malpractice)

A

There is a causal relationship between the breach in the standard of care and the client’s injuries

59
Q

Damages defined (as relates to negligence/malpractice)

A

There are permanent and substantial damages to the client as a result of the breach in the standard of care

60
Q

Competency - a legal or medical concept?

A

Legal

61
Q

What is competency?

A

A determination that client can make reasonable judgments and decisions regarding health and treatment

62
Q

Commitment

A

Process of involuntarily forcing an individual to receive evaluation or treatment. Individual must have a psych do, be harmful to self or others, unaware of or unwilling to accept disorder, and be likely to benefit from treatment.

63
Q

Involuntary admission retains all civil liberties except…

A

the ability to come and go as they please

64
Q

Two professional organizations for the FPMHNP

A

APNA (American Psychiatric Nurses Association)

ISPN (International Society of Psychiatric Nurses)

65
Q

The overall goal of case management:

A

To promote quality cost-effective outcomes

66
Q

Primary prevention

A

Aimed at decreasing incidence (number of new cases) of mental disorders. Stress management classes, smoking prevention classes, DARE program.

67
Q

Secondary prevention

A

Aimed at decreasing prevalence (number of existing cases) of mental disorders. Screening, telephone hotlines, crisis intervention, disaster response.

68
Q

Tertiary prevention

A

Aimed at decreasing the disability and severity of a mental disorder. Rehab services, day treatment, social skills training, case management for housing or vocational needs.

69
Q

Three categories of risk and preventive factors

A

Biological (family history, nutrition)
Psychological (self-esteem or self-concept, locus of control)
Social (occupation, SES, education level)

70
Q

Living will

A

Document giving specific instructions while client is mentally competent that providers must follow if client becomes incompetent

71
Q

Durable power of attorney for health care (health care proxy)

A

Designates in writing an agent to act of behalf of a client should they become unable to make health care decisions (including finances)

72
Q

Culture

A

The learned beliefs and behaviors or socially inherited characteristics common to a members of a racial, social, ethnic, or religious group

73
Q

Culture-bound syndromes

A

Specific behaviors related to a person’s culture and not linked to a psychiatric disorder

74
Q

Ethnicity

A

Self-identified race, tribe, or nation with which a person or group identifies and which greatly influences behavior and beliefs

75
Q

Research utilization process (4 steps)

A

Critique research
Synthesize the findings
Apply the findings
Measure the outcomes

76
Q

PICO

A

Patient/population/problem
Intervention
Comparison (of another tx or placebo)
Outcome

77
Q

Internal validity

A

When the independent variable (the treatment) caused a change in the dependent variable (the outcome)

78
Q

External validity

A

When the sample is representative of the population and the results can be generalized

79
Q

Descriptive statistics

A

Used to describe, summarize, organize data or observations. May be qualitative or quantitative.

80
Q

Variance

A

How values are dispersed around the mean - the larger the variance, the larger the dispersion of scores.

81
Q

Inferential statistics

A

Quantitative research results that enable one to reach conclusions.

82
Q

t test

A

Assesses whether the means of two groups are statistically different from each other.

83
Q

ANOVA

A

Analysis of variance

84
Q

What is analysis of variance (ANOVA)?

A

Tests the difference among 3 or more groups.

85
Q

Pearson’s t correlation

A

Tests the relationship between two variables

86
Q

Probability

A

Likelihood of an event occurring; lies between 0 and 1; impossible = 0 and certain = 1.

87
Q

p value

A

Level of significance; describes the probability of a particular result occurring by chance alone. p = .01 means a 1% probability of obtaining a result by chance alone.

88
Q

IRB

A

Institutional review board. Ensures that risks to participants are minimized, safety plans are in place, rights and welfare of human subjects are protected.

89
Q

The Belmont Report (1979)

A

Requires that all investigators take and pass a test on protection of human participants.

ANCC (48 decks)

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