Ugochukwu Flashcards
PMHP REVIEW (56 cards)
1
Q
History of NP
A
- 1950 two psychiatric nurses June Mellow and Hildegard Peplau with seminal work
- The emergence of the psychiatric-mental health nurse practitioner growth
a. the acceptance of brain-base etiology
b. awareness of of need to provide holistic nurse care
2
Q
Competencies
A
- leadership
- Quality
- policy
- Independent
3
Q
Leadership
A
- NP participate in community and population-focused programs that evaluate and promote in preventing and reducing risk in mental health problems
- Advocate of patient and family for right and issues
- collaborate with other professional about advocating ,making policy to reduce health problem and good health outcome.
4
Q
Quality :
A
Evaluate the proper use of seclusion and restraint.
5
Q
Policy
A
NP Employs opportunities to influence health policy to reduce stigma
6
Q
History of NP 1965
A
1965 Loretta C Ford and Henry K Silver. University of Colorado
Proven competence brought about an acceptance of NP role by healthcare system and public.The first NP program was Pediatric NP program
7
Q
Growth of NP role
.Facilitating factors for growth
A
a. Public /consumer demand for service
b. Acceptance of NP role
c. Emergence of PMHP role
d. Decreasing stigmatization
Integration of health services
8
Q
Constraining factors
A
- growing competition in the job market
- reimbursement struggle with medicare and other insurance
- Overlapping scope of practice with other NP
9
Q
Regulatory and Statutory Dimension of NP role
State Legislative statutes
A
a. They grant legal authority for NP practice
b. they oversees the Nurse practice act
10
Q
Nurse practice Act of State
A
- provides title protection
- Define advanced practice
- the state law that define scope of practice
- places restriction on practice
They set required credentials to practice
11
Q
State ground for disciplining
A
- Practicing without valid license
- Falsification of record
- Medicare fraud
- Failure to use proper nursing judgment
- Failure to follow standard of practice
- Failure to document accurately
12
Q
Scope of practice
A
- Defines NP role and action
2 Identifies the competencies of NP
3Advsnce Practice PMHP standard are IDENTIFY in Mental health nursing
13
Q
Licensure:
A
A process of government agency grant individual permission to practice
Establish that a person is qualified to perform in a particular professional role.
14
Q
Credentialing
A
Process to protect the public by meeting minimal level of acceptable performance. Ensure that healthcare is provided by qualified individuals
15
Q
Certification:
A
- A credential that provide title protection
- Determined the scope of practice
- Assures the public that the person has mastered the knowledge of the field or specialty
16
Q
Standard of practice
A
The ANA defines standard of practice as authoritative statements of the duties that all registered nurse are expected to perform competently
17
Q
Professional Role Responsibilities Confidentiality HIPAA Health information Technology for Economic and Clinical Health ACT Telehealth
A
Confidentiality:
- The information by client given to healthcare provider will not be disclosed
- Protected on the act of 1995 Medical Record Confidentiality Act
- Provider is required to discuss confidentiality issues with client, establish consent and clarify any question client might have for disclosure
- Provider to obtain a signed medical authorization and consent form to release medical records when requested by client and another health provider
18
Q
HIPAA
A
The first national comprehensive privacy protection act that grantee client 4 rights
19
Q
Client four Rights
A
- To be educated about privacy protection
- To have access to their own medical records
- To request amendment of the information their object
- To require client permission in disclosing their personal information
20
Q
HIPAA Title
A
- Title 1 Protect health insurance coverage of client and their families
- Title 11 Administrative Simplification: Require the establishment of national standards for electronic health care transactions,national ID for providers,health insurance plan and employers
21
Q
The Office for Civil Right enforces the HIPAA by
A
- Protecting the privacy of client information
- HIPAA Security Rule, which set a national standard for protection of individual health information
- Confidentiality provision of patient Safety Rule, which protect identifiable information being use to analyze patient safety event and improve safety
22
Q
Examples of HIPAA protected information
A
- Written information in the medical records
- Conversation among healthcare providers about patient treatment
3.Patient information stored in the computer system
4.Patient billing information in the clinic - Patient health information can not be shared or used without patient written permission.
Without patient written authorization,provider cannot disclose information to one’s employer,share for marketing or share private note about patient healthcare
23
Q
Health Information Technology for Economic and Clinical Health ACT,Health Resource and Service Administration
Electronic Medical Records
A
- Incentive payment for sharing specific electronic health record data, meaningful use incentive
- Health Record can improve both individual and population base health outcome,safety, quality ,efficiency and effectiveness by
a. E-prescribing
b. Computerized provider’s order sets
c. Tracking and avoiding duplication of services
24
Q
Situation for which Health Information IS allowed to be shared
A
- when the need for treatment outweigh confidentiality
- When patient indicate an intent to harm self or others
3 Information given to attorney in litigation
4.Release health information to insurance companies
5 When patient’s family or relative are identify as being involve in bill payment or care
6.protecting the public by reporting disease outbreak - Making police report or court summonses
- In case of child or elder abuse
25
Patient Safety and Quality Improvement Act
1. It is a voluntary reporting system to enhance the data available and resolve patient safety and healthcare quality issues
2. It provides federal privilege and confidentiality protection for patient safety information ,so as to encourage reporting and analyzing medical errors.
3. The confidentiality provision improves patient safety and creating an environment for provider to report and examining patient safety events without fear of liability risk
26
Confidentiality VS "Duty to warn" (Tarasoff Principle
1. The "duty to warn" supersedes the right to confidentiality in the patient condition may endanger others
2. The duty to protect patient from harm self supersedes confidentiality
3. Duty to warm potential victim of imminent danger of homicidal client
27
Informed consent
Life-threatening condition
Right to refuse care
1. It is communication process between the provider and the patient that result of patient accepting or rejecting the treatment
2.Patient able to make decision about their treatment
Generally, consent can be assumed if patient condition is life -threatening.
3.Patient must be advise at the time of admission in healthcare institution that they have the right to refuse care as long as they competent
28
Exception to refusal
1. Patient is in immediate danger or presenting immediate danger to others
2. Civil legal motions may be initiated for involuntary treatment
29
Element of informed consent to explained to client
1. The nature and purpose of propose of the treatment procedure
2. Risk of discomforts and benefits of the treatment.
3. Risk and benefits of reusing the treatment
4. Alternative procedure or treatment.
5. Diagnosis and prognosis
30
Provider documentation
Provider must document in the medical record that the consent has been obtained from patient.
31
Ethics principles
Ethics is the study of moral rules and standards governing the conduct of individuals and it is aspect of NP role
32
Key Ethical principle
Provides the foundation and direction for complex decision
33
Justice
Doing what is fair,duty to be fair
34
Beneficence
Promoting well-being and doing good,duty to prevent harm and promote good
35
Nonmaleficence
Doing no harm,duty to avoid harm
36
Fidelity
Being true and loyal,Duty to be faithful
37
Autonomy
Doing for self,duty to respect individual thoughts and action
38
Veracity
Telling the truth,duty to be truthful
39
Respect
Treating everyone with equal respect
40
Utilitarianism
The right act is the one that produces the greatest good for the greatest number
41
Important Ethical principle Psychiatry
1. Patient must be involve in their decision making
2. Patient have right to treatment in least restricted setting
3. Patient have the right to refuse treatment unless legally mandated by the court to obtain treatment.
42
Ethical dilemma
1.Occurs when there are2 or more justifiable alternative situation
2.Occurs when the choice is to promote good
Which situation is less harmful
43
Risk and Benefit of Disclosure of Disability
Americans with Disability Acts: work to prevent discrimination by employer with 15 or more including mental illness
44
Risk of disclosure
1. Employer may find away not to hire disabled person
2. Coworker may harass or discriminate against disabled person
3. Assumption that mental ill patient is less productive
4. Disability may limit chance of advancement
5. Poor feedback may given to psychiatric illnesses because behavior
45
Benefits
Able to request accommodation
Able to have job coach who may come to worksite and communicate with employer
Coworker may offer support
May empower another to disclose their illness.
46
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Legal Considerations
Malpractice
Liability
Negligence
Assault
Battery
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Malpractice : Failure of a professional to render services with the degree of care,diligence and precaution that another member of the same profession under the same circumstances would render to prevent injury
Liability: The legal responsibility failure that NP has to meet the standard care of patient that resulted to actual or potential harm to patient
Negligence: Failure of NP to provide care as any reasonable NP would resulting to harm to patient
Assault: Attempt to commit a battery or an intentional act performed by one individual that produces imminent harm to another individual, if the victim is touched is Battery
47
Malpractice insurance
Provides financial protection against claims of malpractice , coverage for professional negligent acts, universally recommended for all NP
Do not protect NP who is practicing outside the legal scope of practice
Provides NP their own legal representative
48
Four element to establish malpractice
Duty: NP had duty to exercise reasonable care when
providing care to patient
Breach of duty: violation of applicable standard
Proximate: There is a casual relationship between the breach in the standard of care and the patient injury
Damage: The patient experienced permanent or substantial injury as a result of breach of standard of care
49
Competency
A legal and not medical concept. A person is deem competent until a court rules that the person is incompetent . If person is deemed incompetent court appointed guardian will make health decisions for that person
50
Commitment
| Involuntary
Process of forcing a person to receive involuntary evaluation or treatment.
Involuntary commitment: Admitting a person into mental health unit against their will
51
Basic Criteria for commitment
Diagnosed psychiatric disorder
Harm to self or to others
Person unaware or unwilling to accept the nature or severity of illness and treatment will improve the disorder
52
Use of Restraint
It is legal to forcefully restrain patient to prevent from harm to self or others.
53
Health Care Delivery
When initiating change begin with hospital level, community level,regional level ,then state and national
54
Treating patient
medical condition first before psych-social condition
55
Healthy People 2020
Access to health care and improved health are both major issues for health policy
Continuance of health people 2000 (DHHS)
56
Goals Healthy People 2020
Increase the quality and years of healthy life
Eliminate Health disparities among Americans
Documents contains Leading Health Indicators
Objectives relate to
a. equal access
b.availability,
c.cost,
d. quality of care
