PMHNP Ethics/Legal/QI AQA
ALREADY PASSED
Scope of practice - ✔✔● Determined by state legislature (state BON) ● Defines NP roles & actions ●
Identifies competencies assumed to be held by all NPs who function in a particular role ● Varies broadly
from state to state. Some states may require additional certifications
Standards of Practice - ✔✔Quality of practice does not change based on location. ● Determined by
ANA. ● Guidelines/Protocols/recommendations ● Reflect expectations for the care that should be
provided ● Reflect professional agreement focused on the minimum levels of acceptable performance ●
Can be used to legally describe the standard of care that must be met by a provider
Confidentiality - ✔✔● Client's right to assume that information given to provider will not be disclosed ●
Protected under federal statute thru the Medical Record Confidentiality Act ● Pertains to verbal &
written client information ● Requires that the provider discuss confidentiality issues with clients,
establish consent, & clarify any questions about disclosure of information ● Requires that providers
obtain a signed medical authorization & consent form to release medical records & information when
requested by the client or another healthcare provider
Two separate releases are required for - ✔✔psychiatric and opioid use disorders. All psychiatric records
go on one form. Need an additional form for chemical dependency.
HIPPA - ✔✔● The 1st national comprehensive privacy protection act ● Guarantees clients four
fundamental rights 1) To be educated about HIPPA privacy protection. 2) To have access to their own
medical records. 3) To request amendment of health information to which they object. 4) To require
their permission for disclosure of their personal information
By adding psych services to an OB or PCP practice, we are - ✔✔↑access to care for people who need it
the most
, Exceptions to Confidentiality - ✔✔When appropriate persons or organizations determine the need for
information outweighs the principle of confidentiality ● Intent to harm self or others ● Attorneys
involved in litigation ● Insurance companies ● Court orders, subpoenas, summonses ● Mandatory
disease reporting ● Child/elder abuse ● Tarasoff principle: Duty to warn of imminent danger of
homicidal clients. Does not apply to every state. Verify with state BON
While you are interviewing a patient, she tells you that her husband is threatening to harm himself - ✔
✔Obtain his address & call crisis hotline
Informed consent - ✔✔● Communication process between provider & client ● Results in client's
acceptance or rejection of proposed treatment ● Explanation of relevant information, enabling client to
make appropriate & informed decision ● The right of all competent adults or emancipated minors
Emancipated minor - ✔✔<18, married, parents, or self-sufficiently living away from family
Capacity - ✔✔Ability to make a decision. ▫ Verify if they have a decision maker. ● You can assess for
decision-making capacity.
Competence - ✔✔Legal not a medical concept. Needs to pass through a court of law.
Disclosure - ✔✔Provider should disclose info on the treatment, test, procedure, including expected
benefits, risks, & likelihood that benefits & risks will occur
Comprehension - ✔✔The patient should be able to comprehend the relevant information
Voluntariness - ✔✔The patient should voluntarily grant consent, without coercion
Documentation - ✔✔Provider must document in medical record that informed consent has been
obtained from client
ALREADY PASSED
Scope of practice - ✔✔● Determined by state legislature (state BON) ● Defines NP roles & actions ●
Identifies competencies assumed to be held by all NPs who function in a particular role ● Varies broadly
from state to state. Some states may require additional certifications
Standards of Practice - ✔✔Quality of practice does not change based on location. ● Determined by
ANA. ● Guidelines/Protocols/recommendations ● Reflect expectations for the care that should be
provided ● Reflect professional agreement focused on the minimum levels of acceptable performance ●
Can be used to legally describe the standard of care that must be met by a provider
Confidentiality - ✔✔● Client's right to assume that information given to provider will not be disclosed ●
Protected under federal statute thru the Medical Record Confidentiality Act ● Pertains to verbal &
written client information ● Requires that the provider discuss confidentiality issues with clients,
establish consent, & clarify any questions about disclosure of information ● Requires that providers
obtain a signed medical authorization & consent form to release medical records & information when
requested by the client or another healthcare provider
Two separate releases are required for - ✔✔psychiatric and opioid use disorders. All psychiatric records
go on one form. Need an additional form for chemical dependency.
HIPPA - ✔✔● The 1st national comprehensive privacy protection act ● Guarantees clients four
fundamental rights 1) To be educated about HIPPA privacy protection. 2) To have access to their own
medical records. 3) To request amendment of health information to which they object. 4) To require
their permission for disclosure of their personal information
By adding psych services to an OB or PCP practice, we are - ✔✔↑access to care for people who need it
the most
, Exceptions to Confidentiality - ✔✔When appropriate persons or organizations determine the need for
information outweighs the principle of confidentiality ● Intent to harm self or others ● Attorneys
involved in litigation ● Insurance companies ● Court orders, subpoenas, summonses ● Mandatory
disease reporting ● Child/elder abuse ● Tarasoff principle: Duty to warn of imminent danger of
homicidal clients. Does not apply to every state. Verify with state BON
While you are interviewing a patient, she tells you that her husband is threatening to harm himself - ✔
✔Obtain his address & call crisis hotline
Informed consent - ✔✔● Communication process between provider & client ● Results in client's
acceptance or rejection of proposed treatment ● Explanation of relevant information, enabling client to
make appropriate & informed decision ● The right of all competent adults or emancipated minors
Emancipated minor - ✔✔<18, married, parents, or self-sufficiently living away from family
Capacity - ✔✔Ability to make a decision. ▫ Verify if they have a decision maker. ● You can assess for
decision-making capacity.
Competence - ✔✔Legal not a medical concept. Needs to pass through a court of law.
Disclosure - ✔✔Provider should disclose info on the treatment, test, procedure, including expected
benefits, risks, & likelihood that benefits & risks will occur
Comprehension - ✔✔The patient should be able to comprehend the relevant information
Voluntariness - ✔✔The patient should voluntarily grant consent, without coercion
Documentation - ✔✔Provider must document in medical record that informed consent has been
obtained from client
