xNR 548 Study Guide Week 1 - 8

9 1973 – ANA first published Standards of Psychiatric-Mental Health Nursing Practice 10 1980s – Over time, research turned towards the neurobiological basis for mental illness. With advances in psychotropic medications, psychopharmacology has played an increased role in treatment. In the 1980s, states began to grant prescriptive authority to advanced practice registered nurses (APRNs), adding medication prescribing and management to the traditional therapy role of the psychiatric mental health (PMH) APRN. 11 2000s – Certification exams for adult and family psychiatric mental health nurse practitioner (PMHNP) developed. These exams were retired in 2015 when psychiatric certification exams were combined to a single Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC). 12 Present – Current trends in care focus on integrated treatment of those with co-occurring medical and psychiatric diagnoses and co-occurring psychiatric and substance use disorders, leading to a need to add content in advanced health assessment, pharmacology, pathophysiology, and the diagnosis of psychiatric illness to graduate psychiatric nursing curricula. Primary care has become the point of entry to psychiatric care for many clients. PMHNPs are helping to address the growing need for primary mental health services and mental illness prevention. Though the number of advanced practice psychiatric nurses has increased, there are still limitations in access for many clients, which has led to disparities in mental health treatment. ANA Definition of the PMHNP/Clinical Practice Settings/PMHNP Practice Focus Psychiatric-mental health nursing employs the art and science of nursing to promote mental health and address mental disorders, behavioral issues, and comorbid conditions across the lifespan. The American Nurses Association (ANA et al., 2022) provides further guidance for advanced practice registered nurses practicing in the psychiatric-mental health specialty area. According to the ANA (ANA et al., 2022), “Both PMHNPs and psychiatric mental health clinical nurse specialists (PMH CNS)" are considered PMH APRNs. Their roles are essentially synonymous in purpose, essential functions, settings, and qualifications. Both APRN roles have essential roles in integrating physical and mental health needs; and both APRNS work in inpatient and outpatient settings. The promotion of mental health in society is a crucial element of the PMH-APRN role, as is collaboration with and referral to other health professionals as appropriate. The Consensus Model for APRN Regulation has provided recommendations for licensure, accreditation, certification, and education (LACE) pertaining to all APRN practice. PMHNP certification exam criteria is set by the American Nurses Credentialing Center (ANCC). Clinical Practice Settings • Crisis intervention and psychiatric emergency services occur in a hospital, psychiatric facility or community setting. These services focus on psychiatric and substance-related emergencies. • Acute inpatient care is a short-term treatment. It occurs in the inpatient setting providing care for acutely ill clients at risk for harming self or others or unable to meet basic needs due to impairment. The focus is crisis stabilization. • Intermediate and long-term care may admit clients directly or accept transfers from acute inpatient care. They provide intermediate or long-term care for clients at chronic risk to self or others or unable to function without