mental health - napnap
TRANSCRIPT
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Mental Health
Cathy Haut, DNP, CPNP‐AC/PC, CCRN, FAANP, Coordinator of Research and Evidence Based Practice
NAPNAP Acute Care Review Course
ACPNP PICU, Sinai Hospital of Baltimore
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Disclosures
Catherine Haut claims no actual or potential conflicts of interest in relation to this program.
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NAPNAP Acute Care Review Course
•Test Taking Strategies•Growth and Development: Round Robin**•Professional Practice Role•Mental Health
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Objectives
At the end of this session, the acute care nurse practitioner candidate will be able to:
1. List personal goals for preparation and test taking skills to prepare for a national certification exam.
3. Identify professional, legal and ethical issues that are important to acute care PNP practice and may affect or impact the care of acutely ill children.
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Preparation for Certification
History and Purpose of certification – why are you taking a test?
Goals of Review – what is the point?
Educational Program –what did you learn?
Application of knowledge – how is a test going to measure this?
Competency – are you minimally competent to practice?
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Test Taking Preparation
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Preparation for Test Taking
• You spent:
• 500 – 1000 clinical hours learning
• Average of 40 – 100 didactic hours learning and many more writing and studying!
• $$$$$$$
• You are here!!
• You will be successful!!
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Plan Study Activities: timing, personal goals, involve colleagues
Do not plan other time‐taking or stressful activities when you are studying.
Practice Relaxation Techniques that work for you!
Practice feeling confident! You have this!
Overall Advice
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Test Taking Strategies
• Study Skills – how do you learn and remember?
• Time management – what to do before and during the exam process.
• Personal readiness – how do you know when to sign up?
• Scheduling and the Test site
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Relaxation Techniques
• Meditate• Breathe Deeply• Be Present – think about YOU!• Reach Out – call a friend!• Decompress• Laugh out Loud• Crank up the Tunes – soothing music• Keep Moving – exercise, take a walk• Be Grateful – list the good things in your life!
Jeannette Moninger, 2017
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Test Taking Strategies
• DON’T• Schedule your test during a stressful or exciting life event• Schedule your test when you are too relaxed• Plan to drive a distance immediately prior to testing• Work a series of days or nights immediately prior to testing or the night before!
• Skip meals or try to diet right before testing• Drink too much caffeine• Go to the testing center ill or exhausted
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Test Taking Strategies• DO:
• Get a good night’s sleep prior to testing• Schedule your exam during your most awake time
• Eat breakfast!• Allow plenty of time to get to the testing center
• Have confidence that you are prepared• Practice relaxation and breathing techniques
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The Test
• Read each question carefully.• Answer those that you are sure of first.• Come back to the unsure items. • Cover the answers and try to answer without looking at them.
• Do not read into questions: answer what they are asking!
• You know the right answers!!! By KF ‐ English Wikipedia.http://en.wikipedia.org/wiki/Image:Test.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=594188
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PNCB ACUTE CARE EXAM CONTENT OUTLINE• ASSESSMENT
• 45 QUESTIONS (was 30)• DIAGNOSIS
• 38 QUESTIONS• MANAGEMENT
• 60 QUESTIONS (was 75)• PROFESSIONAL PRACTICE ROLE
• 7 QUESTIONS
• Procedures: Airway adjunct, CL, Chest tube insertion and removal, LP, Procedural sedation, invasive and non‐invasive ventilator management
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In the Test Center
• Maintain a positive attitude.• Don't get anxious if you do not know answers to the first few questions! Move on and find success with other questions, mark and then go back to those hard ones.
• Avoid watching for patterns in answers. Testing companies are aware of this thought process!
• Rely on your first impressions.• The answer which comes to mind first is usually the answer!• Nervously reviewing questions and changing answers can do more harm than good.
• Plan to finish early and have time for review.• Answer those questions you are most familiar with first.• Return to difficult questions you marked for review.• Make sure you answer all the questions!
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Test Taking – One More Reminder
• Prepare your family and friends!• Make sure your family is aware of your plans so they can provide support.
• Decide whether to disclose your test date or NOT!
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Professional Issues
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Professional Practice Exam Content for 2020
• PROFESSIONAL PRACTICE ROLE: 7 questions
Leadership and Evidence‐based Practice • Evaluate research and apply findings to clinical practice • Collaborate in the development, implementation, and/or modification of clinical practice guidelines and QI initiatives
• Develop and promote professional and collaborative relationships• Advocate for policy
• Legal and Ethical • Patient safety • Incorporate cultural sensitivity and inclusiveness • Ethical practice and decision‐making • Professional accountability : for example, licensing, credentialing, privileging, competency
PNCB AC PNP Content Outline, 2020
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Research and Evidence Based Practice
• Research, evidence‐based practice, quality improvement and decision making• Meta‐analysis: combining results from multiple studies to determine an overall effect of an intervention.
• Systematic Review: critical review of many research studies • RCT: high level of evidence, tests efficacy or effectiveness of intervention; eliminates some bias
• Correlational Study: relationship between 2 variables; cause and effect• Prospective Study – cohort; follows over a certain time a group of individuals• Cross‐sectional study: data collected at a defined time; answers causes of disease or results of medical intervention
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Professional Issues
Acute Care Test Content Outline PNCB, 2020
https://commons.wikimedia.org/wiki/File:This_was_4_of_Dafydd_Evans%27_children..gif
Clinical Practice Guidelines• Sources: National Organizations, Government‐based, Institution specific
Quality Improvement• Methodology: Plan, Do, Study, Act• Outcome‐Driven
Professional Relationships• Mentoring• Precepting• Educating
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Professional Issues: Legal and Ethical
• Professional Accountability• Certification, Licensure and Credentialing, Competency
• Advocacy and Policy• Consent, assent
• Ethical decision making• Ethics Committee• Ethical Guidelines/Terminology
• Documentation and Reimbursement ??
Acute Care Test Content Outline PNCB, 2020
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Principles of Ethics
Beneficence: doing what is best for the patients
Nonmaleficence: to do no harm
Distributive Justice: fair allocation of goods, benefits and services
Autonomy/ Self Determination: foster personal responsibility and plan to develop
Veracity: telling the truth
Fidelity: keeping promises
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Ethical Issues
• Competency• Patient Care and Collaborative Care• Assent and Consent; informed consent• Allocation of Resources• Patient confidentiality, HIPPA• End of Life
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Certification, Credentialing and Privileging
• Certification: validation through objective testing• Licensure: permission to practice granted by a specific organization• Credentialing: verification of qualifications. Regulated by the institution, mandated by Joint Commission.
• Privileging: process through which skills are verified.• Scope of Practice determined by national organizations, guidelines and controlled by state
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Patient Safety
• Quality and Safety are parallel
• Identify patients
• Improve staff communication and staff to patient/family
• Use medications safely
• Use alarms safely
• Prevent infection (hand hygiene, bundles)
• Prevent mistakes in surgery
• Identify patient safety risks (suicide, falls)
Joint Commission 2019 Patient Safety Goals
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Advocacy
• Awareness of policy related to children’s interest• Safety: car seats, playground, infant equipment, toys• Protection: environmental, maltreatment• Child rights – can’t advocate for themselves• National and/or local issues, especially for nurse practitioners• Lobbying by national organizations
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Test Question
1. Maleficence2. Nonmaleficence3. Veracity4. Fidelity
An infant with Trisomy 13 requires cardiac surgery, but the cardiac surgeons are not anxious to operate, because the risks to the child are significant. What is the ethical principle involved in the surgeons’ decision‐making?
10
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Answer:
An infant with Trisomy 13 requires cardiac surgery, but the cardiac surgeons are not anxious to operate, because the risks to the child are significant. What is the ethical principle involved in the surgeons’ decision‐making?
2. Nonmaleficence
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Test Question
Which of the following scenarios would BEST be determined by an Ethics Committee?
1. Giving chemotherapy with significant side effects to a child who has a curable cancer diagnosis.
2. Resuscitating a child who is thought to be brain‐dead, but does not have an order for DNR
3. Ordering pain medication immediately after assessment for a child who presents with burns.
4. Calling the chaplain for a child who was involved in a serious accident, whose parents do not claim a religious affiliation.
10
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Answer:
Which of the following scenarios would BEST be determined by an Ethics Committee?
2.Resuscitating a child who is thought to be brain‐dead, but does not have an order for DNR
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Test Question
An AC PNP is applying for a role as hospitalist in a small, rural community hospital. The credentialing manager has requested a record of technical skills that are to be performed while in the position. What is this process known as?
1. Privileging2. Credentialing3. Licensure4. Certification
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Answer:
An AC PNP is applying for a role as hospitalist in a small, rural community hospital. The credentialing manager has requested a record of technical skills that are to be performed while in the position. What is this process known as?
1.Privileging
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Test QuestionA 13‐year‐old with severe seizure disorder and chronic lung disease presents to the ED after a respiratory arrest which occurred at school. Parents have a DNR order at home which was not active in the school. They arrive to the ED and ask that resuscitation be discontinued. What is the appropriate response?
1. Continue resuscitation efforts until the cause of arrest is determined
2. Explain to the parents that since the efforts were started they must be continued
3. Immediately discontinue all efforts of advanced life support
4. Evaluate the patient and situation and then if appropriate discontinue support 10
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Answer:
A 13‐year‐old with severe seizure disorder and chronic lung disease presents to the ED after a respiratory arrest which occurred at school. Parents have a DNR order at home which was not active in the school. They arrive to the ED and ask that resuscitation be discontinued. What is the appropriate response?
4.Evaluate the patient and situation and then if appropriate discontinue support
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Test Question
A PNP who works in the PICU and is on the unit patient safety committee, notes a rise in the occurrence of urinary tract infections in children with foley catheters. She does a literature review and determines an evidence‐based approach for prevention. What is her next best step?
1. Involve stakeholders to collect data to identify the problem and the best method to put the EBP plan into place.
2. Post a new bundle protocol in the unit for staff to follow. 3. Complete a chart review to identify what treatments were used
for those patients with UTI.4. Report findings from chart review and intervention at PICU
staff meeting 10
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Answer:
A PNP who works in the PICU and is on the unit patient safety committee, notes a rise in the occurrence of urinary tract infections in children with foley catheters. She does a literature review and determines an evidence‐based approach for prevention. What is her next best step?
1.Involve stakeholders to collect data to identify the problem and the best method to put the EBP plan into place.
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Test Question
An ACPNP feels strongly that injuries sustained on local school playgrounds could be prevented by using mulch as a base. The BEST way to advocate for this recommendation is to:
1. Call the local school board and ask that they put mulch down on all school playgrounds in the area.
2. Contact a local representative who can lobby for a bill and funding to support this effort.
3. Contact each school nurse to begin to collect data about the number of injuries on the playground.
10
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Answer:
An ACPNP feels strongly that injuries sustained on local school playgrounds could be prevented by using mulch as a base. The BEST way to advocate for this recommendation is to:
2.Contact a local representative who can lobby for a bill and funding to support this effort.