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WK8 NRNP 6675

Learning Resources

Required Readings (click to expand/reduce)

Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.

· Chapter 7, “Negligence and Malpractice”

· Chapter 8, “Risk Management”

· Chapter 16, “Resolving Ethical Dilemmas”

National Institute for Health and Care Excellence (2019). Brøset violence checklist. http://riskassessment.no/

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)

· Chapter 23, “Emergency Psychiatric Medicine”

· Chapter 36.2, “Ethics in Psychiatry”

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

· Chapter 19, “Legal Issues in the Care and Treatment of Children With Mental Health Problems”

· Chapter 64, “Suicidal Behavior and Self-Harm”

U.S. Department of Veterans Affairs. (2019). VA/DoD clinical practice guidelines: Assessment and management of patients at risk for suicide (2019).

https://www.healthquality.va.gov/guidelines/MH/srb/

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

· Chapter 15, “Violence and Abuse”

Medication Review
Review the FDA-approved use of the following medicines related to treating psychiatric emergencies:

Aggression

Behavioral problems

Cataplexy syndrome

clozapine propranolol zuclopenthixol

aripiprazole asenapine chlorpromazine haloperidol iloperidone lurasidone olanzapine paliperidone quetiapine risperidone ziprasidone

clomipramine imipramine sodium oxybate

Catatonia

Extrapyramidal side effects

Mania

alprazolam chlordiazepoxide clonazepam clorazepate diazepam estazolam flunitrazepam flurazepam loflazepate lorazepam midazolam oxazepam quazepam temazepam triazolam

benztropine diphenhydramine trihexyphenidyl

alprazolam (adjunct) aripiprazole asenapine carbamazepine chlorpromazine clonazepam (adjunct) iloperidone lamotrigine levetiracetam lithium lorazepam (adjunct) lurasidone olanzapine quetiapine risperidone sertindole valproate (divalproex) ziprasidone zotepine

Assignment: Legal and Ethical Issues Related to Psychiatric Emergencies
Photo Credit: Getty Images

The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.

In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.

To Prepare
· Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.

The Assignment
In 2–3 pages, address the following:

· Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.

· Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.

· Explain the difference between capacity and competency in mental health contexts.

· Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.

· Identify one evidence-based suicide risk assessment that you could use to screen patients.

· Identify one evidence-based violence risk assessment that you could use to screen patients.

Rubric Detail

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Name: NRNP_6675_Week8_Assignment_Rubric
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Show Descriptions

In 2–3 pages, address the following:
• Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.

—
Excellent 90%–100% 14 (14%) – 15 (15%)

Good 80%–89% 12 (12%) – 13 (13%)

Fair 70%–79% 11 (11%) – 11 (11%)

Poor 0%–69% 0 (0%) – 10 (10%)

• Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.–
Excellent 90%–100% 14 (14%) – 15 (15%)

Good 80%–89% 12 (12%) – 13 (13%)

Fair 70%–79% 11 (11%) – 11 (11%)

Poor 0%–69% 0 (0%) – 10 (10%)

• Explain the difference between capacity and competency in mental health contexts.–
Excellent 90%–100% 9 (9%) – 10 (10%)

Good 80%–89% 8 (8%) – 8 (8%)

Fair 70%–79% 7 (7%) – 7 (7%)

Poor 0%–69% 0 (0%) – 6 (6%)

• Select one of the following topics and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.–
Excellent 90%–100% 14 (14%) – 15 (15%)

Good 80%–89% 12 (12%) – 13 (13%)

Fair 70%–79% 11 (11%) – 11 (11%)

Poor 0%–69% 0 (0%) – 10 (10%)

•Identify one evidence-based suicide risk assessment that you could use to screen patients. Attach a copy or a link to the assessment you identified.–
Excellent 90%–100% 14 (14%) – 15 (15%)

Good 80%–89% 12 (12%) – 13 (13%)

Fair 70%–79% 11 (11%) – 11 (11%)

Poor 0%–69% 0 (0%) – 10 (10%)

• Identify one evidence-based violence risk assessment that you could use to screen patients. Attach a copy or a link to the assessment you identified.–
Excellent 90%–100% 14 (14%) – 15 (15%)

Good 80%–89% 12 (12%) – 13 (13%)

Fair 70%–79% 11 (11%) – 11 (11%)

Poor 0%–69% 0 (0%) – 10 (10%)

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

—
Excellent 90%–100% 5 (5%) – 5 (5%)

Good 80%–89% 4 (4%) – 4 (4%)

Fair 70%–79% 3.5 (3.5%) – 3.5 (3.5%)

Poor 0%–69% 0 (0%) – 3 (3%)

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation

—
Excellent 90%–100% 5 (5%) – 5 (5%)

Good 80%–89% 4 (4%) – 4 (4%)

Fair 70%–79% 3.5 (3.5%) – 3.5 (3.5%)

Poor 0%–69% 0 (0%) – 3 (3%)

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.–
Excellent 90%–100% 5 (5%) – 5 (5%)

Good 80%–89% 4 (4%) – 4 (4%)

Fair 70%–79% 3.5 (3.5%) – 3.5 (3.5%)

Poor 0%–69% 0 (0%) – 3 (3%)

Total Points: 100

Name: NRNP_6675_Week8_Assignment_Rubric