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Psychiatric Nurse Practitioner

Erin Ellington
Despite psychiatric nurses' competency in identifying comorbid substance use disorders, at-risk users are often overlooked. The National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse support screening, brief intervention, and referral to treatment (SBIRT) as an intervention that reduces mortality, alcohol and substance use, and health care and societal costs. SBIRT for Adolescents (SBIRT-A) has the potential to provide similar outcomes during this critical developmental stage...
February 1, 2019: Journal of Psychosocial Nursing and Mental Health Services
Chase J Boyer, Michael J Rice, Tanya R Sorrell, Alyssa M Spurling
BACKGROUND: There is an increased need for mental health providers to be more attuned to behavioral health needs of racial/ethnic/cultural minorities and the role of social milieus. AIMS: We prioritized training and assessing racial/ethnic and cultural sensitivity among psychiatric mental health nurse practitioner students throughout coursework, clinical practice, and experiences in underserved settings. METHOD: Prior to beginning clinical coursework, students completed a course on culturally competent care where we measured their ( n = 26) perception of their ability to be racially/ethnically sensitive providers at the beginning and end of the semester, demonstrating significant improvement...
January 28, 2019: Journal of the American Psychiatric Nurses Association
Susan M Duncan, Nora B Whyte
Nursing organizations including regulatory colleges are undergoing transitions that fundamentally alter the face of Canadian nursing. As British Columbia regulatory and professional organizational transitions are held up as a potential model for the rest of Canada, we offer a critical commentary on a most recent transition to the One Nursing Regulator of all nursing role designations in the formation of the British Columbia College of Nursing Professionals in 2018. We draw attention to amalgamation processes - professional regulation and governance, the preservation of nursing history, allocation of nurses' fees and resources and the role distinctions and identities of registrant groups - Registered Nurses, Nurse Practitioners, Licensed Practical Nurses and Registered Psychiatric Nurses...
September 2018: Nursing Leadership
Marissa D Abram, Maryann O Forbes
As the demand for Psychiatric Mental Health Nurse Practitioners (PMHNPs) continues to grow, innovative teaching strategies that can enhance competency learning with skill transfer into the clinical setting is essential. Educational programs must adequately prepare the student for the complexity of the clinical environment. Simulation is an educational approach that replicates aspects of the real world in a safe environment so that learners can engage in an interactive manner. High-fidelity simulation (HFS) has been identified as an effective teaching strategy and mechanism to transfer knowledge and skills learned in the classroom to the clinical setting...
January 14, 2019: Issues in Mental Health Nursing
Roseann V Regan, Theresa Fay-Hillier, Dana Murphy-Parker
OBJECTIVE: The purpose of this simulation educational activity was to assist psychiatric mental health nurse practitioner students (PMHNPs) with identifying military veterans as a vulnerable group with health care disparities and provide competent military veteran care in the private sector. Mindful of all the varied terms for military service, this article will use the term military veteran. METHODS: The simulation educational activity included applying the conceptual frameworks of the healthcare disparities framework (HDF) and nursing education simulation framework (NESF)...
January 8, 2019: Issues in Mental Health Nursing
Margaret R Emerson
Access to mental health care is a considerable problem for individuals suffering from a mental illness. Of the 44.7 million adults, aged 18 or older, experiencing a mental illness in 2016 only 43.1% reported receiving treatment. Utilizing integrated and collaborative models can enhance identification and treatment for individuals in need of mental health. The purpose of this paper is threefold: (a) to describe the process of implementing hybrid-collaborative care model (hybrid-CCM) in a practice setting, (b) to discuss the similarities and differences in a hybrid-CCM when compared to a traditional collaborative care model, and (c) to discuss practical considerations for nurse practitioners fulfilling the psychiatric consultant role in a hybrid-CCM or traditional collaborative care model...
January 4, 2019: Issues in Mental Health Nursing
Jennifer W Carpenter, W Chance Nicholson, Mary J Lee, Jessica W Richardson, Teena M McGuinness
The longstanding partnership between the Birmingham Veterans Affairs Medical Center (BVAMC) and the University of Alabama at Birmingham School of Nursing inspired the establishment of one of the country's first psychiatric-mental health nurse practitioner (PMHNP) residencies and subsequent formation of a Resident Continuity Clinic (RCC). Within the RCC, PMHNP residents deliver evidence-based care that is informed by measurement-based care (MBC) to improve patient outcomes and reduce time to recovery. Determined by the BVAMC Institutional Review Board to be a quality improvement project, PMHNP residents administered the Patient Stress Questionnaire (PSQ), a MBC tool that uses four independently validated screening tools to measure the behavioral health symptoms of depression, anxiety, trauma, and alcohol use...
December 26, 2018: Journal of Psychosocial Nursing and Mental Health Services
Jason Fogler, Jocelyn Kuhn, Lisa Prock, Jenny Radesky, Joseph Gonzalez-Heydrich
James is a 7½-year-old boy born in Vietnam to a mother with mental illness. Little is known about his early history; he spent the first 6 months of his life in an orphanage, followed by foster care and a disrupted adoption. He moved to the U.S. at age 1½ and joined his current adoptive family at age 4 years. Shortly thereafter, James' psychiatric nurse practitioner diagnosed him with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Pragmatic language and syntax deficits were also noted from an early age...
January 2019: Journal of Developmental and Behavioral Pediatrics: JDBP
Bridget Niebruegge, James M Holbrook, Christa Vernon, Connor Grotton, Andrea Maric
Advanced practice providers (APPs) have come to play an increasingly significant role in the United States healthcare system in the past five decades, particularly in primary care. The first portion of this paper will explore the utilization of APPs in specific patient populations: pediatrics, obstetrics, geriatrics, and psychiatry. After a brief discussion of the demand for these specialties, the authors will outline the educational preparation and competencies that nurse practitioners and physician assistants must achieve before working with these special populations...
December 21, 2018: Disease-a-month: DM
Sheldon H Preskorn
This column is the second in a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. The first column in this series discussed why patients being treated with psychiatric medications are at increased risk for taking multiple medications and thus experiencing DDIs and how to recognize such DDIs, and strategies for avoiding them. This second column in the series discusses strategies for minimizing adverse outcomes from such unintended DDIs. Given the huge and rapidly increasing number of available prescription and over-the-counter medications as well as nutritional supplements, the author recommends that all prescribers develop a personal formulary of ∼30 drugs that they use in everyday practice and with which they are intimately familiar...
September 2018: Journal of Psychiatric Practice
R Lee Tyson, Susan Brammer, Diana McIntosh
BACKGROUND: This article summarizes the experiences that a Midwest college of nursing had when telepsychiatry was introduced for psychiatric-mental health post-master's nurse practitioner students to use in a clinical internship. AIMS: Implications for nurse practitioner educators will be identified, and recommendations for future research will be explored. METHOD: Described are the following: (1) policies and procedures the institution considered, (2) challenges that were encountered by faculty and students, and (3) strategies and limitations of these strategies defining best practice, what didactic content should be taught, and how clinical placements needed to be structured...
November 2, 2018: Journal of the American Psychiatric Nurses Association
Deborah S Johnson
A significant challenge related to nurse practitioner (NP) training is the shortage of clinical sites with qualified faculty to precept NP interns. The problem is compounded in rural communities with provider shortages, restricting their opportunities to train (and potentially recruit) new APRNs. Consequently, these underserved communities have difficulty accessing specialty providers, such as Psychiatric Mental Health Nurse Practitioners (PMHNPs). Combined with geographic distance from urban communities and generally lower pay, many rural and/or remote communities struggle with the disparity in contrast to more populated regions...
October 30, 2018: Issues in Mental Health Nursing
Richard N Keers, Madalena Plácido, Karen Bennett, Kristen Clayton, Petra Brown, Darren M Ashcroft
OBJECTIVE: Medication administration errors (MAEs) are a common risk to patient safety in mental health hospitals, but an absence of in-depth studies to understand the underlying causes of these errors limits the development of effective remedial interventions. This study aimed to investigate the causes of MAEs affecting inpatients in a mental health National Health Service (NHS) hospital in the North West of England. METHODS: Registered and student mental health nurses working in inpatient psychiatric units were identified using a combination of direct advertisement and incident reports and invited to participate in semi-structured interviews utilising the critical incident technique...
2018: PloS One
Mary M Rock
BACKGROUND: Perinatal depression (PD) screening has been defined for decades, but treatment remains ill-defined, with few mental health (MH) providers helping depressed women during this delicate time. The nurse practitioner (NP) is in a position to help women through PD with the use of a collaborative treatment model. AIMS: This DNP (doctor of nursing practice) inquiry investigated a stepped collaborative care model (CCM) to see whether the PD model improved time from referral to evaluation and decreased depression scores over a 6-month treatment period for women who came to an NP MH practice...
August 23, 2018: Journal of the American Psychiatric Nurses Association
Emily B Jones
To explore the practice characteristics of nurse practitioners in mental health and psychiatric settings, descriptive statistics and multivariable logistic regression models were constructed with weighted data from the 2012 National Sample Survey of Nurse Practitioners. The 5.6% of nurse practitioners in mental health and psychiatric settings were less likely to have hospital admitting privileges and more likely to practice without a physician on-site, to have their own billing number, and to have a DEA number...
August 2018: Archives of Psychiatric Nursing
Issa Papiss Bagayogo, Katharina Turcios-Wiswe, Kanako Taku, Lauren Peccoralo, Craig L Katz
Mental illness is a significant cause of disability worldwide, including here in the United States. Given the shortage of trained mental health professionals, a significant portion of patients needing care are managed in the primary care setting. Accountable Care Organizations (ACOs), for example, are seeking to improve the quality of care for this vulnerable population, but many are facing significant challenges relating to integration of new services. We sought to elucidate barriers faced by primary care practitioners (PCPs)-physicians, physician trainees and nurse practitioners-at a New York primary care clinic, which impede delivery of optimal care to those suffering from mental illness...
December 2018: Psychiatric Quarterly
Tebogo Tema, Marie Poggenpoel, Chris Myburgh
BACKGROUND:  Hostile behaviour by mental health care users (MHCUs) is prevalent in forensic units in South Africa, and this causes service providers distress and burnout. Psychiatric nurses (PNs) find it difficult to render quality care to MHCUs who are threatening them and also challenging their authority in a forensic unit. Forensic mental health care practitioners may be challenged to engage authentically with MHCUs who constitute a risk to their personal safety or who have committed acts the practitioner finds morally disturbing...
June 13, 2018: Curationis
Yvonne C van der Zalm, Fabian Termorshuizen, Peter F Schulte, Jan P Bogers, Machteld Marcelis, Iris E Sommer, Jean Paul Selten
Purpose: To our knowledge, no study has examined in a structured way the extent of underprescription of clozapine in ambulatory patients with Non-Affective Psychotic Disorder (NAPD). In the Netherlands, psychiatric care for such patients is provided by Flexible Assertive Community Treatment (FACT) teams and by early intervention teams. In 20 FACT teams and 3 early intervention teams we assessed the proportion of patients who: use clozapine (type 1 patients), previously used this drug (type 2), have an unfulfilled indication for this drug, by type of indication (type 3), or were at least markedly psychotic, but had not yet received two adequate treatments with other antipsychotic drugs (type 4)...
2018: Frontiers in Psychiatry
Magda Tasma, Lukas O Roebroek, Edith J Liemburg, Henderikus Knegtering, Philippe A Delespaul, Albert Boonstra, Marte Swart, Stynke Castelein
BACKGROUND: Routinely monitoring of symptoms and medical needs can improve the diagnostics and treatment of medical problems, including psychiatric. However, several studies show that few clinicians use Routine Outcome Monitoring (ROM) in their daily work. We describe the development and first evaluation of a ROM based computerized clinical decision aid, Treatment-E-Assist (TREAT) for the treatment of psychotic disorders. The goal is to generate personalized treatment recommendations, based on international guidelines combined with outcomes of mental and physical health acquired through ROM...
June 1, 2018: BMC Psychiatry
Susan A Chapman, Bethany J Phoenix, Talia E Hahn, Deborah C Strod
INTRODUCTION: Expanded insurance coverage through the Affordable Care Act and parity in behavioral health coverage have increased demand for services. Yet there is a persistent shortage in the behavioral health workforce. Psychiatric Mental Health Nurse Practitioners (PMHNPs) may be part of the solution to shortages but are not yet fully utilized. The purpose of this study was to describe how PMHNPs are utilized, identify barriers to full utilization, and assess PMHNPs' economic contribution in public behavioral health systems...
June 2018: American Journal of Preventive Medicine
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