psychiatric emergencies
Assignment_____
A psychiatric emergency is a situation that if left untreated is likely to cause harm to oneself or others. These acute disturbances of behavior may manifest as suicidal ideation or attempts, violence, agitation, drug overdose, delirium, psychosis, mania, neuroleptic malignant syndrome, or serotonin syndrome. When psychiatric emergencies arise, they can present many challenges to the PMHNP. While many approaches to emergencies are similar when dealing with children and adolescents versus adults, significant differences also exist. This is particularly true with coordination of care, availability of resources, and legal implications of the psychiatric emergency.
This week, you examine psychiatric emergencies and explain the ethical and legal issues surrounding these events. You will also review evidence-based suicide and violence risk assessments that you may use to screen patients.
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 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.
Attach copies of or links to the suicide and violence risk assessments you selected. You will lose points if you do not attach copies or links to the suicide and violence risk assessments you selected in the body of your paper or as appendices which are separate from the reference list. It is not enough to only include the references for the links in the list of references.
You will lose points if your paper has more than 3 pages (excluding the title page of the assignment, reference list, and appendices if any).
You will lose points if your paper does not follow APA style. APA style includes use of headings and page numbers. Insert page numbers in the top right corner. Make sure your assignment is double-spaced. You need to include headings to identify the content of each of the distinct topics you are asked to address. Review the syllabus for explanation of primary and secondary sources.
LEARNING RESOURCES
Required Readings
· 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).
Br
ø
set violence checklist Links to an external site.
. 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 Links to an external site.
: 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 |
aripiprazole |
clomipramine |
Catatonia |
Extrapyramidal side effects |
Mania |
alprazolam |
benztropine |
alprazolam (adjunct) |
Rubric
NRNP_6675_Week8_Assignment_Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeIn 2–3 pages, address the
f
ollowing: • 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.
15 to >13.0 pts
Excellent 90%–100%
The response includes a thorough and well-organized explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.
13 to >11.0 pts
Good 80%–89%
The response includes an accurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.
11 to >10.0 pts
Fair 70%–79%
The response includes a somewhat vague or inaccurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.
10 to >0 pts
Poor 0%–69%
The response includes a vague or inaccurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies. Or the response is missing.
1
5 pts
This criterion is linked to a Learning Outcome• Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
15 to >13.0 pts
Excellent 90%–100%
The response includes an accurate and concise explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
13 to >11.0 pts
Good 80%–89%
The response includes a well-organized explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
11 to >10.0 pts
Fair 70%–79%
The response includes a somewhat vague explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
10 to >0 pts
Poor 0%–69%
The response includes a vague explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. Or the response is missing.
15 pts
This criterion is linked to a Learning Outcome• Explain the difference between capacity and competency in mental health contexts.
10 to >8.0 pts
Excellent 90%–100%
The response includes an accurate and concise explanation of the difference between capacity and competency in mental health contexts.
8 to >7.0 pts
Good 80%–89%
The response includes an accurate explanation of the difference between capacity and competency in mental health contexts.
7 to >6.0 pts
Fair 70%–79%
The response includes a somewhat vague or incomplete explanation of the difference between capacity and competency in mental health contexts.
6 to >0 pts
Poor 0%–69%
The response includes a vague or inaccurate explanation of the difference between capacity and competency in mental health contexts. Or the response is missing.
10 pts
This criterion is linked to a Learning Outcome• 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.
15 to >13.0 pts
Excellent 90%–100%
The response accurately and concisely explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.
13 to >11.0 pts
Good 80%–89%
The response accurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.
11 to >10.0 pts
Fair 70%–79%
The response somewhat vaguely or innacurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.
10 to >0 pts
Poor 0%–69%
The response vaguely or innacurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies. Or, response is missing.
15 pts
This criterion is linked to a Learning Outcome•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.
15 to >13.0 pts
Excellent 90%–100%
The response identifies and explains an appropriate, evidence-based suicide risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.
13 to >11.0 pts
Good 80%–89%
The response identifies an appropriate, evidence-based suicide risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.
11 to >10.0 pts
Fair 70%–79%
The risk assessment identified is somewhat inappropriate for the intended use or dated. A copy of or a link to the assessment may be missing.
10 to >0 pts
Poor 0%–69%
The risk assessment identified is inappropriate for the intended use, not evidence based, or dated. Or, response is missing.
15 pts
This criterion is linked to a Learning Outcome• 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.
15 to >13.0 pts
Excellent 90%–100%
The response identifies and explains an appropriate, evidence-based violence risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.
13 to >11.0 pts
Good 80%–89%
The response identifies an appropriate, evidence-based violence risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.
11 to >10.0 pts
Fair 70%–79%
The risk assessment identified is somewhat inappropriate for the intended use or dated. A copy of or a link to the assessment may be missing.
10 to >0 pts
Poor 0%–69%
The risk assessment identified is inappropriate for the intended use, not evidence based, or dated. Or, response is missing.
15 pts
This criterion is linked to a Learning OutcomeWritten 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.
5 to >4.0 pts
Excellent 90%–100%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 to >3.5 pts
Good 80%–89%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.
3.5 to >3.0 pts
Fair 70%–79%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic.
3 to >0 pts
Poor 0%–69%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.... No purpose statement, introduction, or conclusion were provided.
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 grammar, spelling, and punctuation errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 grammar, spelling, and punctuation errors
3 to >0 pts
Poor 0%–69%
Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
This criterion is linked to a Learning OutcomeWritten 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.
5 to >4.0 pts
Excellent 90%–100%
Uses correct APA format with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 APA format errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 APA format errors
3 to >0 pts
Poor 0%–69%
Contains five or more APA format errors
5 pts
Total Points: 100
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