NR 548 Psychiatric Assessment for Psychiatric-
Mental Health Nurse Practitioner
Final Exam Week 7-8
1. In 2018, the American Psychiatric Association (APA), in conjunction with the
American Telemedicine Association (ATA) developed
::Ans- best practices for pro- viding videoconferencing-based telepsychiatric care-
guidelines inform the technicalconsiderations and administrative requirements needed to
provide these services
2. best practices for providing videoconferencing-based telepsychiatric care:-
: ::Ans- -Use of a designated technology platform. Telesessions should not be conducted
using alternate platforms; however, an alternate plan, such as a telephone call, maybe used
in case of technology failure.
-Provisions for the verification of confidential and secure client information. -Suffi-cient
,bandwidth to provide clear, appropriate video and audio quality.
-Device compliance with Health Insurance Portability and Accountability Act of 1996
(HIPAA) and state requirements.
3. During telepsychiatry sessions, both the provider and client locations
should be treated as a: ::Ans- Confidential space
4. During telepsychiatry sessions, provisions must be taken to ensure
::Ans- -the discussion cannot be overheard by other-adequate lighting and ambiance is
provid-ed that is appropriate to the session -place the camera so that the eyes and face of
the participants are visible
5. Telepsychiatry Legal and Regulatory Considerations: Best practices: ::Ans- -
Malpractice insurance-Licensure requirements-Federal and state prescribing guidelines
-Reimbursement
6. Telepsychiatry Legal and Regulatory Considerations: Malpractice insur- ance:
::Ans- Malpractice insurance is required and some policies require additional policies for
telehealth.
,7. Telepsychiatry Legal and Regulatory Considerations: Licensure require- ments:
::Ans- Licensure requirements differ from in-person practice.-Providers must holda
license to practice in the state where the client resides.-The PMHNP is responsiblefor
following standards for the state in which they are practicing.
8. Telepsychiatry Legal and Regulatory Considerations: Federal and state pre-
scribing guidelines: ::Ans- Federal and state prescribing guidelines differ for
telepsychiatry.-The Ryan Haight Online Pharmacy Consumer Protection Act of 2008
governsthe prescribing of controlled substances via teleconferencing.• To safely
prescribe,the provider must conduct an in-person medical evaluation at least once every
24 months and comply with all federal and state prescribing guidelines.
9. Telepsychiatry Legal and Regulatory Considerations: Billing and Reim-
bursement: -Reimbursement varies by state and insurance provider.• Currently, 48
states provide Medicaid reimbursement for telepsychiatry services.-pt made aware of any
and all financial charges that may arise from the services prior to thecommencement of
initial services
,10. Best practices for determining the appropriateness of telepsychiatry services
include consideration of the following
::Ans- -cognitive capacity of the client-client history and medical status -geographic
distance to emergency facilities
-client support system
11. Best practices related to special populations: Forensic and Correctional-
: -follow applicable standards of consent in terms of client's legal status and rights
-develop clear, site-specific protocols
12. Telemental health Children and Adolescents: environment: ::Ans- should
facilitatethe assessment by providing an adequate room size, furniture arrangement, toys,
and activities that allow the youth to engage with the accompanying parent, presen-ter,
and provider and demonstrate age-appropriate skills
13. best practices related to special populations: Children and Adolescents: -::Ans-
follow the same guidelines presented for adults•modify care based on developmen-tal
status (motor functioning, speech and language capabilities, relatedness, and relevant
regulatory issues)-include family as appropriate-Providers should considerhow the
presenter's involvement can affect service delivery -Appropriateness for telemental care
shall consider safety of the youth, the availability of supportive adults, the mental health
,status of those adults, and ability of the site to respond
to any urgent or emergent situations.
14. Best practices related to special populations: Geriatric: ::Ans- -include family as
clinically appropriate-adapt care for cognitive or sensory impairment
15. best practices related to special populations: Military and Veteran: -be familiar
with federal and organizational structures and guidelines -be familiar withmilitary
cultural competence
16. best practices related to special populations: Substance Use Disorder
Treatment: comply with federal, state, and local regulations related to prescribing
controlled substances
-coordinate with on-site staff as appropriate to ensure care coordination and moni-toring
17. best practices related to special populations: Inpatient and Residential
Settings: ::Ans- -participate in administration and organizational meetings as
appropriate
-optimize use of site-staff for consultation and care coordination
18. best practices related to special populations: Primary Care: leverage
telepsychiatry to support integrated care
19. best practices related to special populations: Rural: be aware of impact of rural
environments in relation to firearm ownership, kinship, and geographic barriersto care
, 20. Typically, the standard operating procedures (SOP) addresses
::Ans- roles, re-sponsibilities, licensing, client identification, and systematic quality
improvement.
-backup plan to address technical difficulties is frequently included
21. standard protocols to support telepsychiatry services: (4 steps): Step 1:Confirm
the name and credentials of provider and the name of the client.
Step 2: Identify the location of the client.
Step 3: Gather contact information for provider and client in case of interruption of
session.
Step 4: Provide guidance for appropriate contact between sessions and review emergency
management protocols for client.-If client is in a location with clinical staff, the provider
will inform staff of emergent situations -If client is in another location, the provider may
identify a support person to contact for potential emer- gencies.-If the client requires
emergency intervention in the community setting, theprovider must coordinate with
local emergency staff.
22. Telehealthcare: the use of telecommunications technology to remove time and
distance barriers from the delivery of health care services and related health
care activities-Traditionally, the use of telehealth and tele-mental health care was
designed to meet the needs of rural populations and geographic areas with identified
