College of Registered Psychiatric Nurses of British Columbia. Guidelines Registered Psychiatric Nurses in Independent Practice

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1 Coege of Registered Psychiatric Nurses of British Coumbia Guideines Registered Psychiatric Nurses in Independent Practice March 27, 2008

2 Tabe of Contents Introduction and Background...page 2 Definition of Independent Practice...page 2 Context of Independent Practice...page 3 Critica Eements for Independent Practice...page 4 Eigibiity Criteria...page 4 Competency Profie...page 6 Current Competency Profie Continuing Competency Program Service Deivery Pan...page 6 Accountabiity Informed Consent Confidentiaity Confict of Interest Mapractice Liabiity Insurance Documentation and Records Business Records and Practices Continuous Quaity Improvement Termination of Practice Appendices I - Gossary II - Registered Psychiatric Nurses: Competency Profie for the Profession in Canada RPNC, 2001

3 Introduction and Background The Coege of Registered Psychiatric Nurses of British Coumbia (CRPNBC) recognizes that independent practice is a egitimate option sphere of practice for Registered Psychiatric Nurses. In recent years, growing numbers of Registered Psychiatric Nurses have begun entering independent practice. The growing numbers of Registered Psychiatric Nurses in independent practice paces an additiona responsibiity on Registered Psychiatric Nurses to ensure appropriate practices. The fu extent of the professiona responsibiity fas upon the individua professiona to ensure that a aspects of independent practice fa within the overa scope of practice of Registered Psychiatric Nurses in British Coumbia. In an effort to meet the additiona responsibiity, a greater emphasis on quaifications and practica experience has been advocated. The need for further quaifications for independent practice has been recognized and emphasized by Registered Psychiatric Nurses in independent practice themseves. In 2005/2006 draft guideines were distributed to a Registered Psychiatric Nurses in independent practice in British Coumbia. The Guideines for Registered Psychiatric Nurses in Independent Practice in British Coumbia incorporates the feedback received during the consutation process. Definition of Independent Practice Independent practice is the appication of psychiatric nursing knowedge and principes in an unsupervised, sef-empoyment setting in psychiatric nursing practice and/or psychiatric nursing services. Registered Psychiatric Nurses in independent practice must conform to the CRPNBC Standards of Psychiatric Nursing Practice, professiona CRPNBC Code of Ethics and competencies identified for a Registered Psychiatric Nurse in independent practice. The Registered Psychiatric Nurse in independent practice: is a graduate from an approved psychiatric nursing education program with additiona education and experience as defined by the CRPNBC is advised to deveop a Service Deivery Pan consistent with the overa scope of practice for Registered Psychiatric Nurses as defined by the 2

4 Coege of Registered Psychiatric Nurses of British Coumbia must be a practising registrant with the CRPNBC is soey responsibe for his/her practice may incude the provision of independent, interdependent and dependent psychiatric nursing practice through an agency or business Independent psychiatric nursing practice comprises two components: service deivery and business management. Service deivery incudes, but is not imited to, aspects of aw, ethics and pubic safety in offering psychiatric nursing services to cients. Business management incudes the organization and operation of business and financia structures which support the deivery of the psychiatric nursing services. Context of Practice Independent practice is the appication of psychiatric nursing theory and principes in a sef-directed, sef-empoyment setting. The parameters are determined within the context of the scope of practice of the Registered Psychiatric Nurse, jurisdictiona egisation, CRPNBC Code of Ethics, CRPNBC Standards of Psychiatric Nursing Practice, competencies identified for a Registered Psychiatric Nurse in independent practice and eigibiity criteria as identified by the CRPNBC. Independent psychiatric nursing practice is highy diversified and may occur in the domains of: cinica practice education research administration Independent psychiatric nursing practice may occur in, but is not imited to: crisis consutation and intervention individua, famiy and group counseing or psychotherapy education programs consutation with pubic, private or vountary organizations program deveopment psychosocia rehabiitation community iaison with resource agencies or individuas 3

5 vocationa counseing in residentia or day programs menta heath and addiction services contract work projects or initiatives consutation services Critica Eements for Independent Practice Critica eements for independent psychiatric nursing practice incude, but are not imited to: n psychiatric nursing practice theory and appication integration of critica thinking and cinica judgement, advocacy and eadership menta heath promotion and prevention primary, secondary and tertiary interventions and principes the appication of community deveopment frameworks psychiatric nursing research professionaism - knowedge and appication of federa and provincia egisation, principes of consent and confidentiaity professiona practice - deiberate sef-care, awareness of professiona issues in psychiatric nursing practice, appication of the CRPNBC Standards of Psychiatric Nursing Practice and CRPNBC Code of Ethics and the incorporation of evidence-based practices cutura awareness and cutura safety in psychiatric nursing practice Eigibiity Criteria Members currenty identified as Registered Psychiatric Nurses in independent practice wi continue to be eigibe for independent practice status. A Registered Psychiatric Nurses in independent practice require a strong theory base as we as a demonstrated appropriate eve of cinica skis. An individua is eigibe to be registered with the Coege of Registered Psychiatric Nurses of British Coumbia as a Registered Psychiatric Nurse in independent practice if: he or she is a practicing registrant 4

6 is a Registered Psychiatric Nurse who has successfuy competed undergraduate preparation from an accredited educationa institution and which woud incude one (1) of the foowing three (3) options: A Registered Psychiatric Nurse with a Baccaaureate Degree recognized by the CRPNBC such as a Bacheor of Heath Sciences (Psychiatric Nursing) BHSc (PN), a Bacheor of Science in Menta Heath (BScMH), a Bacheor of Science in Psychiatric Nursing (BSPN) or a Bacheor of Psychiatric Nursing (BPN). The Registered Psychiatric Nurse must have been activey working within the identified scope of practice for a minimum of five (5) years of fu time equivaence in the speciaty area of independent practice. OR A Registered Psychiatric Nurse with a Baccaaureate Degree recognized by the CRPNBC and which is considered equivaent to one of the degrees noted in the option above. The Registered Psychiatric Nurse must have been activey working within the identified scope of practice for a minimum of five (5) years of fu time equivaence in the speciaty area of independent practice. OR A Registered Psychiatric Nurse with a combination of experience, forma and informa education which incudes a of the foowing requirements: activey working as a Registered Psychiatric Nurse for a minimum of five (5) years fu time equivaence in the speciaty area of independent practice documentation of reated professiona deveopment education the etters of reference referred to beow must be from two (2) practicing Registered Psychiatric Nurses or two (2) other heath care professionas who have directy observed the appicant in his/her area of speciaity It is an expectation that a Registered Psychiatric Nurses in independent practice wi provide the CRPNBC with documented evidence of ongoing competence and the expectation to engage in peer review and consutation with other heath care professionas. Prior to commencement of independent practice, a appicants for independent practice registration must provide the CRPNBC with two (2) written reference 5

7 etters, approved by the CRPNBC, that sha attest to the appicants eve of ski and competence reated to the area of speciaty within the independent practice fied. The Registered Psychiatric Nurse in independent practice must know when to seek professiona assistance, support or referra for cinica, ethica and other issues where gaps and imitations in knowedge base are evident or when a cient s needs exceeds the competencies of the Registered Psychiatric Nurse. Competency Profie The Registered Psychiatric Nurse in independent practice must maintain documented evidence of current competency profie requirements as we as to ongoing continuing competency programs reated to the speciaity area of independent practice. The competency profie for Registered Psychiatric Nurses in independent practice is identified in the Registered Psychiatric Nurses of Canada document tited Registered Psychiatric Nurses: Competency Profie for the Profession in Canada, RPNC, Competency L-9: Psychiatric Nursing in Independent Practice. The competency area referenced is in the area of cinica practice. The competency profie and the continuing competency program for Registered Psychiatric Nurses in British Coumbia can be accessed by contacting the CRPNBC. Service Deivery Pan The Registered Psychiatric Nurse who is in independent practice is advised to deveop a Service Deivery Pan consistent with the overa scope of practice of Registered Psychiatric Nurses as defined by the Coege of Registered Psychiatric Nurses of British Coumbia. The Service Deivery Pan shoud incude the foowing eements, but is not imited to: an outine of the cinica focus and the scope of services or independent practice the purpose, goas and expected outcomes of the services or practice ocation of the business, teephone number and hours of operation 6

8 fees and payment schedues quaifications of the independent practitioner - education, experience and speciaization expectations of the nurse/cient reationship accountabiity for service informed consent confidentiaity confict of interest mapractice iabiity insurance documentation and records continuous quaity improvement continuing competence termination of practice Each of the above components has different and significant impications for taxation, iabiity and succession. It is recommended that Registered Psychiatric Nurses in independent practice consut a business awyer and/or accountant to be advised on what type of business structure best suits the respective Registered Psychiatric Nurse and the menta heath cients to whom services wi be provided. Accountabiity The Registered Psychiatric Nurse in independent practice must demonstrate accountabiity to the cient, the pubic and the CRPNBC by: recognizing persona and professiona boundaries and imitations making appropriate referras seeking out appropriate persona and professiona resources assuming responsibiity for continuay maintaining and upgrading skis and education in cinica areas of focus appying the concepts of accountabiity, responsibiity and continuing competency knowing professiona issues in psychiatric nursing practice knowing and appying the CRPNBC Standards of Psychiatric Nursing Practice and professiona CRPNBC Code of Ethics identifying and incorporating best practices Informed Consent The Registered Psychiatric Nurse in independent practice must demonstrate knowedge and understanding that the issues of competency, capacity and consent arise in numerous contexts incuding, but not imited to: 7

9 consent and competency/capacity to consent to admission/entry to a hospita/faciity, agency/service or psychiatric nursing care, treatment, psychiatric nursing interventions, tests and procedures, research and reease of information The Registered Psychiatric Nurse in independent practice must demonstrate an understanding that the ega principes governing competence/capacity to consent vary depending on the context: age of consent identified under federa and provincia/territoria egisation cient s abiity to understand the nature of the treatment or procedure, the benefits and risks cient s inteectua capacity to understand what is proposed cient s cognitive capacity to understand and comprehend what is being proposed cient s menta status The Registered Psychiatric Nurse in independent practice must demonstrate knowedge of and effective appication of the principes of consent as they appy to psychiatric nursing practice incuding, but not imited to: impicit or expicit consent consent is considered vaid ony when given vountariy (cient s decision is the product of theconscious mind) and not coerced in any way consent is considered to be vaid ony if the cient is competent consent of next-of-kin is ony reevant if the cient is not capabe of consenting and if the next-of-kin is duy appointed as the substitute decision-maker consent is to be obtained in advance of the initiation of any test, procedure or psychiatric nursing intervention consent must reate to specific treatment or psychiatric nursing intervention(s) undertaken record keeping, reporting and other discosures of information fu and frank discosure of the nature of the intervention(s), the risks and aternatives the scope of consent emergency treatment under provincia or federa aw, imminent and serious risk to sef or imminent and serious risk to others Informed consent must be obtained at the beginning of the professiona reationship. If the conditions that the cient imposes woud render the intervention(s) futie or harmfu, the Registered Psychiatric Nurse in independent practice shoud withdraw from the reationship. 8

10 The Registered Psychiatric Nurse must ceary identify processes to be foowed to address issues of consent. Confidentiaity Written cient authorization is required prior to the reeasing or obtaining of information about that cient to or from anyone, incuding referring agencies or individuas. Professionay acquired information must be treated as confidentia communication. The obigation of confidentiaity begins in any situation in which there woud be a reasonabe expectation of privacy. The Registered Psychiatric Nurse in independent practice must demonstrate knowedge and appication of confidentiaity principes in the therapeutic reationship and manage and store a information about cients in ways that maintain confidentiaity. The Registered Psychiatric Nurse in independent practice must be famiiar with the ega and ethica guideines concerning confidentiaity and demonstrate knowedge and abiity to define those circumstances where confidentiaity can be breached. These incude: imminent or serious risk to sef imminent or serious risk to others imminent risk for substantia menta or physica deterioration court subpoena or when required by aw where the Registered Psychiatric Nurse is a defendant in a civi, crimina or discipinary action arising from the professiona reationship where there is informed consent previousy obtained in writing; and then, such information may ony be reveaed in accordance with the terms of the consent Confict of Interest The Registered Psychiatric Nurse in independent practice must adhere to a ethica principes and abide by the CRPNBC Code of Ethics when providing psychiatric nursing practices or services. Such issues incude, but are not imited to: n directy or indirecty recruiting cients from one s empoyer providing services to a cient personay known to the Registered Psychiatric Nurse on a socia basis 9

11 providing services to a minor uness parenta consent is formay obtained recognition of confict of interest situations The Registered Psychiatric Nurses in independent practice is advised to seek professiona assistance, in consutation with the CRPNBC, if it is uncear whether or not a specific situation constitutes a confict of interest. Mapractice Liabiity Insurance The Registered Psychiatric Nurse in independent practice must have adequate professiona iabiity and business insurance coverage. Documentation and Records The Registered Psychiatric Nurse in independent practice must maintain confidentia and accurate records for each menta heath cient. The records must show evidence of continuity and demonstrate a professiona sense of responsibiity. Records refer to documentation kept about cients, whether on paper, on computer, or by any other means. Documents wi incude but are not imited to: a genera cient information form a vountary consent form signed and dated by the cient or by a duy appointed substitute decision-maker a contract signed and dated by both the independent practitioner and the cient documentation of services provided and any organizationa/operationa poicies used in practice times and dates of contacts with cients referra forms for consutation with other professionas in situations requiring additiona expertise in the event of referra to other heath care professionas or agencies, a signed reease of information must be obtained from the cient prior to any exchange of information about the cient At a times the cient fies (eectronic or hard copy) and pertinent documentation must be propery secured and maintained to ensure cient confidentiaity. The fies and documentation wi be maintained in accordance with privacy egisation in British Coumbia. 10

12 The onus is on the Registered Psychiatric Nurse in independent practice to determine which statute appies for ength of retention and storage of records. The Registered Psychiatric Nurse in independent practice is required to keep accurate and adequate records. Faiure to do so wi be considered to be professiona misconduct. Business Records and Practices The Registered Psychiatric Nurse in independent practice must be personay and professionay responsibe for a cinica and business aspects of the service. These aspects incude, but are not imited to: scheduing of cients purchasing of equipment and suppies deveoping referra sources maintaining cient records paying bis and taxes coecting fees writing reports maintaining appropriate insurance keeping accurate records nature and scope of the service service ocation mutua expectations between the cient and the Registered Psychiatric Nurse education and experience, dipomas, certificates and other reevant documents avaiabe for inspection upon request contractua agreements with estabished agencies for third party reimbursement Continuous Quaity Improvement The Registered Psychiatric Nurse in independent practice must maintain a means of quaity measurement for a cients to evauate psychiatric nursing practices empoyed in the provision of services. The Registered Psychiatric Nurse in independent practice must ensure that any advertising wi provide accurate and factua information and wi not exaggerate the benefits of the services provided, misead the pubic, or detract from the pubic image of the psychiatric nursing profession. The Registered Psychiatric Nurse in independent practice must not use the CRPN- 11

13 BC ogo or make any other representation which woud impy speaking on behaf of or in any way representing the reguatory body. The Registered Psychiatric Nurse in independent practice must recognize the need for referras and consutation with other professionas or resources in situations requiring additiona expertise. The Registered Psychiatric Nurse in independent practice must maintain evidence of a commitment to meet current competency profie requirements and to ongoing continuing competency programs reated to the speciaty area of practice or service. Termination of Practice The Registered Psychiatric Nurse in independent practice must have a pan for the termination of practice as it reates to: cients of the service referra sources professiona coeagues transfer of cients transfer of cient fies when appropriate written permission has been obtained from the cient maintaining or destroying cient fies in a confidentia manner cosure of business accounts and payment of fees catastrophic events such as death or unforeseen circumstance 12

14 Appendix I Gossary

15 Gossary abiities advocate advocacy accountabiity accompaniment arenas of deiberate consciousness assessment of sef baseine boundaries capacities cient coaboration community appication of knowedge and ski in performing activities with judgement, reasoning and comprehension to pead for, defend, recommend and/or support the function of an advocate being answerabe for one s own actions an interpersona process that supports capacity buiding, empowerment, sef-efficacy and sef-determination whie providing an effective professiona presence and guidance the parts of an individua that compromise the whoe sef incuding physica, emotiona, socia and spiritua a critica and refective evauation of one s own performance the starting point the imits or margins that support and maintain therapeutic reationships maximum interna or externa power or resources anyone to whom a Registered Psychiatric Nurse provides service. An individua, famiy, group or community that participates with Registered Psychiatric Nurses through promotion, prevention or rehabiitation. A cient may be more than someone receiving direct patient care; for exampe, an educator s cients may incude students; a researcher s cients may incude the research subjects; an administrator s cients may incude staff the process of co-operation or joint effort that embraces respect and shared responsibiity. The focus is on probem soving. a body of peope united by common needs and interests 14

16 competency continuing competency counseing consutation critica sef-refection current deiberate consciousness the knowedge, skis, judgements, attitudes and vaues required for successfu functioning of the Registered Psychiatric Nurse maintaining competence throughout one s career the process of deveoping authentic partnerships with cients that are time-imited and goa-directed. The Registered Psychiatric Nurse strives to insti hope whie promoting the sharing of responsibiity, accountabiity and decision-making interactiona or communication process between two or more persons; the one is the consutant, the other(s) the consutee a process intentionay originated to examine or re-examine one s beiefs, practices or behaviours prevaent at the moment an intentiona and continua process which invoves critica sef-examination at the persona and professiona eves determinant of socia variabes that infuence menta heath as identified by menta heath Heath Canada, Menta Heath Promotion Unit (1998) egaitarian reationships empowerment evauation famiy group heaing arenas reationships that support equa rights and opportunities of consumers a process that creates the reaization of interna and externa resources that foster menta heath the panned systematic comparison with the stated outcomes, objectives or standards a group of persons united by ancestry or choice a number of persons who share common characteristics. Three arenas identified by Keinman (1978) where individuas see support to promote menta heath prior to and/or during a menta iness: 15

17 fok arena: non-professiona heaing speciaists professiona arena: Western medicine, indigenous or other cutura heaing traditions popuar arena: individua, famiy and community individua intersectora judgement eadership menta heath menta heath promotion menta iness primary menta heath resiiency a singuar, distinct and unique person an integrated system where the emphasis is on maintaining the heath of individuas, groups and communities. An interdiscipinary team of providers from various sectors may work coaborativey and in a coordinated manner in the deivery of services to form an opinion about, to estimate, to appraise the use of one s own ski to infuence others to perform to the best of their abiities. A process of infuencing the activities of an organized group toward goa-setting and goa-achievement a state which supports affective, cognitive and reationa capacity to experience the tripe standard of empoyment, eisure and reationships an emerging distinct discipine that supports heath promotion through directing action upon the determinants of menta heath across a popuations. Menta heath promotion strives to contribute to deveoping heathy pubic menta heath poicy through fostering menta, socia, emotiona and spiritua heath/weness in diverse environments. Menta heath promotion aims to estabish conditions that foster positive states and optimum eves of functioning an imprecise term that cassifies or groups conditions which create imbaances in a person s hoistic heath focuses on improving the menta heath state through partnerships created with cients within the context of promotion, prevention, cure, rehabiitation or support the abiity to recover and re-discover interna strengths that 16

18 support menta heath scope of practice sef-efficacy therapeutic miieu transdiscipinary team tripe standard of menta heath area(s) covered by an individua s professiona practice a state of sef-confidence that promotes consumers abiity to enhance menta heath creation of growth-producing environments or settings a muti-sectora team that affords consumers meaningfu participation by reducing the professiona discipines contros through sharing of professiona information, roes and consensus decision-making. Transdiscipinary teams maximize communication to reduce imitations often posed by the mutidiscipinary team. three major ife areas (working we, paying we and oving we) that provide a itmus test to measure menta heath in a broad manner. 17

19

20 Appendix II Registered Psychiatric Nurses: Competency Profie for the Profession in Canada: 2001 Registered Psychiatric Nurses Association of Canada

21 Competency Profie for Registered Psychiatric Nurses: 2001 Competencies for Registered Psychiatric Nurses in Independent Practice are identified under Competency L - 9 in the document tited Registered Psychiatric Nurses: Competency Profie for the Profession in Canada: Competency L-9 identifies 26 major competencies in the area of cinica practice. Competencies have not been identified in the other domains of practice reated to administration, education or research. Specific competencies are highighted as we as other competency areas that impact Registered Psychiatric Nurses in Independent Practice. A competencies referenced in this document can be ocated by accessing the respective provincia reguatory body website: (Aberta); www. crpnbc.bc.ca (British Coumbia); (Manitoba) and com (Saskatchewan). L-9-1 L-9-2 L-9-3 L-9-4 Demonstrate knowedge of and abiity to work with individuas affected by Initia, acute, cycic and persistent menta inesses Refer to competency areas: E-2: Knowedge of Cognitive Disorders; E-3: Knowedge of Substance-Reated Disorders; E-4: Knowedge of Schizophrenia and Other Psychotic Disorders; E-5: Knowedge of Mood Disorders; E-6: Knowedge of Anxiety Disorders; E-7: Knowedge of Personaity Disorders and E-8: Knowedge of Other Psychiatric Disorders Demonstrate knowedge and understanding of the reationship between concurring disorders incuding, but not imited to, dua diagnosis and muti-axia diagnoses Demonstrate knowedge and appication of the therapeutic use of sef Refer to competency areas: A-2: Knowedge and Appication of Sef in the Therapeutic Process and R-1: Knowedge and Appication of Deiberate Sef-Care Demonstrate knowedge and appication of counseing and effective interpersona communication skis Refer to competency areas: A-1: Knowedge and Appication of Interpersona Communication Skis and A-3: Knowedge and Appication of the Characteristics of the Therapeutic Reationship 20

22 L-9-5 L-9-6 L-9-7 L-9-8 L-9-9 Demonstrate knowedge and appication of teaching skis Refer to competency area A-4: Knowedge and Appication of Teaching Skis Demonstrate awareness of own eve of practice based on education, quaifications and experience Demonstrate knowedge and abiity to deveop a business pan (service deivery pan) outining cinica focus and services offered Demonstrate knowedge and abiity to deveop a service agreement or contract structured to incude, but not imit to: purpose, goas and expected outcomes time, ocation and frequency of therapy mutua expectations fees and payment schedues confidentiaity individuas invoved in therapy imits to the service definition of the scope of the service Demonstrate knowedge and abiity to integrate cinica thinking and cinica judgement in the pharmacoogica assessment and treatment of individuas Refer to competency area I-5-4: Knowedge and Appication of Pharmacoogica Therapies L-9-10 Demonstrate knowedge and abiity to conduct a comprehensive and ongoing menta status assessment Refer to competency area G-4: Knowedge and Abiity to Compete a Menta Status Examination L-9-11 Demonstrate knowedge and abiity to conduct a comprehensive psychiatric nursing assessment Refer to competency areas C: Knowedge of Human Growth and Deveopment; F: Knowedge of Socia and Famiy Systems; G-2: Knowedge of Assessment Skis; G-3: Knowedge and Appication of Psychiatric Nursing Assessment Skis and I-3-1: Knowedge of Admission/Entry to the Systems Procedures L-9-12 Demonstrate knowedge and abiity to conduct physica assessments Refer to competency areas B: Knowedge of Bioogica Systems; D-2-1: 21

23 Knowedge of Activities of Daiy Living; D-2-2: Knowedge of Monitoring of Vita Signs; G-5: Knowedge of Physica Assessment Skis and I-4-2: Abiity to Assess and Manage Eimination Needs L-9-13 Demonstrate knowedge and abiity to deveop and impement a therapeutic pan based on the needs of the cient and accepted nursing practice Refer to competency areas G-1: Knowedge and Abiity to Appy the Nursing Process in Psychiatric Nursing Practice; G-6: Knowedge of Psychiatric Nursing Diagnosis; H-1: Knowedge and Abiity to Compete the Panning Phase of the Nursing Process; I-1: Knowedge of the Impementation Phase of the Nursing Process and J-1: Knowedge and Abiity to Compete the Evauation Phase of the Nursing Process L-9-14 Demonstrate a recognition that decisions affecting the therapeutic pan are made in coaboration with the cient Refer to competency area K: Probem-Soving, Coaboration and Leadership L-9-15 Demonstrate knowedge and abiity to participate in and/or educate the cient about therapeutic modaities incuding, but not imited to: group therapies recreation therapies individua therapies famiy therapies miieu therapy crisis intervention behaviour therapies somatic therapies (eectroconvusive therapy, phototherapy) Refer to competency areas I-5-1: Knowedge and Appication of Therapeutic Miieu Therapy; I-5-2 Knowedge and Appication of Techniques of Individua Therapy and I-5-3: Knowedge of Group Processes L-9-16 Demonstrate knowedge and abiity to conduct a comprehensive risk assessment and to respond to psychiatric emergencies Refer to competency areas I-2-2: Abiity to Recognize, Manage and Document Aggressive Behaviour; I-2-3: Abiity to Recognize and Report Abuse and I-2-5: Knowedge and Abiity to Respond to Psychiatric Emergencies L-9-17 Demonstrate knowedge and abiity to provide psychiatric nursing care based on a comprehensive approach to the cient s 22

24 we-being incuding, but not imited to: physica menta emotiona spiritua cutura socia Refer to competency areas M-1: Knowedge of Primary, Secondary and Tertiary Prevention; M-2: Knowedge and Appication of Menta Heath Promotions and S: Cutura Awareness and Cutura Safety in Psychiatric Nursing L-9-18 Demonstrate knowedge and abiity to provide for advocacy with individuas, famiies, groups and communities Refer to competency area K-4: Abiity to Advocate L-9-19 Demonstrate knowedge and abiity to identify and access reevant community resources incuding, but not imited to: addictions services domestic vioence services sexua assaut services crisis services acute psychiatric care resources tertiary care resources cuturay-appropriate crisis and counseing services deveopmenta disabiity services age-appropriate crisis and counseing services housing resources income/financia resources HIV/AIDS and STD services L-9-20 Demonstrate knowedge and abiity to provide consutation services to individuas, groups and communities by: deineating the roe of the psychiatric nurse sharing psychiatric nursing assessment skis sharing information about resources L-9-21 Demonstrate knowedge and abiity to appy reevant aspects of the current federa and/or provincia/territoria egisation in psychiatric nursing practice Refer to competency areas Q-1: Knowedge and Appication of Federa and Provincia Legisation in Psychiatric Nursing Practice and Q-2: Knowedge and Appication of the Principes of Consent and Confidentiaity 23

25 L-9-22 Demonstrate knowedge and abiity to measure outcomes in order to determine the effectiveness of services Refer to competency area J-1: Knowedge and Abiity to Compete the Evauation Phase of the Nursing Process L-9-23 Demonstrate knowedge and abiity to deveop cear and consistent documentation practices in the independent practice environment incuding, but not imited to: consents service agreements or contracts consents to reease information charting reports to externa agencies Refer to competency area D-4-1: Knowedge and Appication of Documentation and Reportin Skis L-9-24 Demonstrate knowedge and understanding of research and its impications in psychiatric nursing practice L-9-25 Demonstrate accountabiity to the cient, the pubic and the professiona/reguatory body by: recognizing persona and professiona boundaries and imitations making appropriate referras when necessary seeking out appropriate persona and professiona resources when necessary assuming responsibiity for maintaining and upgrading eve of skis and education in cinica area of focus L-9-26 Demonstrate knowedge and appication of the concepts of accountabiity, responsibiity and continuing competence Refer to competency areas R-2: Knowedge of Professiona Issues in Psychiatric Nursing Practice; R-3: Knowedge and Appication of Standards of Psychiatric Nursing Practice; R-4: Knowedge and Appication of Professiona Ethics and R-5: Abiity to Identify and Incorporate Best Practices 24

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