Academic journal article Online Journal of Issues in Nursing

The 2014 Scope and Standards of Practice for Psychiatric Mental Health Nursing: Key Updates

Academic journal article Online Journal of Issues in Nursing

The 2014 Scope and Standards of Practice for Psychiatric Mental Health Nursing: Key Updates

Article excerpt

The American Nurses Association (ANA) established a formal process in the late 1990s to recognize specialty areas of nursing practice as they develop and evolve with advancements in healthcare. Presently, there are over twenty specialties for which ANA produces a dedicated Scope and Standards of Practice. The ANA production schedule aims to publish revisions of each volume every five years.

The scope portion of these volumes identifies the focus of the specialty by defining nursing practice extents and limits. Therefore, the presentation of the scope of practice varies from specialty to specialty in the topics and contexts addressed. Standards are statements that identify the duties and obligations for which specialty nurses are held accountable, including general registered nurses and advanced practice nurses. All of the standards follow the organization of the ANA Nursing: Scope and Standards of Practice, 2nd Edition (2010).

Scope and Standards publications serve as a reference document for the relevant specialty, nursing in general, and across roles, including education, research and practice. These documents are also used by regulators, payors, policy makers and other stakeholders. The current article offers information and commentary that addresses the specialty of psychiatric mental health (PMH) nursing practice, specifically the Psychiatric-Mental Health Nursing: Scope and Standards of Practice, 2nd Edition (referred to as PMH Scope and Standards).

Brief Overview of the Revision Process

To review and update such a significant document, numerous strategies were employed by ANA to ensure both the expertise of the contributors and representation across the specialty on the dedicated Joint Task Force for revision. Sources of expertise were drawn from national nursing organizations and members of the previous task force. For revision of the PMH Scope and Standards, two nursing organizations identified representatives to serve as co-chairs for the review process; neither had served on the ANA Joint Task Force for the 2007 edition. Five of the fourteen members had served on the previous Joint Task Force. Members represented all educational levels from bachelors to doctoral level preparation; sub-specialty areas; and settings including community and inpatient practice, child/adolescent, consultation liaison, acute and primary care. Due to contributions to practice, education and/or research, as well as recognition in the field for their leadership, these members of the Joint Task Force were recognized PMH nursing experts.

The ANA Joint Task Force convened in April 2012, with the objective to review and revise the first edition of the Psychiatric-Mental Health Nursing: Scope and Standards of Practice for publication in 2013. Given the enormous change in the various contexts and arenas of PMH nursing practice, the task force researched and deliberated a vast amount of material. The second edition was published in June 2014. The next section describes the factors for consideration in the revision process.

Key Factors for the Revision Process

As with any process to revise, there were many considerations to discuss. Several key factors that emerged for review in the revision process included external documents and priorities currently influencing the United States (U.S.) healthcare system; the current emphasis on consumer participation in the recovery process; workforce requirements and challenges for PMH nursing; and regulatory concerns for advanced practice nurses.

External Documents and Priorities

Dynamic and recent changes in the United States healthcare system influenced the deliberations of the task force as review and analysis proceeded. The President's New Freedom Commission Report on Mental Health (President's New Freedom Commission on Mental Health, 2003) launched a review and revision of the structure of mental health care delivery in the United States. The Substance Abuse and Mental Health Services Administration (SAMHSA, 2006) validated the resulting consumer driven framework of a person-centered, recovery-orientation for assessment and treatment. …

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