Consensus Model For APRN Regulation

There are four types of Advanced Practice Nurse roles, the nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, and certified nurse-midwife. The Family Nurse Practitioner is the advanced practice role that will be discussed. According to Hamric, Hanson, Tracy, and O 'Grady (2014) the primary care NP provides care for patients in diverse settings, including community-based settings such as private and public practices, acute, and long-term care settings across the life span (pg. 396). Family Nurse Practitioners have faced many challenges in the medical profession to be recognized as health care providers. Most of these challenges where from fellow nurses. According to Hamric, Hanson, Tracy, and O’Grady (2014) conflict and discord about the Nurse Practitioner role continued to characterize relationships between NPs and other nurses (pg. 18). Despite the resistance to NPs in nursing, physicians increasingly accepted NPs in individual health care practices (Hamric, Hanson, Tracy, and O’Grady, 2014, pg. 18). Physicians readily accepted the role of the Nurse Practitioner, working together to improve patient outcomes and safety.

Credentialing from advanced practice registered nurses (APRNs) perspective is defined as “furnishing the documentation necessary to be authorized by a regulatory body or institution to engage in certain activities and use a certain title” (Hanson, 2014). Credentialing is also define from a local institutional process that consider specific documentations for APRN before they assume the practice role as APRN within their facility. In health care system, credentialing ensures individuals meet required standards of practice and is prepared to perform those duties implied by the credentials. National certification and education are considered as part of credentialing for APRN to acquire basic level of competence to practice. (Hanson, 2014)

The APRN consensus model is a standardize model of regulations approved by 45 national nursing organization so that APRN’s can assume leadership and ownership roles. Harmonizing to McClelland, (2014)., of the four APRN roles the NP is considered the most modern due to changes in education and the new healthcare environments.

The APRN Consensus Model was released in July of 2008 to define advanced practice registered nurse, identify the titles to be used by APRNs, and define specialty area of practice. The Consensus Model also describes population foci, suggests a process for recognition of new APRN roles, and recommends requirements for implementation (American Nurses Association [ANA], 2010). The APRN regulatory model helps uniform scope of practice of APRN across the United States, which benefit individual APRN, enhance patient outcomes, and improve the quality of care. Consensus Model consists of Licensure, Accreditation, Certification, and Education. The Education criteria in LACE Consensus Model relate to all APRN programs regardless of master’s or doctoral

All accredited educational programs include didactic learning that includes advanced assessment, pharmacology and pathophysiology and clinical experience gained through rotations and preceptorship. APN’s complete master’s degrees or post master’s programs in preparation for certification. Certification is granted by The American Academy of Nurse Practitioners and the American Nurses Credentialing Center. Certifications are earned in adult and family, acute care, pediatrics, psychiatric, gerontology and women’s healthy specialties. APN’s are licensed by individual state boards of nursing and they are certified in advanced specialty areas. APN’s have prescriptive authority in all 50 states and can practice without direct physician supervision in several states. They work in a variety of settings including hospitals, clinics, schools, colleges and urgent care facilities. APN’s must recertify every five years with 1000 hours of clinical practice and 75 continuing education hours in the area of

This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component

In 2008, the coalition of members from the Alliance for Advanced Practice Credentialing and the National Council of State Boards of Nursing (NCSBN) created the Consensus Model for Advanced Practicing Registered Nurses (APRN’s). This model creates a framework for APRN’s in licensing, accreditation, certification, and education in the United States (Alleman & Houle, 2013). The establishment of this Consensus Model has developed a bases for the ARNP’s comprehensive knowledge base, ability for clinical reasoning, cultural, and ethical competencies, establishing a model of practice for ARNPs in which to follow. These concepts will be further discussed in this paper.

These organizations developed the Consensus Model document in 2008 to unify practice, identify APRN clinical roles, identify the acceptable titles to for NPs, and define the requirements for general practice and licensure. Note to mention that laws and regulations statute on the APN scope of practice may vary by states, whereas some adhere to full scope of practice, other to reduced practice, or restricted practice. For instance, the state of Florida defines advanced registered nurse practitioner as a licensed person with ability to practice professional nursing and certified to in advanced or specialized nursing practice (Buppert, 2011). The four advanced clinical specialized roles include certified registered nurse anesthetists, certified nurse midwives, clinical nurse specialist, and nurse practitioners (Buppert, 2011). In terms of licensure, 46 states out of 50 require nurse practitioners to pass a certification exam. The Florida Board of Nursing requires certification by an appropriate specialty board and graduation from a program leading to a master’s degree (Buppert,

According to the Texas Board of Nursing, the Advanced Practice Nurse (APN) is a Registered Nurse (RN) who has finished an unconventional educational program that is acceptable to the nursing board, and performs autonomously or in partnership with other health care practitioners to provide quality healthcare services. The APRN titles used in Texas are; Clinical nurse specialist, Certified nurse anesthetist, Certified nurse practitioner, and Certified nurse midwife. All four APRN roles are recognized in the state of Texas providing healthcare to persons, groups and folks in several settings like hospitals, schools, public/private clinics and practices, homes, and offices. The term “licensure”

There have been concerns regarding the identification and credentialing of advanced practiced registered nurses (APRNs). A APRN is a registered nurse who has successfully completed an accredited graduate-level education program, in which the individual is well prepared and successfully passed the nationwide certification examination (APRN Consensus Model, 2008). However, there are still debating issues of who would fall under the APRN category. The National Council of State Boards of Nursing (NCSBN) has identified four APRNs who are deem fit to be called ARPNs; however, only two will be named. They would be certified registered nurse anesthetists (CRNAs) and certified nurse practitioners (CNPs). Whereas, the nurse informatics and the nurse administrations are not considered to be APRNs; although, they are still license registered nurses but they do not provide direct patient care and are not required to take the national certification examination (ARPN Consensus Model, 2008).

The scope of practice for APRNs in Texas are quite dynamic in range. It evolves through experience, acquisition of knowledge, evidence-based practice, technology development and changes in the health care delivery system. The standards of Nursing practice in rule is 217.11. The scope of practice is determined by advanced practice education in a role and specialty if applicable, legal implications such as Board rules, and scope of practice statements as published by national professional specialty and advanced practice nursing

Therefore, reimbursement to APRNs is limited for the many services that are provided to patients (Yee, Boukus, Cross & Samuel, 2013). In Florida, legislative sessions are held at specific dates throughout the year. According to the Florida Association of Nurse Practitioners (FLANP), three specific bills of interest that affect ARNP scope of practice: “SB 96 is proposed in to allow ARNPs to be medical directors; S634/HB 645 will enable ARNPs to sign Certificates of Involuntary Commitment (Baker Act) and CS HB129 will declare all Floridian ARNPs to be medical directors and gain signature ability and HB 7011 which initiates independent full practice for NPs” (Florida Association of Nurse Practitioners (FLANP), 2017).

Hi Swanthi, great post on the APN Consensus Model. In your post you mentioned many healthcare organizations had “criticized the inconsistencies in APRN practice and brought up concerns of patient safety issues due to these competency irregularities.” Although this model was developed in 2008, there are still many regulations and unclear terms that need to be clarify. I can see for nurses that are just beginning their APRN education will be able to eventually achieve the same licensure, accreditation, credentials, and education (LACE), but what about those are currently practicing now? If I was the APRN that had to take extra courses to be licensed in my state than I would feel a bit dissatisfied when another APRN from another state that required

Three issues or trends I see that are important with regard to credentialing are reimbursement, malpractice and education. Within each issue are opportunities for the advance practice nurse (APN) to grow in knowledge and participate in change. It is important to understand why each one effects credentialing for the APN.

Advanced Practice Nursing (APN) covers four types: Certified Nurse Practitioners, Certified Nurse Midwives, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists.