Shaping APRN Practice: Regulatory Consensus

Marilyn W. Edmunds, PhD, CRNP, Co-owner, Nurse Practitioner Alternatives, Inc., Ellicott City, Maryland; Adjunct Clinical Professor, Johns Hopkins University School of Nursing, Baltimore, Maryland Laurie E. Scudder, MS, NP, Accreditation Coordinator, Continuing Professional Education Department, Medscape, LLC; Clinical Assistant Professor, School of Nursing and Allied Health, George Washington University, Washington, DC; Nurse Practitioner, School-Based Health Centers, Baltimore City Public Schools, Baltimore, Maryland
Posted: 04/24/2009

Reaching Consensus on a Regulatory Model: What Does This Mean for APRNs?
Stanley J J Nurse Pract. 2009;5:99-104
Article Summary

This article describes the process whereby nursing's leading professional organizations, after meeting for more than 4 years, reached consensus on a model for future advanced practice registered nurse (APRN) regulation and released the document "Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education." In the absence of national regulations regarding advanced practice nurses, states have developed their own, resulting in a patchwork pattern of regulations. Currently there is no uniformity throughout the United States in regard to who might be called an advanced practice nurse or the education, licensing, and credentials required for this title. The consensus document outlines requirements for states to follow in all of these areas. This landmark document is the collaborative effort of the APRN Consensus Work Group and the National Council of State Boards of Nursing APRN Committee. The document establishes clear expectations for licensure, accreditation, certification, and education for all APRNs. Because the repercussions from implementation of this document will be extensive, the group wants their work to be transparent to all stakeholders. The consensus document identifies 4 roles that will be permitted to carry the title of APRN: certified nurse practitioner, clinical nurse specialist, certified nurse midwife, and certified registered nurse anesthetist. Nurses who have advanced graduate education but practice in informatics, public health, administration, or education will not be eligible to carry the title of APRN because their practice does not require regulatory regulation beyond that of the registered nurse. The focus of the APRN must be on direct patient care. The targeted timeline for implementation of the new model is 2015. This will require sequential and consistent work by universities to upgrade and standardize curriculums to meet the guidelines. The consensus document does not state that a nursing practice doctoral degree is required in any APRN role. Regulatory and certification panels will be necessary, as will considerable legislation to change practice in some states. This document has every intention of shaping future APRN practice.

and they are not often politically active. . This consensus document will give clinicians and educators in every state the authority to confront university administration. The early APRNs fought hard to pass enabling regulations for their practice. and business and industry about moving toward more uniformity and standardization. instilling in APRNs the passion to do the work required will be another challenge. Many new APRNs are unaware of the vulnerability of their role and the need to make such changes. legislators. It will take a lot of work to achieve educational and legislative change.Viewpoint Advanced practice nurses have been crippled in their clinical practice because of restrictive state regulations.

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