NSG 5000 Advance Nurses Roles Assignment
Advanced Practice Roles in Different States
Advanced practise registered nurses (APRN) provide services such as treatment, preventive care, the management of chronic and acute illnesses using high clinical skills, therapeutic interventions and diagnostic reasoning. Advanced practise nurses integrate research, education, leadership, consultation and, management in their clinical roles. APRN nurses work in a variety of health settings and may serve as consultants, speciality care providers or primary care providers (Sullivan et al, 2010).
The term advanced practise nurse is a term used to refer to a registered nurse who has met some advanced educational and clinical practise obligations beyond the basic qualifications of the registered nurse (Lucille, 2013).Different states in the United States have different requirements for advanced practise nurses. There are also national state requirements for advanced practise nurses. The roles of APRN in nursing practise are determined by their speciality (Michaelene et al, 2009). Advanced practise nurses are granted licenses by the state for practise and are regulated by the state board of nursing (Hamric, 2008).
The advanced nursing profession has many nursing specialities and a wide scope of practise. The main scopeof practisefor advanced practise registered nurses is independent practise (Lucille, 2013). This means that advanced practise Nurses can provide direct care to patients without supervision by physicians or without theforced collaboration by physicians (Fitzpatrick et al, 2003).
All states in the United States require advanced practise nurses to have a registered nurse license, and some form of advanced training beyond registered nurse training. Twenty-seven states in the United States require a master’s degree while some 35 states require national certification (Lendingtree, 2013).
Comparison of different states requirements for advanced practise nurses
According to Lendingtree, 2013), the state of Florida requirements for advanced practise nurses are,
1) Advanced practise nurses should have a current unlade license for practise of professional nursing in the stateof Florida
2) Advanced practise nurses also require national advanced practise certificate from an approved nursing speciality board. These boards are, the American College of Nurse Midwives, American Nurses Association, Council on Certification of Nurse Anaesthetists and the Council for Re Certification of Nurse Anaesthetics.
3) APRN nurses also need to take a written examination prior to certification.
4) APRN nurses also need to have completed a formal nursing speciality program before certification.
According to Lendingtree, (2013), Hawaii state nursing requirements for advanced practise are,
1) Nurse practitioners require clinical experience of sufficient breadth and depth for advanced nursing practise.
2) A current practise license certificate in the state of Hawaii
3) An encumbered registered current and active nurse license
4) Advanced practise nurses also require to have completed a master’s degree as a nurse practitioner, clinical nurse specialist, a nurse midwife or a certified registered nurse anaesthetist.
5) A current unlade certificate from a national certification examination that evaluates population focus and role competencies recognised by Hawaii state nurses board
6) Nurse practitioners also need to have acquired clinical skills and knowledge to provide direct care to patients through considerable practical and educationalconcentration on the provision of direct care to patients.
7) Advanced practise nurses also need to demonstrate deep knowledge, a greater independence than registered nurses, a greater blend of intervention knowledge and skills and a greater knowledge in synthesising clinical data.
8) Nurse practitioners must also demonstrate accountability and responsibility for the promotion of health, diagnosis and management of patient problems through the utilization of both non-pharmacologic and pharmacologic interventions
9) Nurse practitioners also require to have paid the appropriate fees to the state board of nursing
According to Lending tree, (2013), In Kansas, the four areas of advanced nursing practise are nurse Practitioner, Nurse Anaesthetist, advanced nurse midwife, and clinical nurse specialist. The
Kansas state requirements for advanced practise nurse are,
The requirements for advanced nursing practitioners in Kansas are,
1) Completion of formal postgraduate nursing education programs offered in the state of Kansas. The graduate degree should prepare the nurse for functioning in an advanced role at the time of application for advanced nursing Practitioner license.
2) A nursing post graduate qualification not located or offered in Kansas but determined by the Kansas state board of nurses to meet the standards for approval authorised by the KAR 60 17-101 to 108.
3) Nurse practitioners who have completed post graduate in nursing degree that may no longer be in existence, but determined by theKansas state board of nurses to meet the regulations for approval of the program during the time of graduation.
4) Advanced practise nurses must also hold an authorization certificate to practise as a registered nurse for the category of specialization applied. Thecertificate must meet the criteria of having been issued by theKansas state board of nurses or another state board of nursing. The certificate must meet the stringent requirements of completion that equal or are greater than the ones established by the KAR 60 17 101 to 108.
5) Advanced registered nurses must also meet the requirement of completing a formal program of post basic study. The nurse must also have the clinical experience practise in the area of specialization for which application is applied.
6) The nurse practitioner must also demonstrate that the curriculum of the formal education program is consistent with the safety policy and public health. The formal education must also prepare them enough to work professionally in nursing as capable people with post basic education in Nursing.
7) Nurses must also meet a thousand hour threshold of advanced nursing practise five years after the date of application as a registered nurse.
8) Nurse practitioners must also have a masters or a Doctorate degree in an area of nursing specialization
9) The advanced practitioner nurses must also have undertaken three college hours in advanced Patho- physiology.
The National regulation model for advanced practise registered nurses
There is a consensus model for the regulation of all advanced practise registered nurses in the United States. There are four advanced practise nurses roles in the United States. They are (CNA), Certified Nurse Anaesthetist, and Certified Nurse Practitioner (CNP) Certified Nurse Midwife (CNM) And Clinical Nurse Specialists (CNS). All these roles are given the common title of (APRN,) Advanced Practise Registered Nurses (AACCN, 2013).
According to AACCN, 2013, the requirements for national certifications of advanced practise nurses are,
1) The certification, licensure and the education requirements of all the registered nurses must be in accordance with the role and the population focus.
2) The education requirements of advanced practise registered nurses is a graduate level of education in an accredited school specialising in any of the four roles of advanced Practise registered nurses. In addition, advanced practise nurses must be educated in at least one of the population foci likefamily or individual, adult gerontology, paediatrics, or gender related health.
3) The defining feature of all advanced practise nurses is that their practise and education must focus on taking direct care of individuals.
4) Advanced registered nurses must also be prepared to be accountable and bear the responsibility for health promotion and maintenance, as well as the diagnosis, assessment and management of patient problems. Advanced practise nurses must also be prepared to use pharmacological and non-pharmacological interventions in their practise.
5) If thegraduateprograms for clinical nursespecialist prepare theregistered nurse to work in both the acute care and primary care competencies, then theregisterednurse must obtaincertification forthe dual rolesin primary and acute care.Thecertification ofprimaryand acute caremust be equivalent to theeducationalrequirements for clinical nurse specialists inthe dual roles.
Certification of nurses
1) All advanced practise nurses must obtain a pass in a national certification exam that evaluates their advanced practise role and their population focus.The advanced practise nurses are also required to build competencies to obtain recertification in their roles and population focus (AACCN, 2013).
2) All APRNS must be assessed and educated through national certification processes across the whole continuum of care from acute care to wellness.
According to AACCN, 2013), nurses must meet the following requirements for licensing
- Advanced practise nurses are licensed as independent nurse practitioners. They must practise within the standards established by their licensing body.
2) Certified nurse practitioners trained for dual roles of primary and acute care must obtain licensure for both roles.
3) Advanced registered nurses can also specialise in some areas such as oncology, orthopaedics, palliative care and cardiology but they cannot be issued with a licensure within their speciality area.
There are many areas of commonality between the national and individual state requirements for accreditation of advanced practise registered nurses. However, individual states have their own additional requirements for nursing credentials to suit their specific needs.
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