The Advanced Practice Registered Nurses (APRNs) include certified nurse-midwives, certified registered nurse anesthetists, certified nurse practitioners and clinical nurse specialists (Stanley, Werner & Apple 2009). The Advanced Practice Registered Nurses (APRN) consensus model outlines the commendations for constant regulations for APRNs licensure, accreditation, certification, and education, collectively referred to as LACE in the United States (Stanley 2012). Licensure is being granted permission to practice. Accreditation refers to the formal review and approval by a recognized agency of certification or educational degree programs in nursing related programs. Certification, on the other hand, is the formal recognition of the skills, knowledge, and experience demonstrated by the achievement of standards identified by profession . Finally, education is the formal preparation of APRNs in post-graduate certification and graduate degree-granting programs (Rounds, Zych & Mallary 2013). Noteworthy, the APRN model applies to every element of LACE, with each element playing an essential part in the implementation model. APRN recommendations reflect the need and desire to collaborate among regulatory bodies to achieve a great model and continued communication with the goal of increasing the clarity of APRN regulations. Due to the significance of APRNs in caring for the future and current patients’ health needs, the certification, accreditation, licensure, and education of APRNs need to be carefully aligned to continue ensuring patient safety as well as expanding patient access to APRNs. The main objective of the model is to create a bond between medical practitioners, the state and the general public and the national legislatures in knowing the roles of the APRNs, with the intention to support their capability to practice to the full capacity of their qualifications and training.
APRNs include certified nurse-midwives, certified registered nurse anesthetists, certified nurse practitioners and clinical nurse specialists (Stanley, Werner & Apple 2009). Within each role, the model designates six population foci that should be used by the boards of nursing and national certification organizations to structure the licensure and certification requirement. They include Family or individual across the lifespan; adult-gerontology; neonatal; pediatrics; women’s health and reproductive health; and psychiatric mental health (Stanley 2012). The model states that each APRN must be trained, qualified and licensed as per their specific roles and the target population. Besides, the model does not commend that an APRN to be licensed in other specialties which do not fall under the population above foci, like palliative care, substance abuse or oncology. However, APRNs can only specialize in the mentioned areas only after getting the necessary training and receiving the appropriate national certificate and state license for the chosen population (Rounds, Zych & Mallary 2013). For instance, a Registered Nurse can get trained and get the necessary certificates and license as a qualified family nurse practitioner, and specialize in nephrology, palliative care, and corporate health nursing later, but will not get any certification in the areas above .
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Noteworthy, APRNs have increased their numbers and capabilities over the past few decades with APRNs being very valued a significant part of the healthcare system. Each APRN role has a unique context and history, but they share the commonality of being APRNs. The consensus model can help advance the practice of advanced practice nursing in several ways. There is a notable lack of common definitions in regards to APRN roles and lack of uniformity in state regulations and educational, which have limited the ability of patients to access APRN care (Stanley 2012). While accreditation, certification, and education are the main components for preparing APRN for practice, the licensing boards, governed by the statutes and regulations of the states, are the final arbiters of who is recognized to practice in a state. The consensus model for APRN should strive to create a bond between the national certification organizations, state nursing boards and nursing programs in their description of the APRN role so that aspiring APRN nurses can face uniforms standards across all states and their education and applications for their certification and licensure. It is also paramount that the aspiring and current APRNs stay updated on the certification changes in their role and the intended population focus. Also , members must seek confirmation from the respective nursing boards to see whether there are any effected changes to the licensure requirements that are required of them to practice in their state of residence.
However, to advance the practice of advanced nursing, there are several barriers faced by the current APRN model in the United States. Currently, there is no uniform model of APRNs regulations across the United States (Stanley, Werner & Apple 2009). Every state determines its independent APRN legal practice scope, the roles that are recognized, the criteria for entry into advanced practice and the certification examinations accepted for entry-level competence assessment. Consequently, APRNs can face significant barriers that may interfere with their practice and training abilities, and render their quest ineffective. For instance, when an APRN decides to move from one state to the other, they must attain different licensure rations for every state that they want to practice (Stanley 2012). Furthermore, there is no standardization across all the states. This , as a result, has made it difficult to expand the APRNs practice scope and make it more difficult. This is because not every state can grant APRNs full practice authority. Therefore, it is paramount to individually change the laws to broaden the practice privileges of the nurses. It is fundamental that the consensus model addresses these issues and other related issues by developing a standard mandate and definitions for APRN licensure and practice. These consequences have greatly interfered with the APRN goal of great service delivery to the patients and equality across state borders since some states have decreased access to care for patients.
References
Rounds, L. R., Zych, J. J., & Mallary, L. L. (2013). The consensus model for regulation of APRNs: Implications for nurse practitioners. Journal of the American academy of nurse practitioners , 25 (4), 180-185.
Stanley, J. M. (2012). Impact of new regulatory standards on advanced practice registered nursing: the APRN Consensus Model and LACE. Nursing Clinics , 47 (2), 241-250.
Stanley, J. M., Werner, K. E., & Apple, K. (2009). Positioning advanced practice registered nurses for health care reform: Consensus on APRN regulation. Journal of Professional Nursing , 25 (6), 340-348.
