Resources for Advanced Practice Nurses

The following resources may be useful in defining practice and roles related to Advanced Practice Nursing. Citations for additional articles to include on this page may be e-mailed to jmower@cc-institute.org

Consensus Model

APRN Consensus Work Group & National Council of State Boards of Nursing APRN Advisory Committee. (2008). The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, Education. Retrieved Dec. 9, 2011 from https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf

National Council of State Boards of Nursing (NCSBN). (2011).  APRN Consensus Model toolkit. Retrieved Dec. 20, 2011 from   https://www.ncsbn.org/2276.htm

Stanley, J. (2009). Reaching consensus on a regulatory model: What does this mean for APRN’s? Journal of Nurse Practitioners, 5(2 ), 99-104.

Stanton, C. (2010, July/August). Preparing for changes: A new model for APRN regulation. AORN Connections, 10.

Thompson, C.J. (2011). The APRN Consensus Model. Clinical Nurse Specialist Journal, 25(6), 327-331.

Education



Under the Graduate Nurse Education Demonstration, CMS will provide reimbursement to up to five eligible hospitals for the reasonable cost of providing clinical training to advanced practice registered nursing (APRN) students added as a result of the demonstration. Go to http://innovations.cms.gov/initiatives/GNE/ for more information.

American Association of Colleges of Nursing (AACN). (2011). The Essentials of Master’s Education for Advanced Practice Nursing. Retrieved Sept. 24, 2012 from http://www.aacn.nche.edu/education-resources/masters-essentials-resource-center

American Association of Colleges of Nursing (AACN).(2011, July 12). The impact of education on nursing practice. Retrieved Dec. 18, 2011 from  http://www.aacn.nche.edu/media-relations/EdImpact.pdf

American Association of Colleges of Nursing (AACN), & National Association of Clinical Nurse Specialists (NACNS). (2010, March). Adult-Gerontology Clinical Nurse Specialist Competencies. Retrieved Dec. 9, 2011 from  http://www.aacn.nche.edu/geriatric-nursing/adultgeroCNScomp.pdf

American Academy of Nurse Practitioners. (2010). Position Statement on Nurse Practitioner Curriculum. Retrieved Dec. 14, 2011 from http://www.aanp.org/NR/rdonlyres/59523729-0179-466A-A7FB-BDEE68160E8E/0/NPCurriculum.pdf

Bellini, S., & Cusson, R.M. (2012, April 18). The Doctor of Nursing Practice for entry into Advanced Practice. Retrieved May  7, 2012 from www.medscape.com.

^Note: although this article contains a short section on  the proposed DNP entry into practice and its impact on neonatal nurse practitioners, the rest of the article gives a  very nice overview of the history of the issue which is applicable to any population.

Doctorate programs in the new millennium. Retrieved May 15, 2012 from http://www.accreditedonlinecolleges.org/nursing/

Institute of Medicine. (2010). The Future of nursing: Leading change, advance health. Retrieved Dec. 18, 2011 from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx

Schools

UCLA Extension RN First Assistant Program
The RN First Assistant (RNFA) program is a 6 day course, consisting of 52 hours of lecture and laboratory plus a required independent preceptorship. Practicing surgeons, clinical professionals, and perioperative nurse specialists provide participants with the knowledge and techniques essential for assuming the responsibilities of the RNFA. An additional 1 day course preparing the APRN with basic perioperative skills is also available. Go to https://www.uclaextension.edu/nursing for more information.

Western University of Health Sciences, College of Graduate Nursing.
The College of Graduate Nursing offers a Master of Science in Nursing and Family Nurse Practitioner program (MSN/FNP), as well as a Post-Master’s Family Nurse Practitioner program (Post-Master’s FNP).

University of Detroit, MercyUniversity of Detroit, Mercy
Adult Gero, online, 21 credits. The certificate program includes advanced pathophysiology, advanced physical assessment, advanced pharmacology, and the role of the clinical nurse specialist. The clinical nurse specialist courses include a total of 500 hours of clinical practicum experience working with a clinical nurse specialist in a variety of settings.

Upon completion of the post-master’s certificate, the nurse will be eligible to sit for the examination for the Adult-Gerontology Clinical Nurse Specialist certification through the American Nurses Credentialing Center or the American Association of Critical Care Nurses.  

University of CA San Francisco School of Nursing
At UCSF School of Nursing, the Post-Master’s certificate program is a special studies program for master’s prepared nurses pursuing State certification in a specialty area or seeking a program of study that may lead to a change in role (e.g. a CNL or CNS seeking an NP specialty certificate).  UCSF offers Post-Master's options for specialized study as a clinical nurse specialist, nurse practitioner or health policy specialist.  The curriculum meets state and national credentialing requirements and provides a certificate upon completion.  Successful students are eligible to apply for national certification examinations. 

Applicants must have a Master’s in the discipline of Nursing (MS), MSN, or MN.  If accepted, applicants must become licensed by the California Board of Registered Nursing and the license must be recognized as valid for practice within the State of California during the complete course of study.  Before beginning their studies, students must complete a background check and obtain any necessary immunizations.  For additional questions please contact Rosalie Bravo at (415) 476-7064 or Rosalie.Bravo@ucsf.edu (email).  For general information on the Post Master's Program at UCSF School of Nursing, please telephone (415) 476-2595.

Adult-Gerontology Clinical Nurse Specialist (AG CNS)
Adult-Gerontology Clinical Nurse Specialists (AG CNS) care for the complex health-care needs of adults and seniors in clinical practice settings. 

Adult-Gerontology Clinical Nurse Specialist – Critical Care/Trauma (AGCNS-CCT)
Adult-Gerontology Clinical Nurse Specialist - Critical Care / Trauma (AGCNS-CCT). Because inpatient care focuses increasingly on treating the sickest of the sick, the need for advanced practice nurses to provide and coordinate care in emergency departments, trauma, critical care, and intensive care units has never been greater. Clinical nurse specialists in critical care, emergency and trauma settings fill that role.

East Carolina University
Master of Science in Nursing Adult-Gerontology Clinical Nurse Specialist – Post-Master’s Certificate

See website for sample curriculums. 

The post-MSN adult-gerontology CNS certificate prepares students in the roles of clinician, educator, clinical consultant, researcher, program planner and leader. Graduates are eligible to sit for national certification examination as a clinical nurse specialist. This concentration was reviewed by the National Association of Clinical Nurse Specialists and meets the criteria for consistency with the standards set by that national organization.

The master’s program at East Carolina University is accredited by the Commission on Collegiate Nursing Education. 

Eastern Michigan University
19 credits. On campus. The Post-Masters CNS certificate program prepares nurses to meet the needs of the community for health care providers/nurses with advanced practice knowledge and skill. Graduates from the Post-Masters CNS program will be prepared to lead and serve in the following capacities: educators, change agents, outcomes managers, and consultants within the healthcare system.  

The goal of the Post-Masters Clinical Nurse Specialist Certificate is to provide an avenue for graduate-prepared nurses (i.e. those already holding an MSN) to transition to a Clinical Nurse Specialist role. This program ensures that graduates are well educated across the continuum from wellness through acute care as required by national accrediting agencies. At the end of this program, the graduate nurse will be eligible to sit for national certification examinations required for Adult-Gerontology Clinical Nurse Specialist and subsequently be eligible for state licensure as a Clinical Nurse Specialist. 

California State University Dominguez Hills
The Post-Masters Certificate in CNS Pediatric or Adult-Gerontology is for nurses with master’s degrees in nursing. Included in the APRN course of study are advanced health assessment, advanced pathophysiology, pharmacology, health promotion, and management of complex care for children and families or for the adult population, from young adult to older adult, including the frail elderly, in various clinical and community settings.  The Certificate Program consists of a total of 28 to 31 units, 16 to 19 units are specifically only to the CNS.  

Purdue University Northwest
The purpose of the Adult-Gerontology Clinical Nurse Specialist Certificate Program at Purdue University Northwest is to prepare qualified master’s prepared nurses as CNSs caring for the Adult-Gerontology population. Clinical nurse specialists are advanced practice nurses who are uniquely prepared to meet complex patients’ needs for expert nursing care. Educational preparation consists of content related to a managing complex adult-gerontology patient as well as content that prepares students to influence nursing personnel and the healthcare system for the purpose of achieving safe, quality patient care. Graduates of CNS programs can advance the practice of nursing through expertise in their specialty and through their skills as leaders, collaborators, consultants, mentors, and innovators. They are also experts at effecting change and introducing evidence-based practice protocols into the healthcare environment.  As a result of their educational preparation and skills, CNSs exert a significant, positive influence on patient, nurse, and healthcare organizational outcomes. 

Credit Hour and Clinical Contact Hour Requirements: The certificate requires students to complete a minimum of 14 hours and a maximum of 30 credit hours.

University of Southern Indiana
The Adult-Gerontology Clinical Nurse Specialist is an advanced clinician holding a master’s degree who functions as an expert clinician, leader, researcher, educator, and consultant that exerts influence in three spheres:  patient/family, nursing personnel, and organization system.  The AG-CNS graduate acquires knowledge and experience to provide services to individuals in an area of specialization across the lifespan in health promotion, disease prevention, and management of common acute and / or chronic illness.

Requirements for Post MSN Certificate Program include a minimum of 3 to 5 actual hours of study per week for each one credit hour (example:  if you are taking a 3-hour course, you will need to study at a minimum of 9 to 15 hours weekly). This is in addition to listening to online lectures.  Clinical courses include clinical hours in addition to the study requirements above.  The range of clinical hours required in APN courses is between 8 to 24 hours weekly. Requires several 2-day on-campus visits. There are a total of 545 clinical hours.

Continuing Education

Free APRN continuing education hours may be obtained from the following websites. Registration is required.
Epocrates  Available at www.epocrates.com
Medscape   Available at www.medscape.org

Reimbursement/Billing

AARP. (2012, May 8). Removing barriers to Advanced Practice Registered Nurse care: Hospital privileges. Retrieved Sept. 24, 2012 from http://search.aarp.org/browse?Ntt=advanced%20practice%20nurses
^ Note: this website contains several articles on Advanced Practice Nurses and their contributions toward increasing access to health care.

Accountable care organizations-ANA Issue brief. Retrieved Nov. 30, 2011 from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/ACOs

Accountable care organizations 101-ANA Issue brief. Retrieved Nov. 30, 2011 from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/ACOs/ACOs-101.pdf

CMS has established the Medicare Fee-For-Service (FFS) Provider Partnership Program which is one of the ways CMS strives to ensure FFS healthcare professionals are kept apprised of the latest Medicare news and information. They publish a weekly newsletter, Medicare FFS Provider e-News, that can provide you with the latest on billing, claims, the shared savings program and PQRS Group Practice Reporting. Sign up to receive this newsletter.

Department of Health and Human Services, Centers for Medicare and Medicaid-What providers need to know about ACO’s. (April 2011). Retrieved Nov. 30, 2011 from http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/ACO_Providers_Factsheet_ICN907406.pdf

Jackson, D. (2011). Accountable Care Organization 101: A primer for RNFA’s and APRN/RNFA’S
Retrieved Sept. 24, 2012 from http://www.aorn.org/Secondary.aspx?id=21189&terms=webinar (scroll down to access Denise’s webinar)

Rhodes, C.A., Bechtle, M., & McNett, M. (2015). An incentive pay plan for advanced practice registered nurses. Nursing Economics, 33(3), 125-131. Retrieved July 28, 2015 from http://www.nursingeconomics.net/ce/2017/article3303125133.pdf

Nurse Practitioner

Articles

Brassard, A. (2013). The Campaign for Action: An update. The American Journal of Nursing, 113(3), 48-51.

Brya, R.H., Buzby, M., & O’Sullivan, A.L. (2012, April 24). The Healthcare Reform Law and APRN practice. Retrieved May 7, 2012 from www.medscape.com

Buppert, C. (2009). Federal laws on prescribing controlled substances. Journal for Nurse Practitioners, 5(1), 15-17.

Keough, V.A., Stevenson, A., Martinovich, Z., Young, R., & Tanabe, P. (2011). Nurse Practitioner certification and practice settings: Implications for education and practice. Journal of Nursing Scholarship, 43(2), 195-202. 

King, C.A., & Sapnas, K.G. (2007). Building a business case for the Advanced Practice Registered Nurse. Perioperative Nursing Clinics, 2(1), 75-79.

Rouse, C.L. (2007). Advanced Practice Nursing: Defining the practice. Perioperative Nursing Clinics, 2(1), 1-7.

Schroeder, J.L. (2008). Acute Care Nurse Practitioner: An advanced practice role for RN First Assistants. AORN Journal, 87(6), 1205-1215.



Wallis, L. (2013). Overcoming state hurdles to independent NP practice. The American Journal of Nursing, 113(3), 16-17.

Wilson, S., & Barron, M. (2007). Issues and answers in the role development for the surgical Advanced Practice Registered Nurse. Perioperative Nursing Clinics 2(1), 23-28.

Resources
American Nurses Association. (2011). Advanced Practice Nurses. Available at http://nursingworld.org/EspeciallyForYou/AdvancedPracticeNurses

AORN. (2010). Perioperative Advanced Practice Nurse competency statements. In Perioperative competencies, position descriptions, and evaluation tools, pp. 140-151. Denver, CO: Author.

Find a preceptor/offer a preceptorship. ENP Network. Available at http://www.enpnetwork.com/nurse-practitioner-preceptors?page=3

Medscape. (2010). Nurse Practitioner Resource Center. Retrieved Aug. 11, 2010 from http://www.medscape.com/resource/nurse-practitioners  

National Organization of Nurse Practitioner Faculties. (2011, April). Nurse Practitioner core competencies. Retrieved April 15, 2015 from
http://c.ymcdn.com/sites/nonpf.site-ym.com/resource/resmgr/Competencies/NPCoreCompsContentFinalNov20.pdf

National Council of State Boards of Nursing (NCSBN). (2007, May). Role delineation study of Nurse Practitioners and Clinical Nurse Specialists. Retrieved Dec. 15, 2011 from https://www.ncsbn.org/06_LPN_RoleDelStudy_NCLEX_30_Web.pdf

CLINICAL NURSE SPECIALIST

Articles
Buppert, C. (2009). Federal laws on prescribing controlled substances.  Journal for Nurse Practitioners, 5(1), 15-17.

Foster, J., & Flanders, S. (2014). Challenges in Clinical Nurse Specialist education and practice. The Online Journal of Issues in Nursing, 19(2). Retrieved from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Challenges-in-CNS-Education-and-Practice.html

France, N.E.M. (2005). Strengthening Clinical Nurse Specialist role socialization. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 19(6), 294-295.

Glover, D.E., Newkirk, L.E., Cole, L.M., Walker, T.J., & Nader, K. (2006). Perioperative Clinical Nurse Specialist role delineation: A systematic review. AORN Journal, 84(6), 1017-1030.



Gordon, J.M, Lorilla, J.D., and Lehman, C.A. (2012). The role of the Clinical Nurse Specialist in the future of health care in the United States. Perioperative Nursing Clinics, 7(3), 343-353.

Goudreau, K. A., Baldwin, K., Clark, A., Fulton, J., Lyon, B., Murray, T., et al. (2007). A vision of the future for Clinical Nurse Specialists. 
Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 21 (6), 310-320.

Jokiniemi, K., Haatainen, K., Meretoja, R., & Pietilä, A-M. (2015). The future of the Clinical Nurse Specialist role in Finland.
Journal of Nursing Scholarship, 47(1), 78-86. 

King, C.A., & Sapnas, K.G. (2007). Building a business case for the Advanced Practice Registered Nurse. Perioperative Nursing Clinics, 2(1), 75-79.

Kring, D.L. (2008). Clinical Nurse Specialist practice domains and evidence-based practice competencies. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 22(4), 179-183.

NACNS. (2013, Dec.). Impact of the Clinical Nurse Specialist role on the costs and quality of healthcare. Retrieved Dec. 19, 2013 from http://www.nacns.org/docs/CNSOutcomes131204.pdf.

Rouse, C.L. (2007). Advanced Practice Nursing: Defining the practice. Perioperative Nursing Clinics, 2(1), 1-7.

Wilson, S., & Barron, M. (2007). Issues and answers in the role development for the surgical Advanced  Practice Registered Nurse. Perioperative Nursing Clinics, 2(1), 23-28.

Resources
American Nurses Association. (2011). Advanced Practice Nurses. Available at http://nursingworld.org/EspeciallyForYou/AdvancedPracticeNurses

AORN. (2010). Perioperative Advanced Practice Nurse competency statements. In Perioperative competencies, position descriptions, and evaluation tools, pp. 140-151. Denver, CO: Author.

National Association of Clinical Nurse Specialists (NACNS). Available at http://nacns.org/

National Council of State Boards of Nursing (NCSBN). (2007, May). Role delineation study of Nurse Practitioners and Clinical Nurse Specialists. Retrieved Dec. 15, 2011 from https://www.ncsbn.org/06_LPN_RoleDelStudy_NCLEX_30_Web.pdf