ANA Supports Advanced Practice

The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education (APRN Consensus Model) is a uniform model of regulation for the future of advanced practice nursing that is designed to align the interrelationships among licensure, accreditation, certification, and education (LACE). The American Nurses Credentialing Center (ANCC) anticipates that the consistency—and clarity—that result from the new regulatory model will benefit individual nurses and enhance patient care. 

The uniformity we anticipate the APRN Consensus Model will produce is expected to enable APRNs to practice to the full extent of their education and licensure. In addition, the more uniform system will provide new opportunities for nurses through the possibility of ease of mobility across state lines.

The APRN Consensus Model is the product of a collaborative effort among more than 40 nursing organizations, including ANCC, that have an interest in making APRN practice more uniform. A complete list of all the organizations that took part is found on pages 30–40 of the APRN Consensus Model document, which can be found on the ANCC Web site at APRN Consensus Model.

ANCC was an active participant in the development and launch of the APRN Consensus Model. Our organization continues to lead the way to ensure that this transformative model will enhance the certification process. APRNs, educators, and collaborative organizations should turn to ANCC for updates regarding the APRN Consensus Model's effects on certification.

The APRN Consensus Model document provides a detailed definition of an APRN on pages 6–9. There are four APRN roles defined in the document:

• Certified Registered Nurse Anesthetist (CRNA)
• Certified Nurse-Midwife (CNM)
• Clinical Nurse Specialist (CNS)
• Certified Nurse Practitioner (CNP)

The necessary coordination among licensure, accreditation, certification, and education bodies required by the APRN Consensus Model called for an incremental implementation process. Although the model was completed in 2008, its full implementation of the uniform APRN regulations across the four essential elements for licensure, accreditation, certification, and education was 2015.

Keeping your certification current through timely renewals—and staying abreast of the information and updates provided by ANCC and other key groups—will be crucial as the APRN Consensus Model is implemented.

There are three key recommendations you should keep in mind throughout the implementation process:

• The first is to stay in touch with the ANA and your specialty nursing organization to learn the latest developments in the transition to the APRN Consensus Model. Use ANCC's Web site at APRN Consensus Model as your resource for questions regarding the APRN Consensus Model's effects on certification. Additional information regarding implementation of all the components of the APRN Consensus Model can be found at www.aprnlace.org.
• Keep your certification current for the most flexibility as this transition unfolds. After 2015, if your certification lapses, you may not be able to renew your existing certification or your license to practice. The Certification page of the ANCC Web site includes links to specialty area pages that will provide updates for your individual certification needs.
• Lastly, regulatory changes, including those to the nurse practice acts, may affect the certification and licensure requirements in your state. Track state-specific updates through the National Council of State Boards of Nursing at www.ncsbn.org/aprn.htm .

The official names and credentials of ANCC's certifications are:

• Adult-Gerontology Acute Care Nurse Practitioner (AGACNP-BC)
• Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP-BC)
• Adult-Gerontology Clinical Nurse Specialist (AGCNS-BC)
• Family Nurse Practitioner (FNP-BC)
• Psychiatric Mental Health Nurse Practitioner (Across the Lifespan) (PMHNP-BC)

Retirement of a certification exam means that the test will no longer be available and new ANCC board certification and credentials will no longer be awarded. APRNs whose ANCC board certification is active and in good standing may continue to renew their certification using professional development activities and clinical practice hours to maintain their certified status, as long as their certification does not lapse.

ANCC allows currently certified nurses to maintain their credentials on certifications with retired exams through timely renewals. Renewal requirements for certifications with retired exams must be met using professional development activities and clinical practice hours only. The option to renew with professional development activities and testing will not be available.

If your certification lapses and you meet the requirements, you may reactivate your certification using professional development activities and clinical practice hours for up to two years after your expiration date. The option to reactivate your certification with professional development activities and testing will not be available for certification with retired exams. The reactivation process and procedure is detailed in ANCC's renewal application.

If your certification lapses and you do not meet the requirements for reactivation, you will not be able to renew your existing certification. This means that you may not meet state licensing, institutional credentialing, or third-party reimbursement requirements. Keeping your certification current through renewal will allow you to have the most flexibility as this process unfolds.

The APRN Consensus Model has combined the Adult and Gerontology populations and, therefore, ANCC will also combine these populations in its new certifications. As a result, nurses who are currently dually certified by ANCC in the following areas will not need to sit for the new exam. Once the new certifications become available, the new credentials will be granted at the time of your next certification renewal (for whichever of your certifications comes up first for renewal). Your second certification will then expire on its regular schedule.

• Nurse Practitioners dually certified with both ANCC Adult NP and Gerontological NP credentials will automatically receive the new Adult-Gerontology Primary Care NP credential of AGPCNP-BC.
• Nurse Practitioners dually certified with both ANCC Acute Care NP and Gerontological NP credentials will automatically receive the new Adult-Gerontology Acute Care NP credential of AGACNP-BC.
• Clinical Nurse Specialists dually certified with both ANCC Adult Health CNS and Gerontological CNS credentials will automatically receive the new Adult-Gerontology CNS credential of AGCNS-BC.

Nurses who do not meet the criteria above and wish to apply for the new certifications will need to meet the eligibility requirements for those certifications, including having completed a graduate educational program in the role and population that correspond directly to the certification they wish to pursue.

If you are currently licensed to practice in your state, there is no regulatory need to change your existing credential, as long as you intend to continue practicing in your state. Your state board of nursing or your employer will inform you of any changes.

If you wish to become licensed to practice in another state, you should check the applicable licensure requirements in that state. You may track state-specific updates through the National Council of State Boards of Nursing at www.ncsbn.org/aprn.htm.

All nurses who want to get a new credential need to apply for the certification using the current eligibility criteria for that certification, including having completed a separate educational program that corresponds directly to each certification for which they wish to apply.

We are happy to review your application if you think you will meet current eligibility for a different certification. Your application must provide evidence of the following:

• Transcripts showing completion of the graduate program (master's, postgraduate, or doctorate) that corresponds to the credential you are seeking. Work experience is not accepted in lieu of education.
• Completing a minimum of 500 faculty-supervised clinical hours in the role and population foci in which you are seeking certification.
• Meeting any and all other eligibility requirements in effect when you apply.

If you are considering a postgraduate program, then your school of nursing will conduct a gap analysis to determine the courses and clinical hours required to award you the postgraduate certificate.

Work experience cannot be used for eligibility. Candidates must meet all the eligibility requirements to sit for a certification exam. This includes completing a graduate educational program with at least 500 hours of faculty-supervised clinical experience in each role and population focus for which you want to become certified.

1. Ask your school of nursing to conduct a gap analysis of the coursework and clinical hours from your previous graduate program. The results of this gap analysis will tell you what is needed to complete the school's postgraduate program that corresponds directly to the desired certification. Work experience cannot be used for eligibility in place of faculty-supervised clinical hours.
2. Complete the coursework and faculty-supervised clinical hours.
3. Submit all graduate transcripts and the gap analysis conducted by the school granting your postgraduate degree with your certification application to ANCC.

For APRNs, the new regulations will require graduation from educational programs that

• Are graduate level;
• Are accredited by a nationally-recognized nursing accrediting agency;
• Prepare the graduate in one of the four APRN roles recognized by the model;
• Prepare the graduate in at least one of the six populations recognized by the model;
• Include three separate and broad-based graduate-level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology (these are often referred to as the "3Ps"); and
• Include a minimum of 500 faculty-supervised clinical hours in the role and population.

Only if the school can provide evidence that the content of the course is broad-based and meets the requirements of the APRN Consensus Model. You will be asked to submit additional documentation, including a syllabus for the course.

As part of the APRN Consensus Model, the school accreditors will launch a preapproval process for new educational programs. This process will help ensure that new graduates are educationally prepared to meet eligibility requirements for certification and licensure. Existing program faculty should keep students informed of certification and licensure requirements.

ANCC has produced an APRN Faculty Tool Kit as a guide for educators.

Additionally, in fall 2012, ANCC will launch a program to provide schools of nursing with an official confirmation of their nurse practitioner and/or clinical nurse specialist programs' congruence with educational eligibility criteria for national certification from ANCC. This program will also provide streamlined communication between schools of nursing and ANCC regarding changes that may influence the ANCC certification applications of future graduates. For more information, please contact APRNFaculty@ana.org.

ANCC currently requires candidates to complete graduate work, which may include a master's, postgraduate certificate, or doctorate. While certification eligibility can change, ANCC has no plans to require a DNP at this time. 

Please contact the National Council of State Boards of Nursing at www.ncsbn.org/aprn.htm to determine licensure requirements.