APRN Consensus Model

Advanced practice registered nurses (APRN) are a vital part of the U.S. health care system. They are registered nurses educated in a specific role and patient population at a Masters or post-Masters level. APRNs are prepared by education and certification to assess, diagnose and manage patient problems, order tests and prescribe medications. NCSBN supports an initiative called NursingAmerica to help states align their APRN regulation with the major elements of the Consensus Model for APRN Regulation.

The Consensus Model for APRN Regulation, Licensure, Accreditation, Certification and Education

Advanced practice registered nurses (APRNs) represent a powerful and growing force in the U.S health care system. Released in 2008, the APRN Consensus Model provides guidance for US jurisdictions to adopt uniformity in the regulation of APRN roles, licensure, accreditation, certification and education.

This regulatory framework includes seven main elements:

1. Title: Advanced Practice Registered Nurse (APRN)
2. License: APRNs holds both an RN and APRN license
3. Four Roles: Certified Nurse Midwife (CNM), Certified Nurse Practitioner (CNP), Certified Registered Nurse Anesthetist (CRNA) and Clinical Nurse Specialist (CNS)
4. Education: Completion of postgraduate education is required
5. National Certification: APRNs must pass a nationally accredited certification exam
6. Independent Practice: APRNs are granted authority to practice independently without physician oversight such as collaborative/supervisory agreement
7. Independent Prescribing: APRNs are granted authority to prescribe without physician oversight such as collaborative/supervisory agreement

APRNs are educated and certified in both their role and one of six population foci:

• Family/individual across the life span
• Adult-gerontology*
• Women's health/gender-related
• Pediatrics*
• Neonatal
• Psychiatric/mental health

* The adult-gerontology and pediatric population foci may be further delineated as primary or acute.

Adoption of the Consensus Model elements moves states toward regulatory uniformity. Although there has been significant progress in the integration of components of the Consensus Model in many nurse practice acts, there continue to be states that have not adopted all the elements of this regulatory framework. This can result in a lack of uniformity from one jurisdiction to another.

Keeping in mind, the unique requirements of each jurisdiction, APRNs relocating to another state, providing care across state borders in person, telephonically or virtually must ensure they meet the regulatory requirements of the state where the patient is located at the time care is provided by the APRN.

As long as regulatory requirements differ from state to state, each border represents an obstacle to license portability - potentially preventing access to APRNs and the high-quality care they provide. The Consensus Model calls for an APRN Compact to remove these barriers and provide licensure mobility for APRNs.