An advanced practice nurse (APN) or advanced practice registered nurse (APRN) is a nurse with advanced didactic and clinical education, knowledge, skills, and scope of practice.
APN defines a level of nursing practice that utilizes extended and expanded skills, experience and knowledge in assessment, planning, implementation, diagnosis and evaluation of the care required. Nurses practicing at this level are educationally prepared at the post-graduate level and may work in either a specialist or generalist capacity. However, the basis of advanced practice is the high degree of knowledge, skill and experience that is applied within the nurse-patient/client relationship to achieve optimal outcomes through critical analysis, problem solving and evidenced based decision making.
APNs demonstrate effective integration of theory, practice and experiences along with increasing degrees of autonomy in judgments and interventions. Intensive post-graduate education is designed to teach an APN to use multiple approaches to decision-making, manage the care of individuals and groups, engage in collaborative practices with the patient or client to achieve best outcomes; provide a supportive environment for colleagues; manage the utilization of staff and physical resources; engage in ethically justifiable nursing practice; protect the rights of individuals and groups; engage in activities to improve nursing practice; develop therapeutic and caring relationships; fulfill the conduct requirements of the profession; act to enhance the professional development of self; and function in accordance with legislation and common law affecting nursing practice.
APN education forms the basis of four recognized general areas of specialization:
Nurse anesthetists (in the United States, Certified Registered Nurse Anesthetists or CRNAs)
Nurse midwives (in the United States, Certified Nurse Midwives or CNMs)
Clinical nurse specialists (CNSs)
Nurse practitioners (NPs)
Each nurse specialty, especially NPs, can have sub-specialties or concentrations in a specific field or patient population in healthcare. Each has a unique history and context, but shares the commonality of being an APN.
While education, accreditation, and certification are necessary components of an overall approach to preparing an APN for practice, these roles are regulated by legislation and specific professional regulation. This allows for prescribing and referral, insurance reimbursement, and admitting privileges to health care facilities. In the US, the licensing boards are governed by State regulations and statutes and are the final arbiters of who is recognized to practice within a given State. While APNs are educated differently depending on their specific specialty, all APNs are now trained at the graduate level and are required to attain at least a master's degree, generally a Master of Science in Nursing in their field of concentration.
In 2004, The American Association of Colleges of Nursing (AACN) in conjunction with the National Council of State Boards of Nursing (NCSBN) recommended that advanced practice nurses move the entry level degree to the doctorate level by 2015. Accordingly, all APRN training programs are required to convert their master's degree to a clinical/practice doctorate degree by the year 2015. Although The American Association of Nurse Anesthetists approved this recommendation, it is not requiring program compliance until the year 2025.
The majority of programs will grant a Doctor of Nursing Practice (DNP). Because 45% of the nurse anesthesia programs are located in Schools of Allied Health, these programs will award a Doctor of Nurse Anesthesia Practice (DNAP). The Doctor of Nursing Practice will be the direct-entry, minimum academic requirement for advanced practice nurses; it is a clinical/practice-based doctorate but because it is not the entry degree for the profession of nursing (which includes advanced practice nursing), it is a terminal degree.
APN defines a level of nursing practice that utilizes extended and expanded skills, experience and knowledge in assessment, planning, implementation, diagnosis and evaluation of the care required. Nurses practicing at this level are educationally prepared at the post-graduate level and may work in either a specialist or generalist capacity. However, the basis of advanced practice is the high degree of knowledge, skill and experience that is applied within the nurse-patient/client relationship to achieve optimal outcomes through critical analysis, problem solving and evidenced based decision making.
APNs demonstrate effective integration of theory, practice and experiences along with increasing degrees of autonomy in judgments and interventions. Intensive post-graduate education is designed to teach an APN to use multiple approaches to decision-making, manage the care of individuals and groups, engage in collaborative practices with the patient or client to achieve best outcomes; provide a supportive environment for colleagues; manage the utilization of staff and physical resources; engage in ethically justifiable nursing practice; protect the rights of individuals and groups; engage in activities to improve nursing practice; develop therapeutic and caring relationships; fulfill the conduct requirements of the profession; act to enhance the professional development of self; and function in accordance with legislation and common law affecting nursing practice.
APN education forms the basis of four recognized general areas of specialization:
Nurse anesthetists (in the United States, Certified Registered Nurse Anesthetists or CRNAs)
Nurse midwives (in the United States, Certified Nurse Midwives or CNMs)
Clinical nurse specialists (CNSs)
Nurse practitioners (NPs)
Each nurse specialty, especially NPs, can have sub-specialties or concentrations in a specific field or patient population in healthcare. Each has a unique history and context, but shares the commonality of being an APN.
While education, accreditation, and certification are necessary components of an overall approach to preparing an APN for practice, these roles are regulated by legislation and specific professional regulation. This allows for prescribing and referral, insurance reimbursement, and admitting privileges to health care facilities. In the US, the licensing boards are governed by State regulations and statutes and are the final arbiters of who is recognized to practice within a given State. While APNs are educated differently depending on their specific specialty, all APNs are now trained at the graduate level and are required to attain at least a master's degree, generally a Master of Science in Nursing in their field of concentration.
In 2004, The American Association of Colleges of Nursing (AACN) in conjunction with the National Council of State Boards of Nursing (NCSBN) recommended that advanced practice nurses move the entry level degree to the doctorate level by 2015. Accordingly, all APRN training programs are required to convert their master's degree to a clinical/practice doctorate degree by the year 2015. Although The American Association of Nurse Anesthetists approved this recommendation, it is not requiring program compliance until the year 2025.
The majority of programs will grant a Doctor of Nursing Practice (DNP). Because 45% of the nurse anesthesia programs are located in Schools of Allied Health, these programs will award a Doctor of Nurse Anesthesia Practice (DNAP). The Doctor of Nursing Practice will be the direct-entry, minimum academic requirement for advanced practice nurses; it is a clinical/practice-based doctorate but because it is not the entry degree for the profession of nursing (which includes advanced practice nursing), it is a terminal degree.