UPDATE ON ARIZONA APRN CONSENSUS MODEL LEGISLATION

Paula Christianson-Silva DNP, RN, FNP-BC, ANP-BCTucson, AZNovember 20, 2015

ObjectivesParticipants will be able to: 1. Identify key components of the APRN Consensus

Model2. Discuss the purpose and implications of APRN

Consensus Model legislation3. Identify strategies to assure successful adoption

of the APRN Consensus Model in Arizona4. Support Arizona APRN Consensus Model

Legislation and formulate a personal action plan for advocacy

Key ComponentsAPRN Consensus Model1

APRN Consensus Work Group, 2004-2007

APRN Consensus Work Group, 2004-2007 N Regulation (published widely 7/8/2008)

National Council of State Boards of Nursing American Association of Colleges of Nursing Stakeholders in Education, Certification,

Accreditation, APRN roles

Endorsed by 45 APRN organizations (now 48)

The Consensus Model for APRN Regulation(published widely 7/8/2008)

Definition of Advanced Practice Registered Nurse (APRN)

An individual who has: Completed an accredited graduate-level

educational program Passed a national certification examination that

matches the educational preparation Acquired advanced clinical skills and knowledge Practice built upon the competencies of an RN Clinical experience of sufficient depth and

breadth to reflect the intended license Obtained a license to practice as an APRN in

one of the four roles(NCSBN, 2008)

APRN Consensus Model Fundamentals

Nurse Practitioner Certified Nurse

Midwife Nurse Anesthetist Clinical Nurse

Specialist

Family/Individual Lifespan

Adult/Gerontology Pediatrics Neonatal Women/Gender Based Psychiatric/Mental

Health

APRN Roles Population Foci

APRN Regulatory Model: LACEAPRN regulation includes: Licensure – the granting of authority to practice Accreditation – formal review and approval by a

recognized agency of educational degree or certification programs in nursing or nursing related programs

Certification – the formal recognition of knowledge, skills and experience demonstrated by the achievement of standards identified by the profession

Education – the formal preparation of APRNs in graduate or post-graduate programs

(NCSBN, 2008)

Source: National Council State Boards of Nursing (2008). www.ncsbn.org

APRN Consensus ModelMet in2012

2013

Licensure change requires legislation in every state and still has a long way to go!

????

What about the DNP?

? ? ?

Target date of 2015 should not be confused with APRN Consensus Model legislation

Purpose and Implications

APRN Consensus Model Legislation2

Purpose and Implications All APRNs would be regulated by

State Boards of Nursing All states would use the same

terminology for APRN roles All states would have one piece of

legislation covering the four APRN roles

All states would require graduate education

Purpose and Implications All states would have full practice

authority for all APRNs Would allow for APRN compact

legislation which lets an APRN hold one multistate license with a privilege to practice in other compact states (and eventually all states)

NCSBN Campaign for Consensus Project

National initiative to assist states in aligning their APRN regulation with the major elements of the Consensus Model for APRN Regulation

See: https://www.ncsbn.org

Strategies for Adoption in Arizona

APRN Consensus Model Legislation3

Arizona APRN Coalition

AZ APRN Coalition - Timeline Meeting since 2013 – now 60+ active

members from each of the four APRN groups APRN Lobby Day – March 2015 Each APRN group wrote their sections; these

were combined into one Sunrise report and submitted to the Joint Legislative Audit Committee (JLAC) - September 2015

Developed APRN Fact Sheet, legislation summary, template for support letters, and document library available at www.aznurse.org

AZ APRN Coalition - Timeline

Meetings with key stakeholders – in progress

Public Relations Campaign (Veridius) - in progress

AzANA Lobbyist Rory Hays, JD Administrative support from AzNA Committee of Reference assigned by

JLAC; Hearing – now December 7, 2015

Goal is to submit to Legislature - January 2016

Lobby Day - January 19, 2016

What is the Sunrise Review Process?

Established by Laws 1985, Title 32, Chapter 31 Arizona’s sunrise review process provides a mechanism for both health professions and nonhealth professions to request regulation and, for health professions, expansion in scope of practice.Link to AZ Sunrise/Sunset Process http://www.azleg.gov/ (Left navigation bar)

Title 32 = Arizona Nurse Practice Act

What changes are included? Consensus among APRN roles – full

and uniform practice authority for all

NPs – remove word “collaboration” in one section; no change in Scope of Practice (SOP)

CNMs – no longer under NPs; no change in SOP

What changes are included? CRNAs – full practice authority,

prescriptive authority (will no longer require MD supervision on site) CNSs – full practice authority,

prescriptive authority (will require 3-4 credit academic courses the “3 P’s” in Pharmacology, Pathophysiology and Physical Assessment)

Personal Action PlanAPRN Consensus Model Legislation4

Personal Action Plan Become a member of your

professional organization Learn more:

https://tucsonnp.enpnetwork.com/ https://arizonanp.enpnetwork.com/ https://www.aznurse.org/ http://www.aanp.org/ https://www.ncsbn.org/

Educate your colleagues and friends – educational materials at: https://arizonanp.enpnetwork.com/nurse-practitioner-

news/95311-consensus-model-educational-materials?utm_medium=email&utm_source=group&utm_campaign=announcement_promotion

Personal Action PlanGather letters of support from:

Physicians Leaders of healthcare facilities Disease focused organizations Patients

Draft letter available at: https://arizonanp.enpnetwork.com

Personal Action Plan Watch for updates from your

professional organization and respond

- at this time, the majority of the Committee of Reference Members are undecided

New PR Logo:

What else can we do?Attend Committee of Reference Hearing

Monday, December 7, 2015 at 9 AMat the AZ State Capital in Phoenix- news conference on the Capital Steps just prior (bring family, friends, patients, etc.)(or sign in online)

Attend Lobby DayTuesday, January 19, 2016at the AZ State Capital in Phoenix

Goal is to have every legislator visited by an APRN constituent!

Questions ?

References American Nurses Association. (2004). Nursing: Scope and standards of practice.

Washington, DC: Author. APRN Consensus Work Group & the National Council of State Boards of Registered Nursing

APRN Advisory Council. (2008, July 7). Consensus model for APRN regulation: Licensure, accreditation, certification & education. Retrieved from https://www.ncsbn.org/7_23_08_Consensue_APRN_Final.pdf

Boland, B. A., Treston, J., Weill, V. a., & O’Sullivan, A. L. (2009, November/December). Are you ready for the consensus model? Implications of the model on NP practice. The American Journal for Nurse Practitioners, 13(11/12), 10-21.

Center on Budget and Policy Priorities. (2006). The number of uninsured Americans is at an all time high. Retrieved from http://www.chpp.org.

Emanuele, D. (2010). APRN Consensus Model: Implications for nursing education and practice (Presentation to California Association for Nurse Practitioners Greater Pasadena Chapter). Pasadena, CA: Author.

IOM. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington DC: The National Academies Press.

Keenan, C. (2010). APRN regulatory consensus: Issues for nurse practitioners (Presentation to California State Board of Nursing). Sacramento, CA: Author.

Link, D. (2015). APRN Consensus Model Legislation (Presentation to Arizona Nurse Practitioner Council). Flagstaff, AZ: Author.

NCSBN. (2008 and 2015). Retrieved from http://www.ncsbn.org. Stanley, J. (2010). The APRN consensus model: Implications for educators and

practitioners (AACN Faculty Link, Powerpoint). Washington DC: AACN.

THANK YOU!Paula Christianson-Silvapchristiansonsil@email.arizona.edu