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Assignment: LACE Presentation

Assignment: LACE Presentation

 

Nursing has several advanced practice nurse (APN) clinical roles including clinical nurse practitioner (CNP), clinical nurse specialist (CNS), certified nurse-midwife (CNM), and certified registered nurse anesthetist (CRNA). There are licensure, accreditation, certification, and education (LACE) standards set for these professionals (Bryant‐Lukosius, 2016). These standards differ from state to state. This paper discusses LACE considerations for the APN roles in California, Washington, and Illinois, evidence-based strategies to help achieve continuity between state regulatory boards, and whether NP practice is independent in New Jersey.

In California, the CNP, CNS, CNM, and CRNA must graduate with an NP program that meets requirements of the board, The CNPs are certified by the recognized bodies such as American Nurses Credentialing Center (ANCC). CNS is certified by the American association of critical care nurses and the American Nurses Credentialing Center, or Oncology Nursing Certification Corporation (California Board of Registered Nursing, 2019). CNM) must earn certification through the American Midwifery Certification Board (AMCB). Certified registered nurse anesthetist (CRNA) must complete an accredited nurse anesthetist program and become nationally certified by the Council on Certification of Nurse Anesthetists. The APNs must obtain their licensure through the California Board of Registered Nursing (BRN). The educational programs must be accredited by the National League of Nursing (NLN) or any other accreditation agency recognized by the California Board of Registered Nursing (BRN).

In Illinois, the APNs (CNP, CNS, CNM, and CRNA) must complete a relevant master program that meets the state requirements and accredited by the National League of Nursing (NLN) and other relevant organizations. The CRNAs are certified by the American Association of Nurse Anesthetists Council on Certification or the American Association of Nurse Anesthetists Council on Recertification (Nursing Licensure.org., 2019). The CNP is certified by recognized bodies such as the American Nurses Credentialing Center (ANCC).  CNS is certified by the American association of critical care nurses and the American Nurses Credentialing Center, or Oncology Nursing Certification Corporation. CNM) must earn certification through the American Midwifery Certification Board (AMCB). The APNs must obtain their licensure through the Illinois Department of Financial and Professional Regulation (IDPR).

In Washington DC, the CNP, CNM, and CRNA must graduate with an NP master program that meets requirements of the state board, The CNPs are certified by the American Nurses Credentialing Center (ANCC) and other recognized bodies. CNS is not licensed in Washington. CNM earn their certification through the American Midwifery Certification Board (AMCB) (Nursing Licensure.org., 2019). Certified registered nurse anesthetist (CRNA) is certified by the National Board of Certification and Recertification for Nurse Anesthetists. The APN obtain their licensure through the Nursing Care Quality Assurance Commission, a part of the Washington Department of Health (DOH). The APN programs are accredited by the National League of Nursing (NLN) or any other recognized accreditation agency.

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There are irregularities regarding licensure, the scope of practice and autonomy of practice for advanced practice nurses from one state to another. These inconsistencies are tied to variations that come with full practice authority for the APN. To ensure continuity

Assignment LACE Presentation

Assignment LACE Presentation

between the state regulatory boards, APNs should be granted full practice authority to minimize these regulatory gaps. According to Altman, Butler, & Shern (2016), full practice authority licensure for NPs is marginal among the US states. Continuity will be achievable if the strategy is applied fully The NCSBN can be allowed to make rules for the states to follow rather than giving each state the freedom to create their own regulations. Also, the advanced practice registered nurses consensus model was developed by the consensus group and the national council of state boards of nursing (NCSBN) committee. If the model is applied a continuity among the states might be achieved.

New Jersey allows its APNs to practice independently, however, they must maintain a written protocol for prescriptive privileges. They must establish a joint protocol with a collaborating physician before prescribing any medication. The written protocol is kept at the site where the NP works and must be reviewed at least once a year. Unlike other ANPs, nurse midwives can prescribe independently without a joint protocol (New Jersey Division of Consumer Affairs, 2019). However, they must first undergo 30 hours course in pharmacology with at least six hours teaching on addiction prevention and management. APNs should be allowed to practice independently because it is the only way they can be provided with the ability to practice to the full extent of their knowledge. This is the main objective of the National Council of State Boards of Nursing’s (NCSBN) APRN Consensus Model, with aims at giving APNs greater autonomy.

In summary, the licensure, accreditation, certification, and education (LACE) standards differ from state to state. Washington unlike other states does not license CNS. Continuity between regulatory state boards can be achieved by allowing APNs full practice authority. NCSBN APRN Consensus Model was developed to give APNs greater autonomy.

Address the following Topics/Questions:
1. How do licensure, accreditation, certification, and education (LACE) considerations differ for all four APN clinical roles (CNP, CNM, CRNA, CNS) for these three states: California, Washington, and Illinois? Provide evidence for your response.
2. Discuss what evidence-based strategies should be implemented to achieve continuity between state regulatory boards. Provide evidence for your response.
3. Is independent NP practice allowed in your state? Discuss your opinion regarding independent NP practice in your state. Should NPs be allowed to practice independently? Provide evidence for your response.

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