Advanced nurse practitioners (ANPs) require highly developed and extensive knowledge in “diagnostics, therapeutics, the biological, social and epidemiological sciences and pharmacology, and their enhanced skills in areas such as consultation and clinical decision-making” (Duke, 2012, p.1027). As such, it is imperative that nurses assuming an advance practice role are equipped and capable of applying intricate logic, critical thinking, deliberation, and analysis in their work, evaluations, clinical analysis, and decisions (Duke, 2012). Moreover, the highly specialized clinical experience in combination with the MSN curricula affords undergraduate nurses with the knowledge, nursing theory, leadership, and management principles necessary to meet core competencies required for advance practice.
Mandating studies at the Master’s level is not only necessary but is also crucial to the success of undergraduate nurses assuming roles in advance practice. Credentialing is a process that ensures standards established by a governmental or nongovernmental agency are met. Credentialing can either be mandatory or voluntary. Organizations, programs, and individuals seek credentialing as proof of their ability to meet the established standards.
Schools must have approval from the state’s Board of Nursing to operate a program. An example of mandatory credentialing includes approval of pre-licensure schools or colleges of nursing by the state where they are located. Approval is granted when the program has met the requirements as set forth by rules and laws. Accreditation is a voluntary process. Colleges and schools seek accreditation to validate that standards have been met as set forth by the accrediting bodies. The Commission on Collegiate Nursing Education (CCNE) and the National League for Nursing Accrediting Commission (NLNAC) are the two accrediting agencies in the United States for nursing education. Once a program has been accredited by one of the entities, a peer review process must be in place to ensure that the institution is meeting or exceeding the criteria as set forth by the accrediting body.
Some states require hospitals and other health care facilities to have a license which is a mandatory obligation to operate in that state. These
facilities must abide by rules and laws to remain open. As with academic programs, health care facilities can be accredited. The Joint Commission (TJC) and the Healthcare Facilities Accreditation Program (HFAP) are two agencies that offer facilities processes to demonstrate its ability to adhere to established criteria. Accreditation for health care facilities is voluntary; however, some third-party payers have linked reimbursement to evidence of meeting accreditation criteria. As a result, some facilities feel the obligation to be accredited.
Health care facilities can also participate in voluntary credentialing by recognition. The American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Recognized facilities demonstrate their ability to comply with established standards based upon the latest evidence. A peer review process guides the organization’s ability to meet these standards. In addition, programs within a health care facility can seek recognition. As an example, TJC provides certification for special programs within an accredited organization that adhere to standards related to implementation of clinical practice guidelines, performance measures, and continuous quality improvement that reflect excellence in practice. These disease-specific certifications include diabetes, stroke, asthma, acute myocardial infarction, and kidney disease.
Organizations that provide continuing education for nurses can seek accreditation through the ANCC. Accreditation for continuing education organizations is a voluntary process that demonstrates its ability to provide quality continuing education. Although accreditation is voluntary, some states have established laws and rules that are mandatory for providers offering continuing education. Some states require mandatory continuing education for licensure.
A form of individual credentialing is licensure. When a license is issued by the State Board of Nursing it is confirmation that the licensee has met the requirements stipulated in law and by rule for safe practice. Licensure boards maintain disciplinary authority over licensees to ensure safe practice. Nurses who fall below the standard of safe practice face licensure action which could include restrictions, suspension, or revocation of the nursing license. Requirements for license renewal are set forth in each state’s rules and laws.
Individuals can obtain certification in specialty practice areas which is another form of individual credentialing. The ANCC offers certification in 23 specialty areas in addition to nine certification examinations for nurse practitioners and nine certification examinations for clinical nurse specialists. Certification is a legal requirement for advanced practice nurses. States establish their own laws and rules regarding requirements around certification for advanced practice recognition. The efforts of the National Council of State Boards of Nursing (NCSBN) Consensus Model for Advanced Practice Nurse Regulation works to provide consistency in advanced practice nurse education, certification, and licensure from state to state.
Choosing to attend a program that is accredited, like the MSN program at ASU, ensures a quality education. Accredited schools demonstrate their ability to meet the requirements set forth by governing boards and state law. It is my opinion that the job market looks favorably at potential employees who earned a degree from an accredited program. As an advanced practice nurse a certification examination is required which is a form of mandatory credentialing for licensure. In addition, continuing education will be required to maintain licensure to ensure quality care to patients and the State Board of Nursing maintains disciplinary authority for those that demonstrate less than standard practice. As a result, continuing professional development will be necessary as an advanced practice nurse. Once in the workforce as an advanced practice nurse, hospitals or other health care facilities require a credentialing process for verification of applicant’s ability to provide safe practice. Credentialing is necessary to provide evidence that the provider has met the established standards of quality.
Dickerson, P. S. (2012). Credentialing; Understanding the terms. The Journal
of Continuing Education in Nursing, 43(5), 197-198.
Duke, N. (2012). Exploring advanced nursing practice: Past, present and future. British Journal of Nursing, 21(7), 1026-30.