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Scope of Practice for Emergency Nurse Practitioners

Campo, Theresa M. DNP, FNP-C, ENP-BC, FAANP; Carman, Margaret J. DNP, ACNP-BC, ENP-BC, FAEN; Evans, Dian PhD, RN, FNP-BC, ENP-BC, FAANP; Hoyt, Karen Sue PhD, FNP-BC, FAEN, FAANP, FAAN; Kincaid, Kyle DNP, ENP, FNP-BC; Ramirez, Elda G. PhD, RN, FNP-BC, FAEN, FAANP; Roberts, Eric DNP, FNP-BC, ENP-BC; Stackhouse, Ken MBA, MSN, RN, FNP-C, ENP-BC; Wilbeck, Jennifer DNP, ACNP-BC, FNP-BC, FAANP; Weltge, Arlo MD, MPH, FACEP

doi: 10.1097/TME.0000000000000126
FROM THE EDITORS
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Co-Director Family Nurse Practitioner Track and Associate Clinical Professor, Drexel University, Philadelphia, PA; Emergency Nurse Practitioner. Atlanticare Regional Medical Center, Atlantic City, NJ

Assistant Professor, Duke University School of Nursing, Emergency Nurse Practitioner, Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC

Clinical Associate Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA; Emergency Nurse Practitioner, Emory Healthcare, Atlanta, GA

Clinical Professor, University of San Diego, Hahn School of Nursing and Health Science: Beyster Institute for Nursing Research, San Diego, CA; Emergency Nurse Practitioner, St. Mary Medical Center, Long Beach, CA, Editor, Advanced Emergency Nursing Journal, Wolters Kluwer, Philadelphia, PA

Section NP/PA Director, Schumacher Clinical Partners, Emergency Nurse Practitioner, Citizens Medical Center, Victoria, TX; Clinical Instructor, UTHealth School of Nursing, University of Texas Health Science Center, Houston, Texas

Professor Clinical Nursing and Director Emergency/Trauma NP Concentration, UTHealth School of Nursing, Houston Texas; President/Founder American Academy of Emergency Nurse Practitioners

Assistant Professor, Marcella Niefhoff School of Nursing, Loyola University, Chicago, IL; Emergency Nurse Practitioner, Rush University Medical Center, Chicago, IL

Emergency Nurse Practitioner CHI St Luke's Memorial San Augustine Hospital, San Augustine, TX; Instructor UTHealth School of Nursing Houston, TX

Associate Professor & ENP Specialty Director, Vanderbilt University School of Nursing, Nashville, TN

Clinical Professor of Emergency Medicine Department of Emergency Medicine, UTHealth McGovern School of Medicine, Houston, TX

Disclosure: Scope of Practice for Emergency Nurse Practitioners currently appears on the AAENP website at http://aaenp-natl.org/index.php Permission to publish this text is given by the President/Founder of AAENP.

THIS DOCUMENT provides an overview of the role, education, accountability, and responsibility of the emergency nurse practitioner (ENP).

The scope of practice for ENPs is based upon nationally recognized licensure, education and certification with inclusion of specialty educational content.

ENP scope of practice must be viewed in conjunction with local, state and national regulatory licensure requirements.

ENP scope of practice may be limited by organizational credentialing and privileging entities.

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ROLE OF THE ENP

Emergency nurse practitioners (ENPs) are specialty care providers and licensed practitioners.

ENPs provide care to patients in ambulatory, urgent, and emergent care settings.

ENPs assess, diagnose, and manage episodic illnesses, injuries and acute exacerbations of chronic diseases.

ENPs are prepared to manage patients across the lifespan, within the scope of population-area of NP education and national certification, inclusive of acuity levels ranging from non-urgent, to urgent and emergent conditions.

In managing the acute resuscitative stage of emergency care, ENPs engage in patient prioritization, triage, medical decision making, differential diagnosis, patient management, monitoring and on-going evaluation, appropriate consultation and in coordinating the transfer of care.

ENPs order and interpret diagnostic studies (e.g., labs, imaging) and prescribe pharmacological and non-pharmacological therapies.

ENPs instruct patients, families, and/or significant others with regard to health/wellness along with injury prevention/patient safety.

ENPs work collaboratively with other health care providers and stakeholders.

ENPs are advocates, researchers, consultants, and educators.

ENPs are culturally competent.

ENPs engage in public health emergency preparedness and response efforts.

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DEFINITION OF ACUTE CARE IN EMERGENCY PRACTICE

Acute care in emergency practice is not defined by setting or population.

Acute care in emergency practice is defined as the dynamic, short term stabilization of conditions including, but not limited to, treatment of injuries, new onset clinical conditions and exacerbation of chronic co-morbidities.

Acute care in emergency practice is inclusive of resuscitative stabilization and the treatment of medical and traumatic clinical presentations for patients across the lifespan within the scope of population area of NP education and national certification.

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ENP EDUCATION

ENP specialization builds upon NP entry-into-practice knowledge and skills and requires a minimum of a master's level preparation or specialized preparation at the post-master's or doctoral level.

Educational preparation provides ENPs with specialized knowledge and clinical competencies which enable them to practice in various health care settings, establish differential diagnoses, manage and initiate treatment plans, order and interpret diagnostic tests, prescribe medications, perform procedures and determine final patient dispositions.

ENP educational preparation includes the evaluation and management of patients across the lifespan within the scope of population-area of NP education, national certification, and the care continuum. ENP program accreditation requirements and competency-based standards ensure that they are educationally prepared to provide quality, comprehensive care through entrustable professional activities (EPAs).

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ENP ACCOUNTABILITY

ENP practice is accountable to patients, families and communities, and provides evidence-based quality health care based on national standards. ENP practice conforms to professional ethical codes of conduct.

ENPs meet national certification requirements (See the American Academy of Nurse Practitioners Certification Program (AANPCP) ENP-C at https://www.aanpcert.org and the American Nurses Credentialing Corporation ENP-BC requirements at http://nursecredentialing.org/EmergencyNP).

ENPs undergo peer review and periodic clinical outcome evaluation.

ENPs provide evidence of continued professional development via continuing education, on the job training, or through post-graduate emergency specific fellowships to meet ongoing clinical practice requirements.

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ENP RESPONSIBILITY

ENPs are responsible to the public as consumers of health care and therefore, keep abreast of the constantly changing landscape of health care trends and of the latest evidence-based research.

ENPs take full responsibility for continued professional development.

ENPs are leaders who are active in their relevant professional organizations.

ENPs are actively engaged with health policy initiatives.

The American Academy of Emergency Nurse Practitioners (AAENP) supports the following documents:

Thank you to the following individuals of the IENAP Advisory Council who reviewed this document:

  • Karen Reilly Follin, MSN, RN, ACNP, CNS, CEN, ACNP-BC, CCNS, SANE (Chairperson)
  • Carla Brim, MN, RN, CNS, CEN, PHCNS-BC
  • Timothy Pruitt, MSN, RN, APRN, FNP-BC
  • Amy Rettig, MSN, MA, RN, NP, CNS, ACNS-BC, PMHNP-BC
  • Amanda Shrout, MSN, RN, CNS, CEN, CCNS
  • Diane K. Fuller Switzer, DNP, RN, ARNP, CEN, CCRN, ENP-BC, FNP-BC
  • Darleen Williams, DNP, CNS, EMT-P, CEN, CCNS
  • Matthew Dunn, MSN, BSN, BS, RN, CRNP, ACNP-BC
  • Justin S. Fulkerson, MS, BSN, RN, ACNP, CEN, ACNP-BC
  • Cindy Kumar, MSN, RN, ACNP-BC, FNP-BC
  • Jean Proehl, RN, MN, CEN, CPEN, TCRN, FAEN (Board Liaison)

Authors

  • Theresa M. Campo, DNP, FNP-C, ENP-BC, FAANP, Co-Director Family Nurse Practitioner Track and Associate Clinical Professor, Drexel University, Philadelphia, PA; Emergency Nurse Practitioner. Atlanticare Regional Medical Center, Atlantic City, NJ
  • Margaret J. Carman, DNP, ACNP-BC, ENP-BC, FAEN, Assistant Professor, Duke University School of Nursing, Emergency Nurse Practitioner, Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC
  • Dian Evans, PhD, RN, FNP-BC, ENP-BC, FAANP, Clinical Associate Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA; Emergency Nurse Practitioner, Emory Healthcare, Atlanta, GA
  • Karen Sue Hoyt, PhD, FNP-BC, FAEN, FAANP, FAAN, Clinical Professor, University of San Diego, Hahn School of Nursing and Health Science: Beyster Institute for Nursing Research, San Diego, CA; Emergency Nurse Practitioner, St. Mary Medical Center, Long Beach, CA, Editor, Advanced Emergency Nursing Journal, Wolters Kluwer, Philadelphia, PA
  • Kyle Kincaid, DNP, ENP, FNP-BC, Section NP/PA Director, Schumacher Clinical Partners, Emergency Nurse Practitioner, Citizens Medical Center, Victoria, TX; Clinical Instructor, UTHealth School of Nursing, University of Texas Health Science Center, Houston, Texas
  • Elda G. Ramirez, PhD, RN, FNP-BC, FAEN, FAANP, Professor Clinical Nursing and Director Emergency/Trauma NP Concentration, UTHealth School of Nursing, Houston Texas; President/Founder American Academy of Emergency Nurse Practitioners
  • Eric Roberts, DNP, FNP-BC, ENP-BC, Assistant Professor, Marcella Niefhoff School of Nursing, Loyola University, Chicago, IL; Emergency Nurse Practitioner, Rush University Medical Center, Chicago, IL
  • Ken Stackhouse MBA, MSN, RN, FNP-C, ENP-BC, Emergency Nurse Practitioner CHI St Luke's Memorial San Augustine Hospital, San Augustine, TX; Instructor UTHealth School of Nursing Houston, TX
  • Jennifer Wilbeck, DNP, ACNP-BC, FNP-BC, FAANP, Associate Professor & ENP Specialty Director, Vanderbilt University School of Nursing, Nashville, TN
  • Arlo Weltge, MD, MPH, FACEP, Clinical Professor of Emergency Medicine Department of Emergency Medicine, UTHealth McGovern School of Medicine, Houston, TX

Developed and approved by the American Academy of Emergency Nurse Practitioners Board of Directors © August, 2016.

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