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Certification and education as determinants of nurse practitioner scope of practice: An investigation of the rules and regulations defining NP scope of practice in the United States

Blackwell, Christopher W. Ph.D., ARNP, ANP-BC, AGACNP-BC, CNE1,a; Neff, Donna Felber Ph.D., RN, FNAP1,b

Journal of the American Association of Nurse Practitioners: October 2015 - Volume 27 - Issue 10 - p 552–557
doi: 10.1002/2327-6924.12261

Purpose and background: In 2008, a consortium of advanced practice nursing organizations authored the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education. The document's aim is to provide guidance for states to adopt uniformity in the regulation of advanced practice registered nurse roles. Despite a target date to complete that work by 2015, there remains an extensive amount of variation in how states define the scope of practice (SOP) for nurse practitioners (NPs).

Data sources: Based on the National Council of State Boards of Nursing online database, state (N = 51 [includes the District of Columbia]) NP practice acts and/or rules and regulations documents were examined for language describing SOP for NPs consistent with the language of the advanced practice registered nurse (APRN) Consensus Model.

Conclusions: Results indicated that 18 states and the District of Columbia (37%) had specific regulations defining NP SOP by certification and/or educational preparation while 23 (45%) did not. The remaining nine states (18%) had SOP regulations that were interpreted as being ambiguous in relation to certification and/or educational preparation.

Implications for practice: The findings suggest much work is needed to ensure NP SOP accurately reflects NP board-certification and graduate educational preparation.

1College of Nursing, University of Central Florida, Orlando, Florida,

a(Associate Professor)

b(Associate Professor & Interim Director of Research)

Received: 11 December 2014; accepted: 4 March 2015

Correspondence Christopher W. Blackwell, College of Nursing, University of Central Florida, Suite 300, 12201 Research Parkway, Orlando, FL 32826. Tel: (407) 823-2517; Fax: (407) 823-5675; E-mail:

© 2015 American Association of Nurse Practitioners
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