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Diverse regulatory criteria, such as variable accreditation standards, disparate certification and licensing requirements, inconsistent population foci, and scopes of practice, represent barriers to optimized APRN function within today's complex healthcare system and, ultimately, reduced access to safe, quality care for patients. The Consensus Model for APRN Regulation promises to unify APRN education, practice, and licensure, promoting greater mobility among nursing professionals. Elimination of inconsistencies in APRN licensure, education, certification, and accreditation requirements will promote greater value and mobility for the APRN within the healthcare system. Rounds, L. R., Zych, J. J. and Mallary, L. L. (2012), The consensus model for regulation of APRNs: Implications for nurse practitioners. Journal of the American Academy of Nurse Practitioners. doi:10.1111/j.1745-7599.2012.00812.x

BACKGROUND: The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program. METHODS: LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program. RESULTS: A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall. CONCLUSION: The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges

This article describes the Consensus Model developed in 2008 for the APRN role for licensure, accreditation and certification across the United States. Though the intended goal for adoption was in 2015 (still has not happened yet), there is still much work that needs to be done at the state and national level to get this to approved.

This article describes the thought behind, process and goal of the Consensus Model for APRN Regulation, which aims to clarify and unify regulations for APRN licensure, accreditation, certification and education (LACE). This model was created in response to inconsistencies in APRN education and practice caused by a need for APRNs.

Interesting viewpoint of the history of nurse midwifery education in the US, as well as a brief history on the speciality in general.