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American Nursing Association (ANA), National council of State Boards of Nursing (NCSBN) and American Association of Nurse Practitioners (AANP) are the three regulatory bodies. The National Council of State Board of Nursing (NCSBN) had their first meeting on June 5, 1978. They are a non-profit organization responsible for ensuring that licensed nurses are providing competent care across the globe. They do so by ensuring that the nurses entering the workforce have the necessary skills and knowledge to carry out safe patient care (National Council of State Board of Nursing, 2019). They developed the licensure examination for nurses known as NCLEX. The APRN committee came together with the NCSBN to develop the consensus model in 2008. This model aims to make APRN program requirements and certification standard across states.

The Joint Commission (TJC) is focused on quality measures that are reported by facilities. The TJC uses an evidence-based approach allowing for an association between the process of performance and patient outcomes. Our facility recently went through the accreditation process for advanced certification in mental health. Education to staff is a key component to this process. A facility reports measurable outcomes to the joint commission. The joint commission comes to evaluate the process. The most difficult part of this evaluation is ensuring that the tasks completed are documented. A program is only as good as the documentation provided in the EMR. The day-to-day challenges of being a bedside nurse are daunting. Nurses accomplish more than what is charted in the EMR. However, the EMR is the only tool that gives others a complete picture of the care for the patient. Once the bedside nurse receives consistent and continual education, the compliance with the documentation increases. Which allows for a better reflection of the care given.

APRN Regulatory Model is designed to bridge the gap between unequal regulation within the role of the APRN. One must have an advanced practice registered nurse degree from an accredited program in one of the four roles. There are four roles under this model are: certified nurse anesthetist, certified nurse mid-wife, clinical nurse specialist and certified nurse practitioner (Denisco & Barker, 2016). APRN’s are educated in one of these roles to provide the focus on the patient throughout their lifespan. Within this focus group there are also specialty practices for specific healthcare needs, such as, palliative medicine and other special practices. This model also dictates that if an APRN is not involved in a role with direct patient care they will not be eligible for licensure moving forward. The APRN must also pass a national certification. Additionally, the APRN must continue to build upon the competencies of the RN with a deeper understanding and expansion of knowledge.

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