Adult-Gerontology Clinical Nurse Specialist & Pediatric Clinical Nurse Specialist Curriculum Maps for Clinical Nurse Specialist Programs Transitioning to Consensus Model Requirements
Why a Curriculum Map? Incorporates seminal documents through cross walk process Demonstrates alignment among key determining resources Provides evidence base for curriculum content
Consensus Model for APRN Regulation Nurse Anesthetist Midwife Nurse Practitioner + Adult- Gerontology* Women’s Health/ Gender Related Family/Individual Across lifespan Neonatal Pediatrics Psych/Mental Health Licensure occurs at Levels of Role & Population Foci POPULATION FOCI APRN ROLES APRN Specialties Focus of Practice beyond role and population focus Linked to health care needs Examples include but are not limited to: Oncology, Older Adults, Orthopedics, Nephrology, Palliative care Clinical Nurse Specialist ++ ++The Clinical Nurse Specialist (CNS) is educated and assessed through national certification processes across the continuum from wellness through acute care. * The population focus, adult-gerontology, encompasses the young adult to the older adult, including the frail elderly. APRNs educated and certified in the adult-gerontology population are educated and certified across both areas of practice and will be titled Adult-Gerontology CNP or CNS. In addition, all APRNs in any of the four roles providing care to the adult population, e.g., family or gender specific, must be prepared to meet the growing needs of the older adult population. Therefore, the education program should include didactic and clinical education experiences necessary to prepare APRNs with these enhanced skills and knowledge.
www.aacn.nche.edu/geriatric-nursing/aprn-education-project
& ACCREDITATION STANDARDS Role & Population Competencies LICENSURE & CERTIFICATION ELIGIBILITY REQUIREMENTS School Mission, Vision, VALUES & THEORETICAL FRAMEWORK
Basic Guidelines for Development of a Course in Diagnosis and Management of Problems in the Clinical Specialty Area for Clinical Nurse Specialists Rule 222.1(6) defines a diagnosis and management course as: A course offering both didactic and clinical content in clinical decision-making and aspects of medical diagnosis and medical management of diseases and conditions. Supervised clinical practice must include the opportunity to provide pharmacological and non-pharmacologic management of diseases and problems considered within the scope of practice of the advanced practice nurse’s specialty and role.
Why a Curriculum Map? Incorporates seminal documents through cross walk process Demonstrates alignment among key determining resources Provides evidence base for curriculum content
Incorporates Seminal Documents AACN-Colleges Essentials Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, Education AACN-Colleges/NACNS/Hartford - Adult-Gerontology Clinical Nurse Specialist Competencies
Incorporates Seminal Documents AACN-Critical Care - Scope & Standards for Acute and Critical-Care Clinical Nurse Specialist Practice ANA/ Society for Pediatric Nurses/National Association of Pediatric Nurse Practitioners - Pediatric Nursing: Scope and Standards of Practice National Association of Neonatal Nurses - Neonatal Nursing: Scope and Standards
Incorporates Seminal Documents National CNS Competency Task Force - Clinical Nurse Specialist Core Competencies NACNS - Criteria for the Evaluation for Clinical Nurse Specialist Master's, Practice Doctorate and Post-Graduate Certificate Educational Programs NCSBN - Criteria for APRN Certification Programs
Why a Curriculum Map? Incorporates seminal documents through cross walk process Demonstrates alignment among key determining resources Provides evidence base for curriculum content
Demonstrates Alignment Among Key Resources Seminal documents identified Core Competencies, Age-Related Competencies, Specialty Competencies and Test Plan are cross walked through the document Annotated Glossary provided
Why a Curriculum Map? Program Directors requested it in response to survey Incorporates seminal documents through cross walk process Demonstrates alignment among key determining resources Provides evidence base for curriculum content
Provides Evidence Base for Curriculum Content Requirements for regulatory examinations: targeted to entry-level practice measure only job-related knowledge, skills, and abilities require demonstration of competence at the minimum level necessary for safe and effective practice; and psychometrically sound
Provides Evidence Base for Curriculum Content Psychometrically sound exams must be Reliable – the exam measures a construct consistently across time, individuals, and situations and Valid – the exam measures what it is intended to measure
Provides Evidence Base for Curriculum Content Job analyses for Adult-Gerontology, Pediatric and Neonatal Clinical Nurse Specialists conducted during 2011 by AACN Certification Corporation JA survey incorporated seminal documents as well as the Center for Disease Control's (CDC) National Health Statistics Reports/National Hospital Discharge Data Set, the CDC's Health, United States, 2010, and the CDC's Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009
Provides Evidence Base for Curriculum Content Adult-Gerontology survey also reviewed by CNS members of the Academy of Medical-Surgical Nurses (AMSN) prior to use CNS representatives of the Society of Pediatric Nurses (SPN) participated in the survey development and review of findings
Provides Evidence Base for Curriculum Content Test Plan includes: Validated CNS competencies Most frequently encountered patient care problem types Skills and procedures performed by Clinical Nurse Specialists at entry-level
Provides Evidence Base for Curriculum Content Role incumbents participated in the job analysis surveys Responded to the question, How significant is this problem/task/action to entry level CNS practice in your setting? Not Necessary Minimally Significant Moderately Significant Significant Quite Significant Of Maximum Significance
Provides Evidence Base for Curriculum Content Decision Rules for incorporating content into the Test Plan Overall mean significance ratings for the total sample Overall percent of "not performed" ratings Comparison of mean significance ratings by region Comparison of mean significance ratings by community, position, setting, number of beds, years of experience as an APRN, hours worked, and whether or not certified as CCNS
Organization of Test Plan AACN Synergy Model for Patient Care Direct Care/Clinical Judgment Standards of Professional Performance
Standards of Professional Performance Advocacy/Moral Agency Caring Practices Collaboration Systems Thinking Response to Diversity Clinical Inquiry Facilitation of Learning
Adult-Gerontology Curriculum Map Cross Walk
Course Course Content Evidenced Based Practice and Research Methodologies Conceptual, theoretical, ethical and empirical knowledge as a basis nursing research questions, identifying research designs, selecting sampling and data collection strategies, and proposing analytic methods to answer a research question, and evaluate completed research for its scientific adequacy and applicability to practice. Approaches to understanding and expanding the scientific body of knowledge in nursing. Role and Scope of the CNS Analysis of the spheres of influence and the practice domains of the CNS in relationship to current health care trends, models of care delivery and advanced nursing practice, evaluation of care, and key issues influencing CNS practice including the CNS leadership role, interprofessional collaboration, health care policy, and advocacy as an independent practitioner. Principles of Health Cae Systems Organizational culture, organizational assessment, patient safety initiatives, problem identification, and quality improvement team building, change theory, process improvement techniques, product value analysis, quality and performance indicators (ex: NDNQI, core measures, HCAP, etc.), as well as integration of health care technologies and informatics systems. Adult-Gerontology Care I (health promotion, disease prevention, wellness) CNS role in wellness (physical and mental), health promotion and disease prevention, risk assessment and reduction, individual and community screening measures, and alternative health practices through the lifespan for early adult to the frail elderly populations. Content includes but is not limited to: assessment and management of STDs, urinary incontinence, cancer screening, cognitive impairment, lifestyle management (nutrition, weight, exercise, smoking cessation, stress management, lipid monitoring, etc.). ++
Pediatric Curriculum Map Cross Walk
Pediatric Curriculum Map Cross Walk
Why so much emphasis on Clinical Judgment?
Increased Emphasis on Clinical Judgment NCSBN Transition to Practice Data Complex Health Care Needs: Newly licensed nurses are expected to care for sicker patients with multiple conditions in increasingly complex health care settings Expertise Gap: Ten percent of a typical hospital’s nursing staff is comprised of new graduate nurses Risk for Practice Errors: Several studies show that new nurses experience increased stress three to six months after hire; data has shown that increased stress levels are risk factors for patient safety and practice errors
Increased Emphasis on Clinical Judgment NCSBN Transition to Practice Data Newly Licensed Nurse Errors: More than 40 percent of newly licensed nurses report making medication errors Life-Threatening Complications: Studies indicate 50 percent of new graduates would fail to recognize life-threatening complications due to lack of experience Patient Safety: Decreased staffing, use of inexperienced staff and increased turnover rates have a negative influence on patient safety and health care outcomes
Increased Emphasis on Clinical Judgment Airlines – 0.43 deaths per million passengers Hospitalizations – 2,300 deaths due to error per million admits
Program Pre-approval New service from AACN CertCorp Streamlines exam application review process Pre-approved programs will be posted on AACN website Assists prospective students in locating programs of interest – location, curriculum, online delivery, how to contact
Mentioned previously…
Questions/Follow-up www.certcorp.org for APRN Resources Email certification@aacn.org for questions and comments