1. Adult-Gerontology Clinical Nurse Specialist & Pediatric Clinical Nurse Specialist
Curriculum Maps
for Clinical Nurse Specialist Programs Transitioning to Consensus Model Requirements

2. Why a Curriculum Map?
Incorporates seminal documents through cross walk process
Demonstrates alignment among key determining resources
Provides evidence base for curriculum content

3. 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.

7. & ACCREDITATION STANDARDS Role & Population Competencies
LICENSURE & CERTIFICATION ELIGIBILITY REQUIREMENTS
School Mission, Vision, VALUES
&
THEORETICAL FRAMEWORK

8. 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.

9. Why a Curriculum Map?
Incorporates seminal documents through cross walk process
Demonstrates alignment among key determining resources
Provides evidence base for curriculum content

10. 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

11. 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

12. 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

13. Why a Curriculum Map?
Incorporates seminal documents through cross walk process
Demonstrates alignment among key determining resources
Provides evidence base for curriculum content

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. Organization of Test Plan
AACN Synergy Model for Patient Care
Direct Care/Clinical Judgment
Standards of Professional Performance

24. Standards of Professional Performance
Advocacy/Moral Agency
Caring Practices
Collaboration
Systems Thinking
Response to Diversity
Clinical Inquiry
Facilitation of Learning

26. Adult-Gerontology Curriculum Map Cross Walk

27. 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.). ++

35. Pediatric Curriculum Map Cross Walk

36. Pediatric Curriculum Map Cross Walk

39. Why so much emphasis on Clinical Judgment?

40. 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

41. 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
ƒLife-Threatening Complications: Studies indicate 50 percent of new graduates would fail to recognize life-threatening complications due to lack of experience
ƒPatient Safety: Decreased staffing, use of inexperienced staff and increased turnover rates have a negative influence on patient safety and health care outcomes

42. Increased Emphasis on Clinical Judgment
Airlines – 0.43 deaths per million passengers
Hospitalizations – 2,300 deaths due to error per million admits

44. 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

45. Mentioned previously…

46. Questions/Follow-up
for APRN Resources for questions and comments