Adult-Gerontology Clinical Adult-Gerontology Clinical Nurse SpecialistNurse Specialist

&&Pediatric Clinical Nurse Pediatric Clinical Nurse

SpecialistSpecialist

Curriculum MapsCurriculum Maps

for Clinical Nurse Specialist for Clinical Nurse Specialist Programs Transitioning to Programs Transitioning to

Consensus Model RequirementsConsensus Model Requirements

Why a Curriculum Map?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

NurseAnesthetist

NurseMidwife

Nurse Practitioner +

Adult-Gerontology*

Women’s Health/Gender Related

Family/IndividualAcross lifespan

Neonatal PediatricsPsych/Mental

Health

Lic

en

su

re o

ccu

rs a

t Levels

of

Role

&

Pop

ula

tion

Foci POPULATION FOCI

APRN ROLES

APRN SpecialtiesFocus 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

ROLE & POPULATION

COMPETENCIES

ACCREDITATION

STANDARDS

SCHOOL MISSION,

VISION, VALUES

THEORETICAL

FRAMEWORK

&

LICENSURE & CERTIFICATION

ELIGIBILITY REQUIREMENTS

Basic Guidelines for Development of a Course in Basic Guidelines for Development of a Course in Diagnosis and Management of Problems in the Diagnosis and Management of Problems in the Clinical Specialty Area for Clinical Nurse Clinical Specialty Area for Clinical Nurse SpecialistsSpecialists

Rule 222.1(6) defines a diagnosis and management Rule 222.1(6) defines a diagnosis and management course as:course as:

A course offering both didactic and clinical content in A course offering both didactic and clinical content in clinical decision-making and aspects of medical clinical decision-making and aspects of medical diagnosis and medical management of diseases and diagnosis and medical management of diseases and conditions. Supervised clinical practice must include conditions. Supervised clinical practice must include the opportunity to provide pharmacological and non-the opportunity to provide pharmacological and non-pharmacologic management of diseases and problems pharmacologic management of diseases and problems considered within the scope of practice of the considered within the scope of practice of the advanced practice nurse’s specialty and role.advanced practice nurse’s specialty and role.

Why a Curriculum Map?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 Incorporates Seminal DocumentsDocuments

• AACN-Colleges Essentials

• Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, Education

• AACN-Colleges/NACNS/Hartford - Adult-Gerontology Clinical Nurse Specialist Competencies

Incorporates Seminal Incorporates Seminal DocumentsDocuments

• 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 Incorporates Seminal DocumentsDocuments

• 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?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 Demonstrates Alignment Among Key ResourcesAmong 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?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 Provides Evidence Base for Curriculum ContentCurriculum 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 Provides Evidence Base for Curriculum ContentCurriculum 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 Provides Evidence Base for Curriculum ContentCurriculum 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 Provides Evidence Base for Curriculum ContentCurriculum 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 Provides Evidence Base for Curriculum ContentCurriculum 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 Provides Evidence Base for Curriculum ContentCurriculum 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 NecessaryMinimally Significant

Moderately SignificantSignificant

Quite SignificantOf Maximum Significance

Provides Evidence Base for Provides Evidence Base for Curriculum ContentCurriculum Content

Decision Rules for incorporating content into the Test Plan

1.Overall mean significance ratings for the total sample2.Overall percent of "not performed" ratings3.Comparison of mean significance ratings by region4.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 PlanOrganization of Test Plan

AACN Synergy Model for Patient Care

I.Direct Care/Clinical Judgment

II.Standards of Professional Performance

Standards of Professional Standards of Professional PerformancePerformance

• Advocacy/Moral Agency• Caring Practices• Collaboration• Systems Thinking• Response to Diversity• Clinical Inquiry• Facilitation of Learning

Adult-Gerontology Adult-Gerontology Curriculum Map Cross WalkCurriculum Map Cross Walk

Pediatric Curriculum Map Pediatric Curriculum Map Cross WalkCross Walk

Pediatric Curriculum Map Pediatric Curriculum Map Cross WalkCross Walk

Why so much emphasis on Why so much emphasis on Clinical Judgment?Clinical Judgment?

Increased Emphasis on Increased Emphasis on Clinical JudgmentClinical 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 Increased Emphasis on Clinical JudgmentClinical 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

Increased Emphasis on Increased Emphasis on Clinical JudgmentClinical Judgment

• Airlines – 0.43 deaths per million passengers

• Hospitalizations – 2,300 deaths due to error per million admits

Program Pre-approvalProgram 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…Mentioned previously…

Questions/Follow-upQuestions/Follow-up

www.certcorp.org for APRN Resources

Email certification@aacn.org for questions and comments