Bruin Brief 2022-01-21: APRN Program and Certification
- Paul Macey
The MSN-APRN Program, State Certification, National Certification and what we can do to assure success
This week, we review and extend our discussion about preparation of graduates of the MSN-APRN program. In review, the Bruin Brief of August 20th displayed national specialty certification pass rates of MSN-APRN graduates. You can re-read the full newsletter here. One graphic was particularly memorable:
The main point is that student certification rates current exceed the 80% pass rate that faculty set as part of the School’s Total Evaluation Plan. Of course, we can always do better or set our goals higher. (NOTE: The graph will be updated with 2021 data as soon as available).
National Certification and the California Nurse Practice Act
California has been one of the few states in the nation that has not required national certification for nurse practitioners. The Board of Registered Nursing (BRN) certifies advanced practice registered nurses (APRNs). The state practice act requires a nurse to have a California registered nurse license before obtaining the BRN certificate for state advanced designation.
Reasons for Obtaining National Certification
Nurse practitioners who obtain certification from an accredited national nurse practitioner certifying body enhance their ability to practice for a number of reasons:
The majority of states in the U.S. require national certification
Most employers require national certification
Medicare, and the majority of payors, require national certification in order to bill for services and be reimbursed for those services. Medicare’s requirements for nurse practitioners include:
Must hold a state license as a nurse practitioner
Certified by a national certifying body
Graduate degree, either Master’s (MSN) or Doctor of Nursing Practice (DNP)
New California Legislation is Changing Requirements for Certification of APRNs
Fortunately, California Assembly Bill 890 (AB 890, sponsored by Wood) was passed out of the California Legislature on August 31, 2020. Entitled NP: Scope of Practice: Practice Without Standardized Procedures, the measure was signed into law by Governor Gavin Newsom on September 29, 2020. The bill became law January 1, 2021. The language in the bill requires nurse practitioners to:
Pass a national nurse practitioner board certification exam
Hold a certification as a nurse practitioner from an accredited national certifying body
Accredited national certifying bodies include:
American Academy of Nurse Practitioner Certification Program (AANPCP)
American Association of Critical Care Nurses (AACN)
American Nurses Credentialing Center (ANCC)
Pediatric Nursing Certification Board (PNCB)
National Certification Corporation for the Obstetric, Gynecologic and Neonatal Nursing Specialties
The California BRN is currently developing the regulations to implement all of the components of AB 890 efficiently with an expected date of January 1, 2023. At that time, national certification will become required rather than optional in the state.
UCLA SON Prepares Graduates for Certification
The MSN-APRN program prepares students for the national certification examination in their chosen specialty in a variety of ways.
Instructors use case-based studies/presentations, patient simulation, and review of the content of certification test questions.
Board Vitals text bank questions and exam preparation tools are built into the MSN-APRN Program as of Fall 2021.
Schedule II Controlled Substances and Risk Addiction, is a three-hour course required by the BRN to furnish (or prescribe) Schedule II Controlled Substances (see footnote below). This course is provided to APRN students in the first quarter of the second year of study. Upon completion of the course, the students receive a certificate for submission to the BRN, allowing them to furnish (or prescribe) these medications.
Prior to sitting for the national certification examination, faculty encourage students to study for the exam through a variety of methods such as self-study, online exam preparation courses, and in-person attendance at conferences that prepare test-takers.
What Can Faculty do to Assure MSN-APRN Students’ Certification Success?
From admission through graduation, we have multiple opportunities to assure success. Take part in these activities:
Admit students who have the educational and experiential foundation for success in advanced practice.
Apply high-quality pedagogical practices in every single class. Adapt teaching to be effective in remote, in-person, clinical, and skills lab settings. Take classes to learn to be the best teacher you can be. Ask your peers to sit in a class or visit a lab to give you honest feedback about how you can improve. Take student evaluations to heart, and make changes to improve your teaching.
Scaffold the curriculum throughout the program to build clinical judgment and synthesis of domains and concepts of practice. The DNP Taskforce is now beginning to revise the APRN curriculum to embrace the new AACN Essentials: Advanced Level Nursing Education Competencies and initiative a change from MSN to DNP preparation.
Reinstate site visits and communication cycles between clinical preceptors and supervising faculty. Mid-point evaluation catches students who are struggling, and offers a chance for remediation and coordination with program directors and faculty to strengthen students’ skills.
Insist on attainment of course competencies. One reason students fail certifying examinations has been coined a “faculty failure to fail” in coursework. If students cannot demonstrate competency for the course, provide detailed feedback. Offer remediation and coaching. Provide the student an opportunity to achieve a passing mark with a future course re-take if needed.
Maximizing the quality of our educational offerings and assuring the rigor of outcome competency assessment gives students what they paid for. And it assures they will be ready for the certifying examination and safe patient care.
Footnote
In the state of California, nurse practitioners obtain and utilize a “furnishing number” to furnish drugs and/or devices. Furnishing is defined as “the act of making a pharmaceutical agent or agents available to the patient in strict accordance with standardized procedures.” With the passage and implementation of AB 890 will be able to “prescribe, administer, dispense, and furnish pharmacological agents, including over-the-counter, legend, and controlled substances”. https://www.rn.ca.gov/forms/pubs.shtml#adv
This Bruin Brief co-written by:
Theresa Brown DNP, ACNP-BC, AACC, FAANP
Adjunct Assistant Professor
Assistant Director, Doctor of Nursing Practice Program
UCLA School of Nursing
Lauren Clark, RN, PhD, FAAN
Professor and Shapiro Family Endowed Chair in Developmental Disability Studies
Associate Dean Academic and Student Affairs
School of Nursing
Office: 310-267-5923
Mobile: 801-503-4755