Certification and education as determinants of nurse practitioner scope of practice: An investigation of the rules and regulations defining NP scope of practice in the United States

PURPOSE AND BACKGROUND: In 2008, a consortium of advanced practice nursing organizations authored the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education. The document's aim is to provide guidance for states to adopt uniformity in the regulation of advanced practice registered nurse roles. Despite a target date to complete that work by 2015, there remains an extensive amount of variation in how states define the scope of practice (SOP) for nurse practitioners (NPs). DATA SOURCES: Based on the National Council of State Boards of Nursing online database, state (N = 51 [includes the District of Columbia]) NP practice acts and/or rules and regulations documents were examined for language describing SOP for NPs consistent with the language of the advanced practice registered nurse (APRN) Consensus Model. CONCLUSIONS: Results indicated that 18 states and the District of Columbia (37%) had specific regulations defining NP SOP by certification and/or educational preparation while 23 (45%) did not. The remaining nine states (18%) had SOP regulations that were interpreted as being ambiguous in relation to certification and/or educational preparation. IMPLICATIONS FOR PRACTICE: The findings suggest much work is needed to ensure NP SOP accurately reflects NP board-certification and graduate educational preparation.