APRN Regulatory Model
APRN Specialties
Licensure at levels of role and
population foci
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
POPULATION FOCI
Family/individual
Across lifespan
Adultgerontology
Gender
Specific
Neonatal
Pediatrics
Psych/Mental
Health
APRN ROLES
Nurse
Anesthetist
Nurse
midwife
Clinical Nurse
Specialist
Nurse Practitioner
Primary care Acute care
New Role
Options for Advanced Practice Psychiatric
Nursing
 A new role
 As a Specialty
 As a Role and Population
A New Role
 Would require vetting of new role among all national and
state regulatory organizations.
 Would require vetting of new role among all third party
reimbursers.
 Would require creating a new title, identity and
recognition by the public, clients, other health and mental
health professionals.
 Would require creation of competencies, perhaps new
affiliations or creations of new organizations.
 Would require creation of new certification exams.
As a Specialty
 Would first be educated, certified and licensed in a role (CNS or NP)
and a population (Family/Lifespan, Gender, Adult/Gerontology,
Pediatrics, Neonatal).
 Then one could chose the specialty of PMH (Adult, child etc.)
 More focused area of practice than role and population foci
 In addition to role and population focus preparation—cannot replace





preparation for role and population foci
Definition built on ANA (2004) Criteria for Recognition as a Nursing
Specialty
Cannot expand scope of practice beyond the role or population focus
Addresses a subset of the population focus
Title may not be used in lieu of licensing title
Is developed, recognized and monitored by the profession
AsWould
a create
Role
and
Population
a foundation for practice as an advanced practice

psychiatric nurse with a role as CNS or NP and a population focus of
psychiatric-mental health.
 Is consistent with the trends in education and certification.
 Would increase workforce for psychiatric-mental health services in
underserved areas where the APRN-PMH is the only mental health
person in the area.
 Would support life span continuity and movement among age groups
with mental health needs. Ex. Someone who sees adolescents could
follow them into young adulthood. Someone who sees the nineteenyear-old brother could see the younger sister.
 As a population-focus, the profession would determine needed
specialties and what would constitute acquisition of that knowledge
and skill.
 Maintains existing identities, titles, competencies, and supports.
ANCC Certification/Exam Trends
2003 to 2006
2003
CNS-Adult Psych
CNS-Adolescent Psych
Adult Psych NP
Family Psych NP
2006
%
n
7356
825
n
6,699
964
Change
-8.9%
16.8%
454
118
1,587
540
249.6%
357.6%
8753
9,790
11.8%
Parallel Processes
 Adult Psychiatric Nurse Practitioner Certification Exam—2002
 Family Psychiatric Nurse Practitioner Certification Exam--2003
 Psychiatric-Mental Health Nurse Practitioner Competencies--2003
 Logical Job Analysis—2005
 Psychiatric Mental Health Nursing Scope and Standards--2007
 Revision of certification exam--2007
 Joint APNA-ISPN Child and Adolescent Taskforce--2007