Adult-Gerontology Clinical
Nurse Specialist
&
Pediatric Clinical Nurse
Specialist
Curriculum Maps
for Clinical Nurse Specialist
Programs Transitioning to
Consensus Model Requirements
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
Licensure occurs at Levels
of Role & Population Foci
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
POPULATION FOCI
Family/Individual
Across lifespan
AdultGerontology*
Women’s Health/
Gender Related
Neonatal
Pediatrics
Psych/Mental
Health
APRN ROLES
Nurse
Anesthetist
Nurse
Midwife
Clinical Nurse
Specialist ++
Nurse
Practitioner +
++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 adultgerontology 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
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 nonpharmacologic management of diseases and problems
considered within the scope of practice of the advanced
practice nurse’s specialty and role.
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
Documents
• AACN-Colleges Essentials
• Consensus Model for APRN Regulation:
Licensure, Accreditation, Certification,
Education
• AACN-Colleges/NACNS/Hartford - AdultGerontology Clinical Nurse Specialist
Competencies
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
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
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
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
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
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
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
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
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
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
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
Provides Evidence Base for
Curriculum Content
Decision Rules for incorporating
content into the Test Plan
1. Overall mean significance ratings for the total
sample
2. Overall percent of "not performed" ratings
3. Comparison of mean significance ratings by
region
4. 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 Plan
AACN Synergy Model for
Patient Care
I. Direct Care/Clinical Judgment
II. Standards of Professional
Performance
Standards of Professional
Performance
•
•
•
•
•
•
•
Advocacy/Moral Agency
Caring Practices
Collaboration
Systems Thinking
Response to Diversity
Clinical Inquiry
Facilitation of Learning
Adult-Gerontology
Curriculum Map Cross Walk
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.). ++
Pediatric Curriculum Map
Cross Walk
Pediatric Curriculum Map
Cross Walk
Why so much emphasis on
Clinical Judgment?
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
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
• ƒ
Life-Threatening Complications: Studies indicate
50 percent of new graduates would fail to recognize
life-threatening complications due to lack of
experience
• ƒ
Patient 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
Clinical Judgment
• Airlines – 0.43 deaths per million
passengers
• Hospitalizations – 2,300 deaths
due to error per million admits
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
Mentioned previously…
Questions/Follow-up
www.certcorp.org for APRN
Resources
Email certification@aacn.org
for questions and comments