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· Follow the discussion questions participation and submission guidelines.· Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences for each paragraph.· All answers or discussion comments submitted must be in APA format according to Publication Manual American Psychological Association (APA) (7th ed.) ISBN: 978-1-4338-3216-1· Minimum of two references, not older than 2015.An RN with 5 years of general medical–surgical acute care experience is interested in obtaining certification in medical–surgical nursing. Research the requirements for such certification and outline what they must do to be eligible to be certified as a medical–surgical nurse.
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Chapter 3
Credentials for Healthcare
Providers
Copyright © 2023 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction
❖Credentials
o Provide information regarding qualifications and
whether standards have been met
❖Quality improvement
❖Certification
o Credentials awarded by educational institutions,
legal licenses awarded by governmental body,
recognition by a professional organization
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Approval and Accreditation of Institutions
and Programs
❖Accreditation of educational institutions
o Major way to know an institution or program
provides quality education
❖Government approval of nursing programs
o Requirement to be eligible to take NCLEX exam
❖Accreditation of nursing education programs
o Helps to strengthen uniform national standards
for nursing education; can be specialized
❖Accreditation of continuing education programs
o Ensures meets appropriate standards
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Credentials for Individuals
❖Diplomas, Degrees, and Certificates of Completion
o Depends on type of program as to which is
awarded on completion
❖Licensure
o Legal credential; each state differs as to
requirement of obtaining a license
❖Certification
o Usually awarded by independent professional
organization; granted on completing educational
program and passing standardized exam
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Question #1
❖Is the following statement true or false?
❖Credentials are written proof of qualifications and
include diplomas awarded by professional groups.
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Answer to Question #1
❖False
❖Rationale: Credentials are written proof of
qualifications and may include diplomas awarded by
educational programs, certification, or registration
by professional groups, and legal licenses awarded
by governmental agencies.
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Nursing Licensure in the United States #1
❖The History of Licensure in Nursing
o One of major concerns of ANA was
establishment of legal licensure for nurses
o Led to Nurse Practice Act
o Mandatory licensure became a major focus;
happened first in New York in 1947; is standard
today in United States, Canada, and most other
countries
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Nursing Licensure in the United States #2
❖Current Nursing Licensure Laws
o Purpose: protect the public, set minimal
qualifications and competencies for safe entrylevel practitioners
o Each jurisdiction’s legislature establishes a
licensure law
o Proposed changes occur through legislative
process through an elected member who has
been persuaded that change is in the best
interest of the public
o Nurses have potential to influence decisions
regarding healthcare
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Nursing Licensure in the United States #3
❖Rules and Regulations
o Administrative law
o State board of nursing
❖Nursing Licensure Law Content
o ANA formulated first model nursing practice act
for states to follow
o NCSBN updated its entire model act and model
rules and regulations in 2014
o Must carefully read Nurse Practice Act in state
you will be working; each are slightly different
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Nursing Licensure in the United States #4
❖State Licensure Laws for Nursing
o Purpose
o Definitions and Scope of Practice
o Qualifications for Licensure Applicants
o Titling
o License Renewal and Continuing Competence
Requirements
o Nursing Education Programs
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Nursing Licensure in the United States #5
❖State Licensure Laws for Nursing (cont.)
o Grounds for Disciplinary Action
o Exceptions
o Administrative Provisions
o Grandfathering
❖Sunset Laws and Nurse Practice Acts
❖Advanced Practice Registered Nurses (APRN)
o Nurse practitioners, nurse anesthetists (CRNA),
nurse–midwives (CNM), clinical nurse specialists
(CNS)
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Nursing Licensure in the United States #6
❖ The Role of the State Board of Nursing
o Establishes standards for licensure
o Examines and licenses applicants
o Provides for interstate endorsement
o Renews licenses, grants temporary licenses, and provides
for inactive status as requested
o Enforces disciplinary codes
o Provides rules for revocation of license
o Regulates specialty practice
o Establishes standards and curricula, and approves nursing
education programs
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Question #2
❖Is the following statement true or false?
❖Permissive licensure requires that all individuals who
wish to practice in the field be licensed to practice.
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Answer to Question #2
❖False
❖Rationale: Permissive licensure allows for those
meeting certain standards voluntarily to be licensed,
whereas mandatory licensure requires that all
individuals who wish to practice in the field be
licensed to practice.
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Obtaining a Nursing License #1
❖ Licensure by Examination
o Required to take appropriate examination (NCLEX-RN or
NCLEX-PN)
o Standardized exam to be taken by all new graduates
administered through computerized adaptive testing
o Covers client need categories (safe effective care
environment, health promotion and maintenance,
psychosocial integrity, physiologic integrity) and
subcategories
o Covers integrated processes: nursing process, caring,
communication and documentation, teaching/learning, and
culture and spirituality
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Obtaining a Nursing License #2
❖Licensure by Endorsement
o Process of obtaining nursing license in a new
state while already licensed in another state
o Each state differs as to criteria for new licensure
o May need to hold licenses in several states
based on situation
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Obtaining a Nursing License #3
❖ Mutual Recognition of Licensure
o Receive RN license in home state and allowed to legally
practice in additional states without obtaining licenses for
those states
o Must follow Nurse Practice Act of client’s location
o Many healthcare organizations operate across state
boundaries, decrease cost of licensing for nurses
o Better enables telenursing opportunities
o Concerns
▪ Requirements for maintaining licensure
▪ Disciplinary processes differs among states
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Revocation or Limitation of a License
❖ License may be revoked by state board of nursing,
designated disciplinary board, or court of law based on
specific reasons stated in the Nurse Practice Act.
❖ Board may provide license with conditions, suspend a
license until certain conditions are met, or revoke a license
completely.
❖ Decision may be appealed in court of law in most states.
❖ If determined actions constitute a felony, obligated to report
to criminal authorities for prosecution.
❖ Individual being investigated should have an attorney; may
be covered by malpractice insurance.
❖ It is your responsibility to know the Nurse Practice Act in
each state you care for clients.
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Question #3
❖Is the following statement true or false?
❖The American Nurses Association is the
administrative agency that has the authority to
carry out the provisions of the Nurse Practice Act.
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Answer to Question #3
❖False
❖Rationale: The state boards of nursing (or their
equivalent) are the administrative agencies that
have the authority to carry out the provisions of the
Nurse Practice Act.
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Licensure for Graduates of Foreign
Nursing Schools #1
❖Must meet two requirements
o Have a visa that permits employment
o Obtain a state license to practice nursing
❖Must provide verification that nursing education
meets state requirements and must take
appropriate NCLEX exam
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Licensure for Graduates of Foreign
Nursing Schools #2
❖ CGFNS International (Commission on Graduates of Foreign
Nursing Schools)
o Provides special visa for nurses after reviewing education,
evaluation of current and previous licenses, assessment of
English language proficiency, and completion of CGFNS
exam or NCLEX-RN
❖ International Centre on Nurse Migration
o Project of CGFNS and ICN
o Works on policies worldwide that affects nurse migration,
collects and reports data on nurse migration, serves as
resource for those working with regulations regarding
nurse migration
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Nursing Licensure Around the World
❖Education and licensure differ greatly around the
world
❖Practice patterns and expectations also differ
❖If interested in international nursing:
o Consider language proficiency
o Educational backgrounds
❖Contact organizations involved in international
healthcare
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Certification in Nursing
❖Certification provides evidence of specialized clinical
knowledge and ability beyond the basic level
❖Certification as nurse practitioner may be used as
basis for legal approval for the ARNP role
❖American Nurses Credentialing Center Certification
o See Box 3.2
❖Other Nursing Certifications Available
❖Certification for Licensed Practical Nurse
o Available for long-term care
Copyright © 2023 Wolters Kluwer · All Rights Reserved
The Future of Credentialing in Healthcare
#1
❖The ideal credential clearly communicates
qualifications and competence
❖Institutional Control of Credentials
o Belief that licensing institution instead of
individuals would be an adequate safeguard for
the public
o Belief that specific competencies should be
certified instead of entire field of practice
o Site-based examination and site-based
certification
o Is not without concerns
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The Future of Credentialing in Healthcare
#2
❖National Academy of Medicine Recommendations
and the Future of Approval/Accreditation
o Promotes higher education for RNs, changes to
scope of practice for APRNs
o Recommended core competencies
▪ Delivering client-centered care
▪ Working as part of interdisciplinary teams
▪ Practicing evidence-based healthcare
▪ Focus on quality improvement
▪ Using information technology
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Question #4
❖Is the following statement true or false?
❖The goal of credentials is to clearly communicate the
necessary qualifications and competence of the
individual.
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Answer to Question #4
❖True
❖Rationale: The use of credentials is to inform others
that the individual with the credential has met the
necessary qualifications and is competent to
complete the task associated with that credential.
Copyright © 2023 Wolters Kluwer · All Rights Reserved
Question #5
❖Is the following statement true or false?
❖Certification as a nurse practitioner may be used as
a basis for legal approval for the advanced
registered nurse practitioner role.
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Answer to Question #5
❖True
❖Rationale: Certification provides evidence of
specialized clinical knowledge and ability beyond the
basic level. Certification as a nurse practitioner may
be used as a basis for legal approval for the
advanced registered nurse practitioner role.
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