Transcript APRN Regulatory Model

Acute Care Exam:
a Profile of
Role Delineation Survey Changes
(2004, 2010)
Description of Demographics of Respondents:
Comparisons between 2004 and 2009
Top 7 Primary Clinical Focus
Areas
Critical Care
Cardiovascular Surgery
Emergency
Oncology/Hematology
General Surgery
Neonatal
Neurology
Other
Location of Practice
Urban
Suburban
Rural
2004
2009
12.4%
10.7%
6.8%
10.7%
5.1%
8.5%
2.5%
43.3%
27.5%
5.4%
10.7%
8.9%
4.1%
3.4%
3.4%
32.5%
2004
2009
85%
13%
2%
86.2%
11%
2.8%
Years Experience as Acute Care
Pediatric Nurse Practitioner
2004
2009
Less than 10 yrs
23.9%
84%
11-15 yrs
20.8%
11%
16 or more yrs
55.3%
5%
2004
2009
Geographic Region
Both surveys (2004 and 2009) produced equal representation
from the Northeast, Southeast, West and Midwest.
Additional Comparisons:
Formal AC Program
** In 2009, survey respondents who completed a formal Acute Care Program: 47.1%
Additional Comparisons:
Percent of Time Spent in Practice Area
2004
2009
How well did the
survey cover the
important activities of
your practice?
2004 AC Exam Content Outline &
Body System Ranking
Body systems (guidelines,
for those categorized):
o Respiratory 14%
o Infectious disease 12%
o Gastrointestinal 11%
o Cardiovascular 10%
o Neurology 9%
o Hematology 8%
o Renal 7%
o Musculoskeletal 5%
o Immunology 5%
o Metabolic 5%
o Endocrine 4%
o Oncology 3%
o Otolaryngology 2%
o Trauma 2%
o Mental health 1%
o Dermatology 1%
o Ophthalmology 1%
2010 AC Exam Content Outline &
Body System Ranking
1. Assessment and Diagnosis
A. Health History
B. Physical Examination and Diagnostics
C. Diagnoses of Health Status
Total
%
48%
8%
14%
26%
N Scored
N = 150
72
12
21
39
2. Management
A. Implement and Evaluate Therapeutic Interventions
B. Education, Collaboration, Consultation and Referral
48%
43
5%
72
65
7
4%
6
100%
150
CONTENT AREA
3. Professional Practice Role to include Research/Evidence
based practice, Education and Leadership
Total
Assessment
Pulmonology
Cardiology
Infectious disease
Neurology
GastrointestinaI
Hematology / Oncology
Trauma
Endocrine / Metabolic
Renal
Musculoskeletal
Immunology
Otolaryngology
Management
1
2
3
4
5
6
7
8
9
10
11
12
Pulmonology
Cardiology
Infectious disease
Neurology
Hematology / Oncology
Trauma
GastrointestinaI
Renal
Musculoskeletal
Endocrine / Metabolic
Immunology
Otolaryngology
Dermatology
1
2
3
4
5
6
7
8
9
10
11
12
13
Comparisons of the
Detailed AC Content Outlines
2004:
2010:
 3 Main content areas,
with 12 sub-content
areas
 Professional Practice:
8% of exam items
 Systems: % Importance
ordered
 3 Main content areas,
collapsed sub-content
areas.
 Professional Practice:
4% of exam items
 Systems: Different order,
still by importance,
specified as Assessment
and Management
Detailed Content Areas: 2010 Highlights
• Health History: More specific to acute care practice
• Physical Examination, Screening and Diagnostics:
Formal Developmental screening not as important, but
growth and development integrated into all facets of AC
PNP practice.
• Sexual and reproductive issues not important in context
of acute care.
• Education, Referral, Consultation and Collaboration as
main content with details related to family, illness,
palliative and end of life care with interdisciplinary focus.