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Frequently Asked Questions About the APRN Consensus Model for Clinical Nurse Specialists

What is the APRN Consensus Model?

The Consensus Model is a broad-based model for regulation of advanced practice registered nurses (APRNs) throughout the United States. The Model was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (NCSBN) APRN Advisory Committee, with extensive input from APRN stakeholders. 

The Consensus Model addresses:

  • lack of common definitions relating to APRN roles.
  • lack of standardization of APRN education programs.
  • proliferation of specialties and subspecialties.
  • lack of common legal recognition across states.

What APRN roles are defined under the Consensus Model?

The Consensus Model defines four APRN roles:

  • Clinical Nurse Specialist (CNS)
  • Certified Nurse Practitioner (CNP)
  • Certified Nurse Midwife (CNM)
  • Certified Registered Nurse Anesthetist (CRNA) 

Is the APRN Regulatory Model the same as the APRN Consensus Model? 

Yes; the full name of the work is the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education.

What is the purpose of the Consensus Model? 

The Consensus Model was created to establish standards for uniform APRN regulation across the country that:

  • facilitates mobility of APRNs.
  • ensures public safety.
  • increases access to healthcare.
  • advocates appropriate scope of practice. 

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When will the Consensus Model go into effect?

The target date for full implementation of the recommendations of the Consensus Model is by 2015.

What are AACN’s plans to comply with requirements of the Consensus Model for clinical nurse specialists?

AACN Certification Corporation has completed a study of practice and is in the process of developing new clinical nurse specialist exams that are in alignment with the population foci defined in the Consensus Model.

When will the new exams be available and what will the credentials be?

AACN Certification Corporation will launch three new clinical nurse specialist certification programs:

  • Adult-Gerontology CNS (ACCNS-AG) – July 2013
  • Pediatric CNS (ACCNS-P) – July 2013
  • Neonatal CNS (ACCNS-N) – 2014 

These new credentials will be awarded to those meeting the population-specific eligibility requirements and passing the corresponding exam.

How will the Consensus Model affect the current CCNS certification program offered by AACN Certification Corporation?

The CCNS exam will be available for initial exam candidates through December 2014; eligible candidates must take and pass the CCNS exam before December 31, 2014. Current CCNS certificants have three renewal options. 

  • 1,000 Practice Hours + 150 CE Points
  • 1,000 Practice Hours + Exam
  • 150 CE Points + Exam

Once the Consensus Model is implemented in 2015, what happens if I allow my CCNS certification to expire?

If you allow your CCNS certification to expire, you will need to meet the eligibility requirements for one of the new CNS exams (ACCNS-AG, ACCNS-N or ACCNS-P). 

How will eligibility for the ACCNS-AG exam differ from eligibility for the existing adult CCNS exam?

Eligible candidates for the ACCNS-AG exam must be educated in an adult-gerontology clinical nurse specialist graduate program that includes in-depth content and competencies to care for the entire adult population (young adults, older adults and the frail elderly) across the continuum from wellness through acute care. Education may be in a master’s, post-graduate or doctorate program.

How will eligibility for the ACCNS-P and ACCNS-N exams differ from eligibility for the existing pediatric and neonatal CCNS exams?

Eligible candidates for the ACCNS-N or ACCNS-P exams must be educated in a neonatal CNS or pediatric CNS graduate program that includes competencies across the continuum from wellness through acute care. Education may be in a master’s, post-graduate or doctorate program.

Is CCNS certification currently accepted for advanced practice licensure in my state?

Most states accept the CCNS credential for advanced practice licensure or designation. For a list of approved states, visit www.certcorp.org > CCNS Introduction. 

States that accept CCNS certification for advanced practice licensure are expected to also accept ACCNS-AG, ACCNS-N and ACCNS-P certification.

We are actively communicating with those states that have not yet approved the CCNS certification program and expect to gain approval from all states prior to implementation of the Consensus Model.

Will my state continue to recognize my current CCNS certification for APRN licensure?

States that currently recognize CCNS certification for advanced practice licensure should continue to do so; however, this will be a state-by-state decision. CNSs are encouraged to contact their board of nursing to find out what is being done to ensure continuation of their practice under the Consensus Model. 

The Consensus Model document states that, “Boards of nursing will institute a grandfathering* clause that will exempt those APRNs already practicing in the state from new eligibility requirements.”

*Grandfathering is a provision in a new law exempting those already in or a part of the existing system that is being regulated. When states adopt new eligibility requirements, currently practicing APRNs will be permitted to continue practicing within the state(s) of their current licensure. 

Will AACN Certification Corporation grandfather current CCNS certificants into the new ACCNS certifications?

No. While individual states may grandfather nurses currently working in the role making them exempt from new requirements, accreditation standards prohibit AACN Certification Corporation from grandfathering current certificants into the new credentials. Additional postgraduate education will most likely be required to become eligible to sit for one of the new ACCNS exams.

What if the board of nursing in my state does not recognize the CNS role for advanced practice licensure?

If you practice in a state that does not currently recognize the CNS role, we strongly urge you to contact the board of nursing to inquire as to their plans for implementation of the Consensus Model, which recognizes the CNS as an APRN role. To contact your state board, visit www.ncsbn.org/contactbon.htm.

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Will a DNP be required for advanced practice licensure in 2015?

The Consensus Model does not require or exclude the DNP as an entry-level degree option for APRNs.

How will the Consensus Model affect the scope of practice of clinical nurse specialists (CNSs)?

CNSs will be required to be educated, and their competencies assessed via national certification exams, across the continuum from wellness through acute care in one of six population foci:

  • psych/mental health
  • family/individual across the lifespan
  • women’s health/gender-related
  • neonatal
  • pediatrics
  • adult-gerontology 

Adult-gerontology CNSs will be required to be educated to care for the entire adult population (young adults, older adults and the frail elderly).

With the Consensus Model, education, certification, licensure and practice of an individual nurse must be congruent in terms of both role and population foci.  

What if I am not currently certified but am practicing as a CNS?

We recommend that you get certified as soon as possible. APRN certification eligibility requirements are based exclusively on educational preparation. You are more likely to be eligible to test under current criteria as opposed to the criteria defined under the Consensus Model.

Identify the certification program that best aligns with your educational preparation and determine if you meet the exam eligibility requirements. If you do not meet current educational eligibility requirements, makeup coursework must be completed in a post-graduate or doctorate program.  

If the scope for the new ACCNS exams is wellness through acute care, why is only acute care called out in the credential titles?

“Acute care” was retained in the exam titles and credentials in order to help ensure protection of the most medically fragile patients by making it explicitly clear to employers, regulators and others that the credential-holder is qualified to care for both acutely ill and less-acute patients.

Is the CCNS an acute and critical care certification?

Yes. In 1999, AACN launched an acute and critical care advanced practice certification, the CCNS. 

The acronym CCNS was, in some cases, misinterpreted and approved by state boards of nursing as a critical care credential. However, CCNS has always been an acute and critical care certification program.

The Consensus Model encompasses acute care, requiring that CNSs be educated, and their competencies assessed via national certification exams, across the continuum from wellness through acute care.

Why isn’t critical care noted in the Consensus Model?

While it is not specifically called out in the Consensus Model, critical care falls under the larger umbrella of acute care. Acute care refers to the care provided to acutely ill patients. The term acute care, while sometimes misunderstood, does not apply to all hospitalized patients. 

As a CCNS, does the Consensus Model affect my ability to work in a critical care area?

No. The umbrella of acute care, under which critical care falls, includes any environment in which patients have care requirements that include complex monitoring and therapies, high-intensity advanced practice nursing intervention and continuous vigilance within the full range of high-acuity care. 

Acutely ill patients may be found in areas such as emergency departments, progressive care units, critical care units, heart failure clinics — those at the higher end of the continuum of wellness to acute care. The term acutely ill refers more to the acuity of the patient, not a specific geographical area.  

As a CNS, what can I do to be prepared for implementation of the Consensus Model? 

AACN Certification Corporation recommends the following:

  • Keep your certification current; don’t let it lapse.
  • Stay connected to AACN for the latest updates on Consensus Model implementation.
  • Monitor what is happening in your state and, as needed, advocate for recognition/protection of your APRN role.

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