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Background/purpose: The growth of advanced practice nursing specialties requires additional expertise for practice that goes beyond entry-level competencies, knowledge, skills, and abilities. A practice standards model for specialty nurse practitioners (PSMSNPs) is introduced that differentiates entry-to-practice population foci competencies from advanced specialty practice standards., Objectives: (a) Differentiate competencies and practice standards in context to specialty NPs using the emergency specialty as the exemplar, (b) articulate the process to develop the PSMSNP that evolved from an evidence-based practice analysis of NPs working in emergency care, (c) apply the PSMSNP for adaptation to other specialties, and (d) provide implications for the utilization of the PSMSNP by educators, clinicians, and employers., Data Sources: American Academy of Nurse Practitioners Certification Board's Practice Analysis of Emergency Nurse Practitioners, Consensus Model for APRN Regulation, Future of Nursing report, Peer Nursing Report, Strong Model of Advanced Practice, Entrustable Professional Activities, Emergency Medicine Milestones Project, and the Advancing Healthcare Transformation: A New Era for Academic Nursing report., Conclusions: The PSMSNP has been defined and adapted to other specialties and threaded through other models of practice for educators, clinicians, and employers. The adaptability of this model differentiates the core population foci and unique practice variables of specialty NPs. National boards of nursing, hospital credentialing committees, colleges, and universities can use this model to establish standards for specialty evaluation and guide clinical practice., Implications for Practice: The implementation of the PSMSNP will support the delineation of the specialty. This model will fulfill the American Nurses Association and Consensus Model specialty constructs.

The role of the Emergency Nurse Practitioner (ENP) has evolved as a specialty and is appreciated within the context of the 2008 Consensus Model document (APRN Consensus Work Group & National Council of State Boards of Nursing APRN Advisory Committee, 2008). The first in a series of five articles, this article describes the appraisal of the ENP role as well as the specialty and the distinctive role of the ENP. The second article, Emergency Nurse Practitioner Practice Analysis: Report and Implications of the Findings, presents research to support the scientific basis of emergency specialty practice and content validity for a national certification program. Article 3, Beyond Competencies; Practice Standards for Emergency Nurse Practitioners: A Model for Clinicians, Educators, and Employers, introduces a new conceptual model that defines the specialty of emergency care's knowledge, skills, and abilities identified by the ENP practice analysis as practice standards not traditional competencies. In Article 4, Proposed Standardized Educational Preparation for the Emergency Nurse Practitioner, essential content for ENP preparation within graduate, postgraduate, and doctoral programs. The fifth article, Envisioning the Future for ENPs: Implications for Clinical Practice, Education, Research, and Health Policy, describes how ENPs are envisioning and impacting the future of emergency care and how their evolution can serve as a model for development of other advanced practice nursing specialties.

The emergency nurse practitioner (ENP) specialty has grown rapidly, responding and adapting to changes within emergency care. Designation and advancement of nurse practitioner (NP) specialties follows a systematic process as defined by the profession. This includes establishment of scope and standards of practice, educational standards, and policy initiatives to ensure quality and safety within the profession. This article describes how the ENP specialty has used evidence to meet health system needs and chart a transformational future. Current recommendations for advancing health care transformation, as described by the American Association of Colleges of Nursing-Manatt Report, inform and frame the processes by which the ENP specialty has collaborated with diverse stakeholders to create a research and policy agenda to ensure that ENPs are appropriately prepared to lead and provide access to safe, affordable, quality health care. These processes provide a future-oriented model that promotes advancement of the NP profession through provision of new NP specialty designations as they emerge to meet changing health care system needs.

The dynamic climate within health care policy-making and academia, in conjunction with updated Emergency Nurse Practitioner (ENP) competencies and a recent role delineation study, supports development of standardized curricula to ensure appropriate preparation for practice. Emergency NP curricular content should align with the updated ENP Practice Standards and National Organization of Nurse Practitioner Faculties' competencies for the Core and Family NP. This article provides rationale for establishing standardized educational curricula for ENP programs, delineates core specialty curricular content for inclusion, and discusses applicability of ENP specialty competencies within graduate academic education and postgraduate fellowship programs. As national ENP program curricula are standardized, clarity of the ENP specialty role will be enhanced and educational outcomes can be uniformly evaluated.

Background and Purpose: A practice analysis of nurse practitioners (NPs) working in emergency care was undertaken to define their job tasks and develop a specialty certification by examination., Method: In phase I, clinical experts created a qualitative description of domains of practice, tasks performed, knowledge required, and procedures performed by NPs in emergency care. Phase II involved validating the qualitative description through a national survey (N = 474) of emergency nurse practitioners (ENPs). Evidence from the validation survey was used to create a test content outline for the ENP examination., Findings and Conclusions: The delineation of ENP practice validated by the survey (Cronbach alpha = 0.86-0.94 across rating scales) included 5 ENP practice domains: medical screening, medical decision-making/differential diagnoses, patient management, patient disposition and professional, legal and ethical practices. There were 22 job tasks across domains, 10 types of patient conditions/emergency types, 42 knowledge areas, and 68 procedures performed by ENPs. These resulted in a test blueprint providing the foundation for the ENP certification examination content validity., Implications for Practice: Beyond certification, the practice analysis has the potential to further inform the scientific basis of emergency specialty practice. Additional uses include refining professional scope and standards of practice, job descriptions, performance appraisals, research, and policy development.