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The National Association of Clinical Nurse Specialists (NACNS) was asked by the Commission on Collegiate Nursing Education (CCNE) to review and respond to CCNE's accreditation standards. NACNSs response, in the form of a letter, is published below.


July 6, 2007


Jennifer Butlin, EdD


Director, Commission on Collegiate Nursing Education


One Dupont Circle, NW, Suite 530


Washington, DC 20036


RE: Comments on CCNE Accreditation Standards


Dear Dr Butlin,


The National Association of Clinical Nurse Specialists (NACNS) appreciates the opportunity to comment on the Commission on Collegiate Nursing Education (CCNE) Accreditation Standards. Members of the NACNS Education Committee who are clinical nurse specialist (CNS) educators reviewed the Standards and our response is largely based on their comments. Because the focus of NACNS is on CNS practice, our expert reviewers examined the Accreditation Standards as they apply to accreditation of master's programs. The reviewers were as follows: Dr Camille Stern, Armstrong State University, Savannah, Georgia; Dr Mary Heye, University of Texas Health Science Center, San Antonio, Texas; Dr Nancey France, Murray State University, Murray, Kentucky; Dr Peggy Gerard, Purdue University Calumet, Hammond, Indiana.


Standard 1. Program Quality: Mission and Governance


Standard 2. Program Quality: Institutional Commitment and Resources


The key elements for these 2 standards are appropriate as stated. No recommendations for additions or revisions.


Standard 3. Program Quality: Curriculum and Teaching-Learning Practices


Most of the key elements are appropriate, but NACNS notes concerns with some of the wording and requirements in the key element III-B. Standard 3 is the only Standard that distinguishes among advanced practice roles, and only the National Organization of Nurse Practitioner Faculty standards are clearly built into the expected performance standard. In fact, CCNE requires that at least 1 member of the visiting team be a practicing nurse practitioner (NP) for the evaluation of programs, which have NP tracks. For these guidelines to be consistent for all types of advanced practice registered nurse (APRN) programs, the reviewers recommended that CCNE either drop the special mention of National Organization of Nurse Practitioner Faculty criteria or incorporate published guidelines for all other APRN groups-CNSs, nurse midwives, and nurse anesthetists-into section III-B. Similarly, if CCNE continues to require that an NP be a member of the visiting team for programs with NP tracks, then CCNE should also require representatives from other APRN groups to be part of the visiting team as appropriate for programs with other specialties. For example, a practicing CNS should be required for the visiting team for programs with CNS tracks.


Section III-B also requires that the curriculum of master's programs be consistent with The Essentials of Master's Education for Advanced Practice Nursing (AACN, 1996). The Essentials are more than 10 years old and should be revised to reflect the preparation needed to prepare APRNs to practice in today's challenging and competitive healthcare environment. One area that must be revised is the description of education needed to prescribe included in the current Essentials document. Currently, the Essentials document focuses exclusively on education needed to prepare APRNs to prescribe medications and fails to recognize the need to prepare APRNs to prescribe and monitor other treatments and interventions. Therefore, NACNS strongly recommends that this section be revised to address the educational preparation that APRNs require for prescribing appropriate to their APRN role and the patient/client condition. This may include but is not limited to: referral and consultation to other healthcare professionals, ordering durable medical equipment, ordering diagnostic tests/surveillance to inform the plan of care, and ordering pharmacologic interventions.


Standard 4. Program Effectiveness: Student Performance and Faculty Accomplishments


NACNS suggests that this accreditation standard should be strengthened by more clearly defined outcomes. Competencies and expected outcomes of the specific roles, especially at the graduate level, should be more clearly delineated as an expectation. Programs should be required to provide evidence that their graduates meet nationally recognized performance/competency standards.


We hope that these comments and recommendations are helpful. Thank you for the opportunity to provide them.




Theresa M. Murray, MSN, RN, CCNS, CCRN