Standards of Practice for Nurse Practitioners
I. Qualifications
Nurse practitioners (NPs) are licensed, independent practitioners who provide primary and/or specialty nursing and medical care in ambulatory, acute and long-term care settings. They are registered nurses with specialized, advanced education and clinical competency to provide health and medical care for diverse populations in a variety of primary care, acute and long-term care settings. Master’s, post-master’s or doctoral preparation is required for entry-level practice (AANP, 2006).
II. Process of Care
The NP utilizes the scientific process and national standards of care as a framework for managing patient care. This process includes the following components:
A. Assessment of health status
The NP assesses health status by:
- Obtaining a relevant health and medical history
- Performing a physical examination based on age and history
- Performing or ordering preventative and diagnostic procedures based on the patient’s age and history
- Identifying health and medical risk factors
B. Diagnosis
The NP makes a diagnosis by:
- Utilizing critical thinking in the diagnostic process
- Synthesizing and analyzing the collected data
- Formulating a differential diagnosis based on the history, physical examination and diagnostic test results
- Establishing priorities to meet the health and medical needs of the individual, family or community
C. Development of a treatment plan
The NP, together with the patient and family, establishes an evidence-based, mutually acceptable, cost-aware plan of care that maximizes health potential. Formulation of the treatment plan includes:
- Ordering and interpreting additional diagnostic tests
- Prescribing or ordering appropriate pharmacologic and non-pharmacologic interventions
- Developing a patient education plan
- Recommending consultations or referrals, as appropriate
D. Implementation of the plan
Interventions are based upon established priorities. Actions by the NP are:
- Individualized
- Consistent with the appropriate plan for care
- Based on scientific principles, theoretical knowledge and clinical expertise
- Consistent with teaching and learning opportunities
E. Follow up and evaluation of the patient status
The NP maintains a process for systematic follow up by:
- Determining the effectiveness of the treatment plan with documentation of patient care outcomes
- Reassessing and modifying the plan with the patient and family, as necessary, to achieve health and medical goals
III. Care Priorities
The NP’s practice model emphasizes:
A. Patient and family education
The NP provides health education and utilizes community resource opportunities for the individual and/or family
B. Facilitation of patient participation in self-care
The NP facilitates patient participation in health and medical care by providing information needed to make decisions and choices about:
- Promotion, maintenance and restoration of health
- Consultation with other appropriate health care personnel
- Appropriate utilization of health care resources
C. Promotion of optimal health
D. Provision of continually competent care
E. Facilitation of entry into the health care system
F. The promotion of a safe environment
IV. Interdisciplinary and Collaborative Responsibilities
As a licensed, independent practitioner, the NP participates as a team leader and member in the provision of health and medical care, interacting with professional colleagues to provide comprehensive care.
V. Accurate Documentation of Patient Status and Care
The NP maintains accurate, legible and confidential records.
VI. Responsibility as a Patient Advocate
Ethical and legal standards provide the basis of patient advocacy. As an advocate, the NP participates in health policy activities at the local, state, national and international levels.
VII. Quality Assurance and Continued Competence
NPs recognize the importance of continued learning through:
A. Participation in quality assurance review, including the systematic, periodic review of records and treatment plans
B. Maintenance of current knowledge by attending continuing education programs
C. Maintenance of certification in compliance with current state law
D. Application of standardized care guidelines in clinical practice
VIII. Adjunct Roles of NPs
NPs combine the roles of provider, mentor, educator, researcher, manager and consultant. The NP interprets his or her role to individuals, families and other professionals.
IX. Research as Basis for Practice
NPs support research by developing clinical research questions, conducting or participating in studies and disseminating and incorporating findings into practice.
© American Association of Nurse Practitioners 1993
Revised 1999, 2003, 2007, 2010, 2013