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The Arkansas Legislature understands the importance of master’s-prepared advanced practice registered nurses (APRN) to the future of healthcare in the state. This is why they have begun taking steps to implement the APRN Consensus Model in recent years, including adopting the APRN title to describe master’s-educated and nationally certified advanced nursing practitioners in 2012.
APRNs in all roles are relied upon to:
- Improve access to care in rural areas and in other healthcare provider-shortage areas
- Augment the healthcare workforce
- Reduce the delay of care
- Coordinate care and create a more effective delivery model
The Board reported that as of 2013, a total of 2,376 nurses were recognized as APRNs in the state, distributed among the four roles as follows:
- Certified Nurse Practitioners: 1,503
- Certified Registered Nurse Anesthetists: 708
- Certified Nurse Midwives: 28
- Clinical Nurse Specialists: 137
In addition to advanced clinical practitioners, other nursing specialists, such as administrators, researchers, and informaticists, also generally possess an MSN or higher.
Licensing Requirements for the Recognized APRN Roles in Arkansas
Arkansas RNs in good standing can become licensed as advanced practice registered nurses by earning a Master of Science in Nursing (MSN) and national certification, both specific to their chosen role and patient population focus.
The Arkansas State Board of Nursing recognizes and licenses APRNs in four distinct roles:
- Certified Nurse Practitioner (CNP)
- Clinical Nurse Specialist (CNS)
- Certified Registered Nurse Anesthetist (CRNA)
- Certified Nurse Midwife (CNM)
While CNMs and CRNAs do not need to select a population focus, CNPs and CNSs would further specialize through education and certification in one of these patient population groups:
- Adult-Gerontology
- Family/Individual Across the Lifespan
- Neonatal
- Pediatrics
- Psychiatric/Mental Health
- Women’s Health/Gender-Related
Upon the successful completion of an accredited APRN program, candidates must take and pass one or more of the following national certification examinations. The Board recognizes the following APRN certifications for the purpose of licensing:
Registered Nurse Practitioner (RNP)
- American Academy of Nurse Practitioners
- Adult Nurse Practitioner (ANP)
- Family Nurse Practitioner (FNP)
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
- American Nurses Credentialing Center
- Adult-Gerontology Acute Care Nurse Practitioner-Board Certified (AGACNP-BC)
- Adult-Gerontology Primary Care Nurse Practitioner-Board Certified (AGPCNP-BC)
- Family Nurse Practitioner-Board Certified (FNP-BC)
- Pediatric Primary Care Nurse Practitioner-Board Certified (PPCNP-BC)
- Psychiatric-Mental Health Nurse Practitioner-Board Certified (PMHNP-BC)
- AACN Certification Corporation
- Acute Care Nurse Practitioner Adult-Gerontology (ACNPC-AG)
- Pediatric Nursing Certification Board
- Pediatric Nurse Practitioner Primary Care (CPNP-PC)
- Pediatric Nurse Practitioner Acute Care (CPNPAC)
- National Certification Corporation
- Women’s Health Care Nurse Practitioner-Board Certified (WHNP-BC)
- Neonatal Nurse Practitioner-Board Certified (NNP-BC)
Clinical Nurse Specialist (CNS)
- AACN Certification Corporation
- Clinical Nurse Specialist; Wellness through Acute Care (Adult-Gerontology) (ACCNS-AG)
- Clinical Nurse Specialist; Wellness through Acute Care (Pediatric) (ACCNS-P)
- Clinical Nurse Specialist; Wellness through Acute Care (Neonatal) (ACCNS-N)
- American Nurses Credentialing Center
- Pediatric Clinical Nurse Specialist-Board Certified (PCNS-BC)
- Adult-Gerontology Clinical Nurse Specialist-Board Certified (AGCNS-BC)
Certified Registered Nurse Anesthetist (CRNA)
- National Board of Certification and Recertification for Nurse Anesthetists
- Certified Registered Nurse Anesthetist (CRNA)
Certified Nurse-Midwife (CNM)
- American Midwifery Certification Board
- Certified in Nurse-Midwifery (CNM)
Choosing a Master of Science in Nursing (MSN) in Arkansas
Thanks to the many institutions that offer fully or partially online MSN degrees and post-graduate APRN certificates, RNs may prepare for APRN licensure even if they don’t live close to a campus-based program. Online programs allow students to complete the didactic requirements of the program through web-based courses and then complete their clinical requirements at partner sites close to home.
Other options found in today’s MSN programs include part-time schedules and accelerated schedules.
The Arkansas Board of Nursing recognizes APRN programs that have been accredited by a nursing accrediting body that is recognized by the U.S. Secretary of Education and/or the Council for Higher Education Accreditation (CHEA).
The following accrediting agencies accredit APRN programs in the U.S. for the respective roles:
Nurse Practitioner and Clinical Nurse Specialist MSN Programs
The Commission on Collegiate Nursing Education (CCNE) accredits nursing programs in the U.S. at all levels. There are four CCNE-accredited master’s degree programs in Arkansas in the following cities:
- Conway
- Fayetteville
- Little Rock
The Accreditation Commission for Education in Nursing (ACEN) accredits post-secondary and the higher degree including, among others, master’s/post-master’s certificates. There are two ACEN-accredited programs in Arkansas in the following cities:
- Russellville
- State University
Nurse Anesthetist Programs
The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) accredits nurse anesthetist programs in the U.S. There is one COA-accredited program in Arkansas.
Nurse-Midwife Programs
Accreditation Commission for Midwifery Education (ACME) accredits nurse-midwifery programs in the U.S. There are no ACME-accredited programs in Arkansas.
Arkansas Board Requirements for MSN Programs that Prepare Advanced Practice Registered Nurses
Board-approved MSN programs for APRNs are expected to meet the nursing accrediting body standards for advanced practice nursing. The curriculum plan must include preparation in one of the four identified APRN roles (CRNA, CNM, CNS, or CNP) and preparation on at least one of the approved population foci (applicable to CNSs and CNPs):
- Adult-Gerontology
- Family/Individual Across the Lifespan
- Neonatal
- Pediatrics
- Psychiatric/Mental Health
- Women’s Health/Gender-Related
The APRN core must include at least three, separate graduate-level courses in:
- Advanced physiology and pathophysiology
- Advanced health assessment
- Advanced pharmacology
All graduate/post-graduate APRN programs must include at least 500 supervised clinical hours in direct clinical practice during the course of the program. APRN programs that prepare graduates for two population foci must have at least 500 supervised clinical hours for EACH population focus.
The clinical supervision and didactic components must be congruent with current national professional organizations and nursing accrediting body standards applicable to the APRN role and population focus:
Certified Nurse-Midwife: The American College of Nurse Midwives (ACNM) requires all CNM programs to meet the ACNM Core Competencies for Basic Midwifery Practice, which includes the following topics of study:
- Anatomy and physiology
- Epidemiology
- Nutrition
- Normal growth and development
- Clinical genetics and genomics
- Pharmacokinetics and pharmacotherapeutics
Certified Registered Nurse Anesthetist: The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) requires the academic curriculum and prerequisite courses of nurse anesthesia programs to include:
- Anatomy, physiology, and pathophysiology (135 hours)
- Basic and advanced anesthesia practices (105 hours)
- Professional aspects of nurse anesthesia practice (45 hours)
- Pharmacology of anesthetic agents and adjuvant drugs within the concepts of biochemistry and chemistry (105 hours)
- Research (30 hours)
- Clinical conferences (45 hours)
- Radiology and ultrasound
Clinical Nurse Specialist: The National Association of Clinical Nurse Specialists oversees the National CNS Competency Task Force, which states that all CNS-accredited programs must prepare students in the following competencies:
- Direct Care Competency
- Consultation Competency
- Systems Leadership Competency
- Collaboration Competency
- Coaching Competency
- Research Competency
- Ethical Decision-Making, Moral Agency and Advocacy Competency
Nurse Practitioner: The National Task Force on Quality Nurse Practitioner Education requires that all accredited nurse practitioner programs teach students in the following competencies:
- Ethics Competencies
- Health Delivery System Competencies
- Independent Practice Competencies
- Leadership Competencies
- Policy Competencies
- Practice Inquiry Competencies
- Quality Competencies
- Scientific Foundation Competencies
- Technology and Information Literacy Competencies
Selecting the Right Type of Program Based on Current Education
Candidates seeking an MSN degree to become an APRN in Arkansas must select a program that builds off their current level of education:
- RNs with a Bachelor of Science in Nursing (BSN): RNs with a BSN can pursue a standard MSN; a program that takes about two years to complete.
- RNs with an Associate’s Degree in Nursing: RNs with an ADN must complete both their BSN and MSN before they can become licensed as APRNs in Arkansas. Although RNs with ADNs may first pursue their BSN and then MSN, RN-to-MSN bridge programs allow RNs to complete both their BSN and MSN in an accelerated format.
- RNs with a Master of Science in Nursing (MSN): RNs with an MSN may pursue a post-graduate APRN that permits them to receive the education and clinical training in a specific APRN specialty.
- Professionals with a Bachelor’s Degree in a Subject Other Than Nursing: Candidates for APRN licensure that already possess a bachelor’s degree in another subject may complete a unique MSN program often called a direct-entry or entry-level MSN program, which includes everything necessary for APRN licensure, including RN licensure and the MSN.
Scope of Practice and Arkansas State Laws Governing Advanced Practice Registered Nursing
According to the Arkansas Board of Nursing, practice standards for all categories of APRN nursing include:
- APRNs must assess clients at an advanced level, identify any abnormal conditions, establish a diagnosis, develop treatment plans, and evaluate client outcomes.
- APRNs must use their advanced knowledge and skills to teach and guide clients and other members of the healthcare team.
- APRNs must use critical thinking and decision making at an advanced level and within their practice category.
- APRNs must possess the knowledge of the statutes and rules of advanced practice nursing and practice within the legal boundaries of their appropriate APRN category.
- APRNs must understand the limits of their knowledge and experience and plan for situations beyond their expertise.
- APRNs must maintain professional accountability for their care when delegating interventions.
- APRNs must maintain current knowledge and skills in their advanced practice nursing category.
- APRNs must practice in accordance with the standards established by the national certifying body from which they hold their national certification for licensure.
The Board of Nursing recognizes additional CRNA practice standards to include:
- CRNAs may be authorized by a hospital or institution to act as their agent or employee in order to administer controlled substances under the DEA registration of the hospital or institution.
- CRNAs may order nurses to administer drugs preoperatively or postoperatively in connection with anesthetic and/or other operative or invasive procedures
Prescriptive Authority for APRNs in Arkansas
All APRNs in Arkansas may be granted prescriptive authority, including the ability to prescribe controlled substances, schedules III-V.
APRNs applying for prescriptive authority must provide the Board with documentation of the following pharmacology coursework, which must include:
- A three-credit-hour graduate course in pharmacology within the two years prior to applying
- At least 45 contact hours (1 contact hours=50-60 minutes) in a pharmacology course that includes a competency component in the two years prior to applying
- A three-credit-hour graduate course in pharmacology, included as part of an advanced practice nursing education program within the five years prior to applying
- At least 300 clock hours of preceptorial experience in the prescription of drugs, medicines, and therapeutic devices with a qualified preceptor, to be initiated with the pharmacology course and completed within one year of the beginning of the course
After being issued an Arkansas APRN license, APRNs may apply for prescriptive authority (eligibility guidelines may be found here). The Board does not automatically grant prescriptive authority with the issuance of an APRN license. In addition to completing an application for prescriptive authority, APRNs must submit the following:
- Collaborative Practice Agreement
- Quality Assurance (QA) Plan
APRNs in Arkansas with prescriptive authority must have prescriptive protocols in place, which include indications and classifications of legend drugs and controlled substances. APRNs must submit prescriptive protocols to the Board at their request. A prescriptive protocol template can be found here.
After receiving full APRN licensure and a prescriptive authority certificate number, APRNs that want to prescribe Schedules III-V controlled substances must apply for a DEA Registration number.
Implementation of the APRN Consensus Model and Collaborative Practice in Arkansas
In 2012, the Arkansas State Board of Nursing took the first step toward implementation of the APRN Consensus Model by passing Senate Bill 161, which changed the title Advanced Practice Nurse (APN) to Advanced Practice Registered Nurse (APRN).
Although Arkansas now aligns with the APRN Consensus model through the use of the APRN title and the recognition of all four APRN roles, APRNs in Arkansas may not practice independently if granted the authority to prescribe.
APRNs with prescriptive authority must have a collaborative practice agreement in place with a practicing physician whose practice and training is the same in scope, specialty, or expertise as the APRN’s. A collaborative practice agreement must detail provisions that address:
- The availability of the collaborating physician for consultation or referral or both
- The methods of management of the collaborative practice, which must include protocols for prescriptive authority
- The coverage of healthcare needs of a patient in the emergency absence of the APRN or physician
- Quality assurance
Continuing Education Requirements for APRNs in Arkansas
The date for renewal for an applicant’s APRN license in Arkansas coincides with the renewal of the applicant’s RN license, which occurs on a biennial basis. APRNs seeking licensure renewal must submit to the Board documentation of current national certification in the appropriate APRN specialty and a current RN license.
The Board of Nursing recognizes national certification as meeting the continuing education criteria for APRN license renewal.
APRNs with prescriptive authority must submit evidence of a current collaborative practice agreement as a prerequisite to license renewal.
Further, APRNs with prescriptive authority must complete at least 5 contact hours of pharmacotherapeutics in their area of certification each biennium prior to license renewal. As least 2 of the 5 contact hours must contain information related to maintaining professional boundaries and the prescribing rules, regulations, and laws that apply to APRNs in Arkansas.