Purpose: To examine the Consensus Model for APRN Regulation as a proposed solution to simplify and unify regulation of advanced nursing practice with respect to licensure, certification, accreditation, and educational standards. Data sources: Policy statements and reports issued by national organizations of nursing professionals and discussion within the scholarly literature provided an overview of regulatory differences among the 50 U.S. states, their impacts on advanced practice registered nurse (APRN) practice, and discussion of the Consensus Model as a potential solution. Conclusions: Major organizations of nursing professionals have endorsed the Consensus Model, indicating the importance of this significant step toward standards and consistent quality in APRN education and practice. Diverse regulatory criteria, such as variable accreditation standards, disparate certification and licensing requirements, inconsistent population foci, and scopes of practice, represent barriers to optimized APRN function within today's complex healthcare system and, ultimately, reduced access to safe, quality care for patients. Implications for practice: The Consensus Model for APRN Regulation promises to unify APRN education, practice, and licensure, promoting greater mobility among nursing professionals. Elimination of inconsistencies in APRN licensure, education, certification, and accreditation requirements will promote greater value and mobility for the APRN within the healthcare system.

Purpose Little is published in the literature about medication adherence rates among patients who are medically indigent and patients receiving primary care from nurse practitioners (NPs). This project examined adherence rates and barriers to adherence among patients at an NP‐managed health clinic (NPMC). Data sources The setting for this research was an NPMC for uninsured and low‐income patients. A cross‐sectional convenience sample of patients (n = 119) completed surveys eliciting demographic information, self‐report of medication adherence, health literacy, and barriers to adherence. Conclusions Analysis of subjects demonstrated a vulnerable population, yet the mean adherence rate was surprisingly high (77%), compared to the rate usually cited in published literature. The best predictive model differentiating patients with high adherence from those with low adherence combined the total number of reported barriers, health literacy, and employment status. The barriers most frequently cited by subjects were difficulty paying for medications, and difficulty reading and understanding written prescription labels, which was particularly prevalent among Spanish‐speaking patients. Implications for practice Clinic efforts to improve patient access to affordable medications may have contributed to subjects’ high rates of adherence. These efforts included helping patients with filling out prescription assistance program paperwork, prescribing generic medications, providing samples, and providing effective patient education.

The Consensus Model for APRN Regulation promises to unify APRN education, practice, and licensure, promoting greater mobility among nursing professionals. Elimination of inconsistencies in APRN licensure, education, certification, and accreditation requirements will promote greater value and mobility for the APRN within the healthcare system.

Staphylococcus aureus was isolated over 2 years from Space Shuttle mission crewmembers to determine dissemination and retention of bacteria. Samples before and after each mission were from nasal, throat, urine, and feces and from air and surface sampling of the Space Shuttle. DNA fingerprinting of samples by digestion of DNA with SmaI restriction endonuclease followed by pulsed-field gel electrophoresis showed S. aureus from each crewmember had a unique fingerprint and usually only one strain was carried by an individual. There was only one instance of transfer between crewmembers. Strains from interior surfaces after flight matched those of crewmembers, suggesting microbial fingerprinting may have forensic application.

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