Providing clarification of the NP scope of practice, especially as it pertains to NPs working in acute care settings, remains needed to support practice based on educational preparation, licensure, certification, and focus of practice.

The nurse practitioner (NP) role has existed for 50 years. During the past 10 years, a national effort to use NPs to the full extent of their education based on the 2008 Consensus Model for Advanced Practice Registered Nurse Regulation and the 2010 Institute of Medicine Report on the Future of Nursing continues to result in variable scopes of practice (SOP) between states. Subsequently, NPs have a lack of clarity on SOP because it relates to population foci and practice setting. Review and analysis of state-based statutes and rules with the current literature focused on NP SOP, including documents by the National Council of State Boards of Nursing, was conducted. Clarification and understanding of SOP is essential for safe practice and optimum access to care. Inconsistent SOP regulation continues to exist between states, and NPs can be in employment situations that place them in a position to possibly breech their SOP. Although practice is not setting specific, NP licensure is based on NP education and certification that is competency based within population foci, and credentialing by employers should align with these parameters. Continuing to work toward a more common NP SOP between states and achievement of full practice authority means periodic reassessment of NP education and practice models. Practice mobility is essential for continued advancement of the NP profession and increased access to care by the public.

A dvanced practice registered nurses (APRNs), including certified nurse practitioners (CNPs), clinical nurse specialists (CNSs), certified registered nurse anesthetists (CRNAs), and certified nurse midwives (CNMs), represent a growing segment of health care professionals who provide care to patients in various settings. Although opportunities for APRNs are expanding, questions about the specific role components and scope of practice have emerged, especially because APRNs, including CNPs, are assuming greater roles in hospitals, acute and critical care, and ambulatory care settings.The term scope of practice broadly refers to the range of responsibilities that determine the boundaries within which a professional practices. 1 Scope of practice is a term used by state licensing boards for various professions to define the procedures, actions, and processes that are permitted for licensed individuals on the basis of their specific education and experience and their specific demonstrated competency. 2 Education, certification type, licensure, and regulations defined by individual state boards of nursing also shape APRN practice. Yet, variability persists in the degree to which state board of nursing regulations promote APRN practice that is consistent with education, certification, and licensure. The Institute of Medicine's 3 report, The Future of Nursing, highlighted the importance of removing scope-ofpractice barriers to promote the ability of APRNs to practice to the full extent of their education and training.In response to the need to ensure consistency in APRN education and practice, the Consensus Model for APRN Regulation emerged from a national effort to address APRN licensure, accreditation, certification, and education requirements across jurisdictions. The APRN Consensus Model proposes that the requirements for APRNs should be framed in a way that ensures the safety of patients while expanding access to APRN care and promoting a consistent scope of practice. 4