What is the Purpose of the APRN Consensus Model?
The Consensus Model provides guidance for states to adopt uniformity in the regulation of APRN roles, licensure, accreditation, certification and education. Although there has been significant progress in the implementation of components of the Consensus Model in many jurisdictions, there continue to be states which have not adopted all the elements for APRN regulation. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education (APRN Consensus Model) is a uniform model of regulation for the future of advanced practice nursing that is designed to align the interrelationships among licensure, .
As a current or future advanced practice nurse APRNyou must understand the Consensus Model and its career implications to practice. Through standardization of licensure, accreditation, certification, and education, the Consensus Model aims to improve access to APRN care. It further specifies six population foci for APRN practice.
Licensure and scope of practice are defined at the level of role and population foci, with the adult gerontology and pediatric NP roles delineated as acute care and primary care based on competencies obtained through formal education. Until the early s, NP education programs focused only on primary care. As NPs began to work with acutely ill patients in areas such as surgery, acute care NP programs consenssu developed.
However, these programs were scarce, compelling nurses with an interest in acute care to enroll in primary care programs. With the adoption of the Consensus Model, NPs with primary care preparation must return for formal acute care education and obtain certification as a condition of state licensure and maintenance of how to convert 30fps to 24fps employment in their acute care role.
This requirement aligns their scope of practice with the patients, diseases, and treatments they manage. However, confusion remains among some nurses, employers, and educators.
Some prospective NP students report being counseled to make themselves more marketable by combining ths what is the consensus model nursing experience with family NP education. The model also affects NPs who work in specialties such as endocrinology or palliative care, where they manage patients with both chronic and acute care needs.
Remember, educational how to erase windows xp are determined by patient acuity, not the healthcare setting.
However, interpretation of the model in these situations is inconsistent and may have job implications. One solution is dual certification. Employers also struggle with interpretation of the Consensus Model, mistakenly hiring NPs prepared in primary care for hospitalist or other acute care positions.
To facilitate the process for experienced NPs committed to aligning their practice with the Consensus Model, some universities have developed condensed programs. However, to ensure access and to support working NPs, schools must develop additional streamlined programs. Some of these challenges may be why the Consensus Model, which how to sign up for target coupons in the mail an implementation goal ofhas not yet been adopted by all U.
However, because many states, employers, and hospital systems have adopted the model, prospective APRNs must carefully choose a graduate program. See Making choices. If you choose the NP route, you then decide whether you want wbat focus on acute care or chronic and preventive care.
July 7, National Organization of Nurse Practitioner Faculties. August 19, June Stanley JM. Nurs Clin North Am. There is a grandfather clause that I read within the Consensus Model. Mldel you elaborate more on this clause? Save my name, email, and website in this browser for the next time I comment. Powered by HealthCom Media. No part of this website or publication may be reproduced, stored, or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the copyright holder.
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Choosing a program
Jun 09, · Collaborating with over forty nursing organizations they created the APRN Consensus Model. Overall, the APRN Consensus Model is a framework for establishing definitions for the various advanced practice nursing roles as well as standardizing licensure, accreditation, certification, and education for advanced practice nurses. The Consensus Model sought to improve patient access to APRNs, support nurses to work more easily across different states, and enhance the ANCC certification process by preserving the highest standards of nursing excellence. Jul 09, · APRN Consensus Model serves to help the states to define and regulated the Advanced Practice Registered Nurse (APRN) role. The Model is developed by the National Council of State Boards of Nursing (NCSBN) and accepted by many states.
Consensus decision-making or consensus politics often abbreviated to consensus is group decision-making processes in which participants develop and decide on proposals with the aim, or requirement, of acceptance by all.
The focus on avoiding negative opinion differentiates consensus from unanimity , which requires all participants to positively support a decision. The word consensus comes from Latin meaning "agreement, accord", which in turn comes from consentire , meaning "feel together". Consensus decision-making is an alternative to commonly practiced group decision-making processes. This book allows the structuring of debate and passage of proposals that can be approved through majority vote.
It does not emphasize the goal of full agreement. Critics of such a process believe that it can involve adversarial debate and the formation of competing factions.
These dynamics may harm group member relationships and undermine the ability of a group to cooperatively implement a contentious decision. Consensus decision-making attempts to address the beliefs of such problems.
Proponents claim that outcomes of the consensus process include:  . Consensus is not synonymous with "unanimity"— though that may be a rule agreed to in a decision making process.
The level of agreement necessary to finalize a decision is known as a "decision rule". In very rapid decision making, simple consensus computer science rules are often imposed, such as:. Generally such rules assume a certain number of participants and thus would satisfy consensus thresholds stated in percentage terms.
Such a statement allows for minorities to be more robustly represented in abstention or absence scenarios. Even in rapid decision making contexts, minorities the "minus" have the right to have dissenting opinion or negative outcome predictions recorded. If there is any single simple rule that defines what is not consensus decision-making , it is censoring the dissenting opinion.
Regardless of how decisions are made, dissents are always recorded in all consensus decision making systems, if only so that accuracy of predictions can be examined later so the group can learn.
This principle can be applied in any system, but it is fundamental to all consensus. More controversially, systems that require unanimity are prone to hiding or intimidating, rather than recording, dissent for example, groupthink.
Many authors consider unanimity to be a sign of an inherently wrong decision. The Sanhedrin courts of ancient Israel were of this view, and an educated reader of the Gospels always notes that the trial of Jesus was inherently unfair for being a unanimous guilty verdict. In groups of human not algorithmic participants, there are psychological implications to dissent and not all participants are equal, they may:.
For these reasons, most consensus decision making emphasizes finding out why dissent occurs. In democratic contexts, political theory debates how to deal with dissent and consensus where violent opposition is possible or even likely.
Weale states the problem as:. Rules and processes simply are never enough to resolve these questions, and a robust debate for millenia on political virtues has focused on what human characteristics participants must cultivate to achieve harmony under diversity.
To ensure the agreement or consent of all participants is valued, many groups choose unanimity or near-unanimity as their decision rule.
Groups that require unanimity allow individual participants the option of blocking a group decision. This provision motivates a group to make sure that all group members consent to any new proposal before it is adopted. Proper guidelines for the use of this option, however, are important.
The ethics of consensus decision-making encourage participants to place the good of the whole group above their own individual preferences. When there is potential for a block to a group decision, both the group and dissenters in the group are encouraged to collaborate until agreement can be reached. Simply vetoing a decision is not considered a responsible use of consensus blocking.
Some common guidelines for the use of consensus blocking include:  . A participant who does not support a proposal may have alternatives to simply blocking it. Some common options may include the ability to:. All attempts at achieving consensus begin with a good faith attempt at generating full-agreement, regardless of decision rule threshold.
In the spokescouncil model, affinity groups make joint decisions by each designating a speaker and sitting behind that circle of spokespeople, akin to the spokes of a wheel.
While speaking rights might be limited to each group's designee, the meeting may allot breakout time for the constituent groups to discuss an issue and return to the circle via their spokesperson.
In the case of an activist spokescouncil preparing for the A16 Washington D. They received the reprieve of letting groups self-organize their protests, and as the city's protest was subsequently divided into pie slices, each blockaded by an affinity group's choice of protest.
Many of the participants learned about the spokescouncil model on the fly by participating in it directly, and came to better understand their planned action by hearing others' concerns and voicing their own. The group first elects, say, three referees or consensors. The debate on the chosen problem is initiated by the facilitator calling for proposals. Every proposed option is accepted if the referees decide it is relevant and conforms with the UN Charter on Human Rights.
The referees produce and display a list of these options. If the debate fails to come to a verbal consensus, the referees draw up a final list of options - usually between 4 and 6 - to represent the debate. The referees decide which option, or which composite of the two leading options, is the outcome. If its level of support surpasses a minimum consensus coefficient, it may be adopted.
Groups that require unanimity commonly use a core set of procedures depicted in this flow chart. Once an agenda for discussion has been set and, optionally, the ground rules for the meeting have been agreed upon, each item of the agenda is addressed in turn. Typically, each decision arising from an agenda item follows through a simple structure:. Quaker -based consensus  is said to be effective because it puts in place a simple, time-tested structure that moves a group towards unity.
The Quaker model is intended to allow hearing individual voices while providing a mechanism for dealing with disagreements. The Quaker model has been adapted by Earlham College for application to secular settings, and can be effectively applied in any consensus decision-making process.
Key components of Quaker-based consensus include a belief in a common humanity and the ability to decide together. The goal is "unity, not unanimity. The facilitator is understood as serving the group rather than acting as person-in-charge. As members' views are taken into account they are likely to support it.
The consensus decision-making process often has several roles designed to make the process run more effectively. Although the name and nature of these roles varies from group to group, the most common are the facilitator , consensor , a timekeeper, an empath and a secretary or notes taker.
Not all decision-making bodies use all of these roles, although the facilitator position is almost always filled, and some groups use supplementary roles, such as a Devil's advocate or greeter. Some decision-making bodies rotate these roles through the group members in order to build the experience and skills of the participants, and prevent any perceived concentration of power. Critics of consensus blocking often observe that the option, while potentially effective for small groups of motivated or trained individuals with a sufficiently high degree of affinity , has a number of possible shortcomings, notably.
Consensus seeks to improve solidarity in the long run. Accordingly, it should not be confused with unanimity in the immediate situation, which is often a symptom of groupthink.
Studies of effective consensus process usually indicate a shunning of unanimity or "illusion of unanimity"  that does not hold up as a group comes under real-world pressure when dissent reappears. Cory Doctorow , Ralph Nader and other proponents of deliberative democracy or judicial-like methods view explicit dissent as a symbol of strength.
In his book about Wikipedia, Joseph Reagle considers the merits and challenges of consensus in open and online communities. Unanimous, or apparently unanimous, decisions can have drawbacks. Unanimity is achieved when the full group apparently consents to a decision.
It has disadvantages insofar as further disagreement, improvements or better ideas then remain hidden, but effectively ends the debate moving it to an implementation phase. Some consider all unanimity a form of groupthink, and some experts propose "coding systems Many people think of consensus as simply an extended voting method in which every one must cast their votes the same way. Since unanimity of this kind only rarely occurs in groups with more than one member, groups that try to use this kind of process usually end up being either extremely frustrated or coercive.
Either decisions are never made leading to the demise of the group, its conversion into a social group that does not accomplish any tasks , they are made covertly, or some group or individual dominates the rest. Sometimes a majority dominates, sometimes a minority, sometimes an individual who employs "the block". But no matter how it is done, it is NOT consensus. Confusion between unanimity and consensus, in other words, usually causes consensus decision-making to fail, and the group then either reverts to majority or supermajority rule or disbands.
Most robust models of consensus exclude uniformly unanimous decisions and require at least documentation of minority concerns. Some state clearly that unanimity is not consensus but rather evidence of intimidation, lack of imagination, lack of courage, failure to include all voices, or deliberate exclusion of the contrary views. Some proponents of consensus decision-making view procedures that use majority rule as undesirable for several reasons. Lijphart reaches the same conclusion about majority rule, noting that majority rule encourages coalition-building.
Some voting theorists, however, argue that majority rule may actually prevent tyranny of the majority, in part because it maximizes the potential for a minority to form a coalition that can overturn an unsatisfactory decision. Some advocates of consensus would assert that a majority decision reduces the commitment of each individual decision-maker to the decision.
Members of a minority position may feel less commitment to a majority decision, and even majority voters who may have taken their positions along party or bloc lines may have a sense of reduced responsibility for the ultimate decision. The result of this reduced commitment, according to many consensus proponents, is potentially less willingness to defend or act upon the decision.
Majority voting cannot measure consensus. Indeed,—so many 'for' and so many 'against'—it measures the very opposite, the degree of dissent. Consensus voting, in contrast, the Modified Borda Count, MBC, can identify the consensus of any electorate, whenever such a consensus exists. Furthermore, the rules laid down for this procedure can be the very catalyst of consensus. Some formal models based on graph theory attempt to explore the implications of suppressed dissent and subsequent sabotage of the group as it takes action.
High-stakes decision-making, such as judicial decisions of appeals courts, always require some such explicit documentation. Consent however is still observed that defies factional explanations.
Another method to promote agreement is to use a voting process under which all members of the group have a strategic incentive to agree rather than block. Once they receive that incentive, they may undermine or refuse to implement the agreement in various and non-obvious ways.
In general voting systems avoid allowing offering incentives or "bribes" to change a heartfelt vote. In the Abilene paradox , a group can unanimously agree on a course of action that no individual member of the group desires because no one individual is willing to go against the perceived will of the decision-making body.
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