The American Academy of Emergency Nurse Practitioners (AAENP) and the Emergency Nurses Association (ENA) are pleased to announce the publication of the 2021 Emergency Nurse Practitioner (ENP) competencies. These competencies represent the integration of previously published competencies from AAENP (2018) and ENA (2019) as delineated by representatives from both organizations. The Consensus Model for APRN Regulation places responsibility for the development and governance of nurse practitioner (NP) specialty areas, including competencies and standards, with professional organizations (Advanced Practice Registered Nurse Consensus Work Group & National Council of State Boards of Nursing APRN Advisory Committee, 2008).

The first set of ENP competencies was delineated in 2008 based on a national Delphi study and practice analysis (ENA, 2008). As ENP practice advanced and expanded, experts identified the need for updated competencies more reflective of current practice. These original competencies were first updated in 2018 when AAENP published ENP competencies, titled Practice Standards for the ENP Specialty, based on data from a 2016 ENP national practice analysis (American Academy of Nurse Practitioners Certification Board [AANPCB], 2016; Tyler et al., 2018). Based on the findings of this research, the knowledge, tasks, and procedures associated with ENP practice were categorized into five domains: medical screening, medical decision-making/differential diagnoses, patient management, patient disposition, and professional, legal, and ethical practices (AAENP, 2018). The competencies can serve to differentiate entry level knowledge, skills, and abilities from advanced ENP specialty expertise within the broader framework of practice standards while carefully encompassing the comprehension, psychomotor capability, and acumen necessary to adeptly guide care for patients across the life span, including procedures most frequently utilized in emergency settings (Ramirez, Schumann, & Agan, 2018).

Also, in 2018, ENA President Jeff Solheim appointed content experts to the ENP Competency Revision Work Group to review and update the 2008 ENA Competencies for Nurse Practitioners in Emergency Care. Utilizing the framework from the 2008 ENP competencies, the workgroup met regularly over 2 years and created a grid to map the competencies with the AANPCB ENP certification examination blueprint, the Scope and Standards for Emergency Nurse Practitioners (AAENP, 2016), and the Practice Standards for the Emergency Nurse Practitioner Specialty (AAENP, 2018). Following a public comment period and resulting revisions, the revised competencies were submitted to the American Nurses Association (ANA) for endorsement and were approved in July 2020.

While ENA (2008,2019) and AAENP (2016) competencies had many similarities, the existence of different ENP competencies published by the two organizations created confusion among the workforce and stakeholders. In 2021, AAENP and ENA Presidents charged the Emergency Nurse Practitioners Competencies Workgroup to align the two sets of competencies. Using a grid-like framework to distinguish similarities and differences between the two documents, the workgroup identified, analyzed, and organized the competencies by theme. Whereas the AAENP competencies were broad, the ENA competencies were very detailed. There were no identified significant variances or gaps other than some terminology differences. Despite being originally derived from different studies, the two sets of competencies demonstrated similar competencies, lending validity to the final merged set of competencies. An agreement was made to use the AAENP core competency domains: medical screening, medical decision-making, patient management, patient disposition, and professional, legal, and ethical practices. Competencies from the AAENP and ENA documents were ultimately merged and arranged according to the appropriate corresponding domain.

Not only were the initial two sets of competencies aligned with each other but they were ultimately also aligned with other national initiatives and documents guiding NP education. Regardless of the population focus during academic education, all NPs are prepared with core competencies (National Organization of Nurse Practitioner Faculties [NONPF], 2017) as a basis for population- and specialty-focused competencies. Specialty competencies are not considered entry level but rather demonstrate and incorporate higher levels of targeted knowledge and abilities. The ENP competencies build upon the Core NP Competencies (NONPF, 2017) and the advanced-level nursing competencies outlined in The Essentials: Core Competencies for Professional Nursing Education (American Association of Colleges of Nursing, 2021). In addition, the 2021 ENP competencies are congruent with The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (National Academies of Sciences, Engineering, & Medicine, 2021).

Although it may appear to be a seemingly simple goal, merging this information was complex and involved deconstructing, analyzing, and synthesizing aspects of ENP practice, along with consensus-based decision-making that resulted in the desired outcome of improving the values, expertise, and quality in managing patient health care by the ENP. Through a collaborative work effort, the unified set of 2021 ENP competencies provides support for academic ENP programs as they move toward competency-based education. In addition, the updated competencies demonstrate the alignment of evidence-based ENP practice in the delivery of safe, quality patient care to support regulatory frameworks, credentialing, and reimbursements.

—Wesley D. Davis, DNP, ENP-C, FNP-C, AGACNP-BC, CEN, FAANP, FAEN
Family and Emergency Nurse
Practitioner Program Coordinator and
Assistant Professor, College of Nursing
University of South Alabama
Mobile, Alabama
—Nancy Denke, DNP, ACNP-BC,
FNP-BC, FAEN, CEN, CCRN
Arizona State University
Tempe, Arizona
—Melanie Gibbons Hallman, DNP,
FNP-BC, ACNP-BC, ENP-C, CNS, CEN,
TCRN, FAEN, FAAN
University of Alabama at Birmingham
Birmingham, Alabama
—David House, DNP, FNP-BC, ENP-C,
CNE, CNS, CEN, FAEN
University of Alabama at Birmingham
Birmingham, Alabama
—Diane Fuller Switzer, DNP, FNP-BC,
ENP-C, ENP-BC, CCRN, CEN, FAEN, FAANP
Seattle University
Seattle, Washington
—Jennifer Wilbeck, DNP, RN, FNP-BC,
ACNP-BC, ENP-C, FAANP, FAAN
Vanderbilt University
Nashville, Tennessee
Guest Editors

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