The American Academy of Emergency Nurse Practitioners (AAENP) is the national professional organization representing nurse practitioners (NPs) working in the emergency care specialty areas such as emergency departments, urgent care centers, and emergency medical services. Emergency nurse practitioner (ENP) programs may achieve AAENP validation by demonstrating their compliance with the AAENP standards. The purpose of this AAENP program validation review column is to provide guidance on the AAENP standards, validation process, and validation designation for academic programs seeking validation.

Although nurse practitioners have been practicing in emergency settings since the 1960s, confusion remains about their scope of practice, clinical role, and capabilities (Doetzel, Rankin, & Then, 2016). According to the Consensus Model for APRN Regulation (APRN Joint Dialogue Group, 2008), “advanced practice registered nurse (APRN) specialties are developed, recognized, and monitored by the profession” (p. 12). The state boards of nursing and national accreditors of nursing programs do not review, validate, regulate, or accredit ENP academic programs. As of 2020, no mechanism existed to ensure ENP programs included appropriate specialty content and were led by properly trained faculty.

Validation is a voluntary process by which AAENP reviews and grants authorized status to academic ENP programs. To ensure standardized ENP education, promote quality of care, and advance the profession, the AAENP Validation Committee formulated validation standards for ENP programs. These criteria are described in the Standards for Academic Emergency Nurse Practitioner Program Validation (AAENP, 2020). ENP programs may achieve AAENP validation by demonstrating their compliance with the AAENP standards. All academic ENP programs seeking AAENP validation must comply with the AAENP standards.

AAENP STANDARDS

The standards established by AAENP focus on robust programmatic structures and specialty curricular content. The ENP program validation process varies from nursing accreditors significantly in specific requirements and the review process. Some differences for ENP program validation include the required aspects of curriculum content, procedural skills, clinical hours, competency requirements, and program leadership. ENP program pedagogy may vary, but the program must teach the essential knowledge, concepts of clinical practice, and procedural skills established in the Emergency Nurse Practitioner Competencies (AAENP & Emergency Nurses Association, 2021). An on-site review is not required for ENP program validation. Nonetheless, ENP programs must be able to provide the required documentation (i.e., curriculum mapping, faculty list, syllabus, clinical sites) to obtain validation.

Academic ENP programs seeking AAENP validation are encouraged to review the Standards for Emergency Nurse Practitioner Academic Program Validation (AAENP, 2020) requirements before designing their program. The AAENP validation requirements (see Table 1) include core curriculum mapping, emergency care procedural skills, practice domains, and general requirements (i.e., faculty, clinical hours, institutional policies).

Table 1. - Frequently asked questions (FAQs) What are the core resources that guide ENP program development? Standards for Emergency Nurse Practitioner Academic Program Validation (AAENP, 2020a) Emergency Nurse Practitioner Competencies (AAENP & Emergency Nurses Association, 2021) Regulation of Emergency Nurse Practitioners Based on Education and Certification (AAENP, 2015) How often must the validation be renewed? Every 5 years How many clinical hours are required? The ENP specialty program/track has a minimum of 300 supervised, direct patient care clinical hours dedicated solely to emergency care. These hours must be separate and distinct from any other required clinical hours for other tracks of study. Clinical hours are distributed to support specialty competency development and to allow application of content in a variety of emergency care settings. What are the ENP curriculum expectations? The expected curriculum should follow the 2021 Emergency Nurse Practitioner Competencies (AAENP & Emergency Nurses Association, 2021). The 2021 ENP Competencies have five domains: Medical Screening; Medical Decision-Making/Differential Diagnoses; Patient Management; Patient Disposition; and Professional, Legal, & Ethical Practices. What are the ENP faculty requirements? Lead faculty/Director: The director/coordinator of the ENP program holds current certification as an ENP by AANPCB and has the responsibility of overall leadership for the ENP program. ENP adjunct/Clinical faculty: All ENP program faculty members who teach within the program/track maintain current certification as an ENP by AANPCB or meet the eligibility requirements to take the ENP certification examination offered by AANPCB. All faculty members teaching in the ENP program maintain currency in clinical practice. Can Adult-Gerontology Acute Care Nurse Practitioner, or Pediatric Nurse Practitioner programs add ENP certificate programs? No. Only FNP programs may add ENP certificate programs due to the life span scope of ENPs.
Refer to the AAENP publication, Acute Care Delivery Within Emergency Care Settings: An Executive Summary (AAENP, 2020b).

Note. AAENP = American Academy of Emergency Nurse Practitioners; AANPCB = American Academy of Nurse Practitioners Certification Board; ENP = emergency nurse practitioner; FNP = family nurse practitioner.

The Validation Committee is a standing committee of AAENP and serves as the primary review body for ENP programs seeking initial or continued validation. The Validation Committee is responsible for reviewing substantive change notifications submitted by validated ENP programs to ensure compliance throughout the validation period. The Validation Committee includes five evaluators: two ENPs currently practicing in emergency care, two ENP academic program directors or faculty, and one NP with academic program design experience. The AAENP Validation Committee Chair appoints all evaluators.

VALIDATION PROCESS

The validation process includes the following steps:

The academic institution submits a letter of intent to the AAENP Validation Committee. The academic institution submits a completed application for validation within 6 months of sending the letter of intent. The AAENP Validation Committee Chair appoints a group of evaluators. No university or program identifiers are included to ensure a blind review process. Evaluators return their completed review to the Validation Committee Chair within 28 days. The Validation Committee meets to review the evaluators' feedback and recommends: validation, validation pending minor revisions, validation pending major revisions, or validation denied. Within 60 days of receiving a complete application, the Validation Committee Chair will issue a formal decision letter to the academic institution. AAENP VALIDATION DESIGNATION

The AAENP Validation Committee grants initial validation to ENP programs demonstrating full compliance with all standards. Program validation is effective for 5 years. AAENP does not automatically renew program validation. For continued program validation, the academic institution must submit a new application for review. AAENP recommends that programs submit a new application 6 months before validation expiration or before making significant program changes (e.g., reduction of resources, added courses, change of faculty composition). In alignment with the AAENP mission, the Validation Committee promotes high-quality ENP standards and evidence-based practice within the emergency care profession.

—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
—Pedro A. Colio, PhD, DNP, FNP-C, ENP-C
Clinical Associate Professor
University of San Diego
San Diego, California

REFERENCES American Academy of Emergency Nurse Practitioners (AAENP). (2015). Regulation of emergency nurse practitioners based on education and certification. Retrieved from https://www.aaenp-natl.org/assets/docs/AAENP_ENPeducation_regulation_paper.pdf American Academy of Emergency Nurse Practitioners (AAENP). (2020a). Standards for emergency nurse practitioner academic program validation. Retrieved from https://www.aaenp-natl.org/assets/Standards%20for%20ENP%20Academic%20Program%20Validation%20%285%29.pdf American Academy of Emergency Nurse Practitioners. (2020b). Acute care delivery within emergency care settings: an executive summary. Retrieved from https://aaenp.memberclicks.net/assets/Acute%20Care%20Executive%20Summary.pdf American Academy of Emergency Nurse Practitioners (AAENP) & Emergency Nurses Association. (2021). Emergency nurse practitioner competencies. Retrieved from https://www.ena.org/docs/default-source/education-document-library/enpcompetencies_final.pdf?sfvrsn=f75b4634_0 APRN Joint Dialogue Group. (2008). Consensus model for APRN regulation: Licensure, accreditation, certifications, and education. Chicago, IL: National Council of State Boards of Nursing. Retrieved from http://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf Doetzel C., Rankin J. A., Then K. L. (2016). Nurse practitioner in the emergency department: Barriers and facilitators for role implementation. Advanced Emergency Nursing Journal, 38(1), 43–55. doi:10.1097/TME.0000000000000090 National Organization of Nurse Practitioner Faculties. (n.d.). NONPF nurse practitioner role core competencies table. Retrieved from https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20220719_nonpf_np_role_core_.pdf National Task Force on Quality Nurse Practitioner Education. (2016). Criteria for evaluation of nurse practitioner programs. Washington, DC: National Organization of Nurse Practitioner Faculties. Retrieved from https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/Docs/EvalCriteria2016Final.pdf