This Advanced Nurse Careers Glossary provides explanations of some terms and phrases used on this site.
APRN Compact
The APRN Compact is a multi-state nursing license agreement developed by the National Council of State Boards of Nursing . An Advanced Practice Registered Nurse (APRN) residing and licensed in any participating state can apply for a multi-state license. This license enables the nurse to practice in participating state without additional license applications or license fees.
This licensing agreement applies only to APRN roles such as Certified Nurse Midwife (CNM), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS), and Nurse Practitioner (NP).
The APRN Compact is relatively new, with only a few participating states. Even though a few states have passed APRN Compact legislation and several are contemplating legislation, the Compact will not go into effect until legislation has been passed in seven states.
Please visit the National Council of State Boards of Nursing for the latest information about the Nurse Licensure Compact.
Compare the APRN Compact to the NLC Compact.
APRN Scope of Practice
APRN Scope of Practice encompasses the range of actions that an Advanced Practice Registered Nurse may undertake and under what circumstances.
Aspects of APRN Scope of Practice include:
- Practice Autonomy – Establishes the degree of practice independence for the APRN.
- Prescriptive Authority – Establishes the degree to which an APRN may prescribe medications.
- Signature Authority – Applies only to Nurse Practitioners (NP)s. Signature Authority establishes if the NP has the authority to sign documents such as Death Certificates, Handicap Parking Permits, or Workers’ Compensation Claims.
The degree of Practice Autonomy and Prescriptive Authority classification are:
- Independent – APRNs may practice without licensed Physician Collaborative Practice Agreement or supervision,
- Collaborative – APRNs may practice only within terms of a Collaborative Practice Agreement with a licensed Physician,
- Supervised – APRNs may practice only under the direct supervision of a licensed Physician, or
- Not Recognized – One or more APRN roles may not be recognized or licensed by the state.
An APRN‘s Practice Autonomy and Prescriptive or Signature Authority may vary by practice setting. Employers may implement Scope of Practice policies that are more restrictive than provided by the state. Scope of Practice policies may differ from large hospital systems to private practice clinics.
Acute vs. Primary Care
- Hospitals and Medical Centers,
- Specialty Clinics, and
- Impatient Treatment Facilities.
- Hospitals and Medical Centers,
- Outpatient Clinics,
- Physician Offices, and
- Private Practice.
Certificate vs. Certification
Graduate nursing schools award Certificates that indicate completion of a course of study that does not result in a degree.
Certification is a credential issued by Certification Boards or Professional Associations to certify the recipient’s knowledge or skills within a specialty.
* These include Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), and Nurse Practitioner (NP).
Critical Access Hospital
Critical Access Hospital ( (CAH) is a designation given to some rural hospitals by the Centers for Medicare and Medicaid Services (CMS) . In order to obtain CAH designation, a hospital must meet the following conditions:
- Have 25 or fewer inpatients beds and provide essential healthcare services to their local community,
- Be located more than 35 miles from another hospital, or more than 15 miles another hospital in mountains or where access is limited to secondary roads,
- Maintain an annual average 96 hour or less length of stay for acute care patients, and
- Provide 24/7 emergency services.
DNP vs. PhD
The Doctor of Nursing Practice (DNP) and the Doctor of Philosophy (PhD) in Nursing are doctoral degrees in nursing. These are both terminal degrees meaning that no higher nursing degree exists. Each of these degrees prepares students for different roles outlined in the following table:
Create new knowledge in nursing by:
- Leading research teams,
- Designing and conducting nursing research,
- Disseminating nursing research results through publishing and lecturing,
- Developing and influencing policies for nursing, and
- Improving healthcare delivery systems at the state, national and international levels.
Applies new knowledge in nursing by:
- Translating nursing research into administrative and nursing Evidence-Based Practice initiatives to improve the quality and safety of patient care and outcomes, and
- Influencing healthcare leadership for nurse executives and clinical providers within healthcare organizations.
Research or Academic organizations, including:
- Colleges and Universities,
- Research Organizations, or
- Research or Academic Medical Centers.
- Hospitals and Medical Centers,
- Clinics,
- Physician Offices, or
- Private Practice.
Evidence-Based Practice
Evidence-Based Practice (EBP) in nursing is the application of scientific and evidence-derived practices that improve and enhance the quality and safety outcomes of care for patients.
This concept was introduced by Dr. David Sackett[1] in 1996 as Evidence-based Medicine (EBM).
Quoting from Dr. David Sackett’s article:
the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating clinical expertise with the best available external clinical evidence from systematic research.
The EBM concept has been adapted into nursing and patient care as Evidence-Based Practice. This adaptation is reflected in a description of Evidence-based Practice from Johns Hopkins Nursing Center for Nursing Inquiry :
EBP is a process used to review, analyze, and translate the latest scientific evidence. The goal is to quickly incorporate the best available research, along with clinical experience and patient preference, into clinical practice, so nurses can make informed patient-care decisions (Dang et al., 2022 ). EBP is the cornerstone of clinical practice. Integrating EBP into your nursing practice improves quality of care and patient outcomes.
NCLEX-RN
The National Council Licensure Examination for Registered Nurses NCLEX-RN is a test exam administered by the National Council of State Boards of Nursing . This exam tests the knowledge, skills, and abilities essential for safe and effective nursing practice. [2]
The applicant must successfully pass the NCLEX-RN before applying for a state-issued Nursing License to practice as a Registered Nurse (RN).
Nurse Licensure Compact
The Nurse Licensure Compact (NLC) is a multi-state nursing license agreement developed by the National Council of State Boards of Nursing . A nurse residing and licensed in any NLC participating state can apply for a multi-state license. This license enables the nurse to practice in another participating state without additional license applications or license fees.
This compact is in full effect in various states while additional states are in different stages of implementation or legislative action. As of 2023, more than forty jurisdictions have implemented NLC licensing.
Note: In January 2018, the National Council of State Boards of Nursing implemented an Enhanced Nurse Licensure Compact (eNLC) to replace the original Nurse Licensure Compact. This change increases access to care while maintaining public protection at the state level.
Please visit the National Council of State Boards of Nursing for the latest information about the Nurse Licensure Compact.
Compare the NLC Compact to the APRN Compact.
Patient-Centered Care
Patient-Centered Care builds a trusting, supportive, and mutually beneficial relationship between healthcare providers, patients, and their family members regarding all decisions for patient care. It is built on respect and dignity by listening to patients, sharing unbiased information about their health and treatment, and the rapport built during this collaboration.
Read more about Patient-Centered Care from the National Academy of Sciences.