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American Association of Neuroscience Nurses Scope and Standards of Practice for Neuroscience Advanced Practice Nurses

Background Specialization in nursing arose as a way to enhance quality of care and improve access to care, in the face of increasing knowledge and technological advances. A nursing specialty is characterized by a unique body of knowledge and skill set, with nurses providing care focused on phenomena unique to the practice. Neuroscience nursing is a unique nursing discipline that addresses the needs of individuals with biopsychosocial alterations because of nervous system dysfunction (Webb, 2000). Recognition of neuroscience nursing as a practice specialty began in the 1960s and resulted in the formation of the American Association of Neurosurgical Nurses in 1968. To reflect the broader practice of its members, the association was renamed the American Association of Neuroscience Nurses in 1983. As neuroscience nursing evolved as a specialty, so did opportunities for advanced practice. The nursing shortage, the need to improve quality of care, restricted residency hours, and promotion of costeffective care have led to increasing use of advanced practice nurses (APNs). The number of APNs in neuroscience nursing has grown in recent decades, reflecting the complexity and diversity of the field. Through education and certification, the neuroscience APN demonstrates basic competency in the role. Neuroscience APNs include clinical nurse specialists (CNSs) and nurse practitioners (NPs). Neuroscience APNs work in a variety of settings, demonstrate specific competencies unique to neuroscience nursing, and have a broad scope of responsibilities. This document provides a framework for the neuroscience APN to practice, addressing the four requirements necessary for regulation of the advanced practice role: licensure, accreditation, certification, and education. Although neuroscience advanced practice nursing roles are defined, procedures and activities that may be performed are not defined because those are subject to individual collaborative practice as guided by state law and institutional or practice policy (Herrmann & Zabramski, 2005). There are many diverse statutes (state, federal, and community) and institutional guidelines that govern APN practice, and the Scope of Practice for Neuroscience Advanced Practice Nurses does not supersede those statutes or guidelines. For those APNs who are required to practice within a contractual agreement, protocols may be collaboratively developed that address specific responsibilities and expectations. The ability to perform specific clinical tasks is a multifaceted process involving APN competency, collaborative agreement with the physician or institution (if required), and state statutes. As practice evolves and statutes change, updates to this document may be necessary to reflect developments in the practice environment.