Advanced Practice Registered Nurse Fellowships

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In 2011, the Institute of Medicine’s (IOM) “The Future of Nursing: Leading Change, Advancing Health” report recommended that State Boards of Nursing, the government, and accrediting bodies support nurses’ completion of residency programs. This recommendation included nurses graduating from prelicensure programs, nurses transitioning to new clinical practice areas, and nurses graduating from advanced practice degree programs. Nurse residency programs have been shown to improve retention, confidence, nurse satisfaction, and overall competence. According to the IOM (2015) report, “Assessing Progress on the Institute of Medicine Report The Future of Nursing,” there are differing needs for advanced practice registered nurses (APRN) from non-advanced practice nurses.
Although RN residencies transition new graduates to their first clinical setting, APRN fellowships are focused more on professionalism and independence. These programs help new APRNs find preceptors, attain needed practice skills, and have demonstrated success in improving competence. The IOM (2015) report states that APRN fellowships operate in various healthcare setting, such as clinics, Department of Veteran Affairs primary care centers, acute care hospitals, and federally qualified health centers. Cosme and Pokorny (2017) state that there are two distinct models for APRN fellowships: one is where the new APRN is trained in a specialty area, such as critical care or cardiac care, and the other is where the APRN is prepared to work in one specific organization. Length of time of orientation will be dependent upon the model and the required competencies the APRN must master. To ensure APRN fellowship quality, the American Nurses Credentialing Center (ANCC) established fellowship standards through its Practice Transition Accreditation Program. In order to attain APRN fellowship accreditation, the program must include an organizational orientation, practice-based experience, and supplemental activities to promote nursing professional development.
In 2014, Dr. Kaleen Cullen, APRN-BC, was asked by the Peak Vista leadership to develop a postlicensure fellowship for new family nurse practitioners. She was hired, in 2015, as the program director. Peak Vista is located in Colorado’s Pikes Peak and East Central Plains regions and serves the community through 26 outpatient centers. The Peak Vista APRN Fellowship has hired their third cohort for the year-long fellowship. Dr. Cullen was asked to share her organization’s journey in creating an APRN fellowship and the challenges in attaining ANCC program accreditation.
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