Nurse Practitioner Programs in Arizona: Preparing for Independent Practice
The American Association of Nurse Practitioners describes Arizona as a full practice state for nurse practitioners. Arizona’s nurse practitioners engage in the full spectrum of activities for which they are qualified, including medication prescription and diagnosis; they do so without ongoing supervision requirements. Even so – and despite some influx from states where nurse practitioners may be more restricted in their practice – there have been challenges in bringing nurse practitioner services everywhere they are needed.
Top Nurse Practitioner Programs in Arizona
#1: Arizona State University offers hybrid-online DNP programs in adult-gerontology, family, pediatric, acute pediatric, family psychiatric mental health, and women’s health. It boasts an 18,000 square foot facility that includes simulation suites, skills labs, and other resources for technology-assisted learning and assessment (https://nursingandhealth.asu.edu/degree-programs/graduate/dnp). ASU is ranked #24 out of all DNP schools in the nation by US News & World Report.
#2: The University of Arizona offers online DNP programs in adult-gerontology, family, pediatric, and psychiatric mental health. It is ranked #28 nationwide.
#3: Northern Arizona University, Grand Canyon University, and the University of Phoenix each boast one or more programs that are CCNE-accredited and Arizona Board-approved. Experienced RNs can pursue family nurse practitioner master’s degrees through any of these institutions.
Foundations for Practice
Arizona considers Registered Nurse Practitioners (RNPs or NPs) to be Advanced Practice Registered Nurses. They hold licensure as RNs; they receive an additional certificate that allows them to practice as NPs (APRN requirements in Arizona). An Arizona nurse practitioner will be authorized to practice in one or more population foci. The following population foci are recognized:
- Families and individuals across the lifespan
- Adult-gerontology acute or primary care
- Pediatric acute or primary care
- Neonatal
- Women’s health/ gender-related
- Psychiatric/ mental health
Arizona considers nurse midwives to be a type of nurse practitioner; they have a women’s health/ gender-related population foci that includes childbirth and neonatal care.
State rule allows for the possibility of recognizing nurse practitioners in population foci other than the ones listed.
Nurse Practitioner Education
Qualifying Nurse Practitioner programs are graduate level; they may award graduate degrees or post-master certificates. The student will need to select a program that qualifies its graduates for one or more national certifying examinations. (Third party certification is an additional licensing requirement.)
Arizona has an approval process for nurse practitioner programs located within its own borders. Among the criteria: that the program is accredited by a nursing accreditation agency or is a candidate for accreditation. New programs are expected to provide substantial evidence of their ability to achieve accreditation. (In some cases, the college will already offer one or more accredited programs; this can be taken as evidence.) Accrediting agencies hold programs accountable in many ways, including examination outcomes. CCNE-accredited programs are expected to maintain 80% first-time pass rates on qualifying certification exams. A program that falls below this standard on even one examination will need an explanation and a plan.
To be approved in Arizona, a program must cover content appropriate to the role and population. Topics will include advanced physiology, diagnosis and disease management, advanced pharmacology, and professional responsibility, among others. The program will include a minimum of 500 clinical practice hours. A program that prepares students for multiple population foci will have at least 500 hours in each.
Arizona stipulates that programs have provisions for nurses who already hold graduate degrees in nursing; ultimately, though, these advanced students will need to master the same content.
Arizona has programs at multiple levels. The two largest state schools have transitioned all nurse practitioner degree programs to the doctoral level; graduates receive a Doctor of Nursing Practice (DNP). CCNE-accredited DNP programs ensure that their students accrue no fewer than 1,000 post-baccalaureate clinical practice hours by the time of graduation. There are more varied population foci options at the DNP level. Family nurse practitioner programs are available at the master’s level. Some schools with master’s options also have CCNE-accredited DNP programs.
The Board maintains lists of approved schools (https://www.azbn.gov/education/nursing-programs-lists/).
Distance learning is permitted; Board rule identifies basic standards. Programs like, online Family Nurse Practitioner programs, must be authorized in their own jurisdiction. Out-of-state schools must seek permission for clinical placements in Arizona.
Third Party Certification
Programs typically identify one or more third party certifications that their graduates can seek.
State rule establishes minimum standards for certification programs. Qualifying examinations must be based on job analysis studies that are carried out every five years. The Arizona State Board of Nursing has identified a number of certification programs that meet its standards; the list is current as of January 19, 2018 (https://www.azbn.gov/media/2880/rules.pdf). The following organizations each offer one or more acceptable programs:
- American Nurses Credentialing Center
- American Academy of Nurse Practitioners
- American Association of Critical-Care Nurses Certification Corporation
- Pediatric Nursing Certification Board
- National Certification Corporation for Obstetric, Gynecological, and Neonatal Nursing Specialties
- American Midwifery Certification Board
Geographic Distribution
The University of Arizona Center for Rural Health has noted some geographic trends (http://crh.arizona.edu/publications/studies-reports). The organization reported in 2014 that Arizona’s nurse practitioners were working predominately in urban areas. In fact, 91% of the state’s NPs were classified as urban, and there were significantly fewer NPs in rural areas even when figured on a per-population basis. Nurse midwives, considered separately, were found in higher concentration in rural Arizona.
The Center for Rural Health has among its goals improving health access by increasing the number of nurse practitioners serving in rural parts of the state. The organization is also a resource about general economic issues that affect the workforce. The CRH has noted NP reimbursement rates that are about 85% to 90% of those of physicians who perform the same services. There are exceptions: among them, services provided at federally qualified rural health clinics.
The CRH noted that there had been some increase in the number of Arizona NPs in the preceding years. A significant contributing factor: influx of nurse practitioners from other states.
BLS data continues to show higher rates of NP employment in metropolitan areas (https://www.bls.gov/oes/current/oes291171.htm). The Phoenix-Mesa-Scottsdale area has the eighth highest level of nurse practitioner employment in the nation, based on total numbers, though some parts of the state have greater concentration. Salaries in the greater Phoenix area are on a par with nonmetropolitan areas, with averages a little over $100,000; nurse practitioners in some of the state’s metropolitan regions enjoy higher pay.
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