Since there is such a variety of methods of approval by states, consistency is not assured. The standards of an accrediting agency need to be higher than minimal requirements. Another example illustrating the need for an accreditation agency that demands more than minimal standards includes the increasing number of programs preparing graduate level nurse practitioners. The explosion in the number of these programs is directly related to managed care and the focus on primary care. Some programs have started with little or no resources, limited faculty expertise, limited experience with graduate program development, and no knowledge of graduate program evaluation.
Students flock to nurse practitioner programs as they see a future secure job situation.
New York State's experience certainly mirrors this experience. In the last 5 to 10 years, the number of registered nurse practitioner programs has grown from 15 to 40. The State Education Department does not require national certification or testing of any type to receive certification to become a nurse practitioner. Nursing educators all over the country are concerned about the evaluation of quality standards for advanced practice. Competencies must be defined and enacted by each program.