To align with the 2022 Standards for Quality Nurse Practitioner Education (6th Edition), the 2023 NANN/NANNP Educational Standards (6^th Edition), and the 2020 NPWH Educational Standards addendum, NCC has updated the clinical hour requirements for the Neonatal Nurse Practitioner (NNP)and Women’s Health Care Nurse Practitioner (WHNP) certifications. These changes reflect the current regulatory climate and national educational benchmarks. Effective January 1, 2030, all applicants graduating after December 31, 2029, must document a minimum of 750 direct patient care clinical hours to be eligible to take NCC's nurse practitioner certification examinations. Simulation hours cannot be used or included to meet this 750-hour requirement. These changes only apply to the NP certifications; non-NP exams are unaffected.

 Based on the foregoing, the NCC Board of Directors has initiated the following actions:

• Starting on January 1, 2030, and thereafter, 750 direct patient care clinical hours in the specialty area will be required for all applicants who graduate after December 31, 2029, to meet eligibility requirements for the NNP or WHNP certification examinations.
• All DNP programs that prepare Neonatal or Women’s Health Care nurse practitioners must have a minimum of 750 direct patient care clinical hours for all graduates who graduate after December 31, 2029. In DNP programs, these hours can be within the 1,000-hour minimum requirements.
• The 750 direct patient care clinical hours must meet the standards set for either NNP or WHNP students in specific practice settings and cannot include simulation hours. WHNP programs may use up to 50 of these hours in telemedicine.
• Starting January 1, 2029, all NPs must test within 5 years of their graduation date.

Transition plan for APRN graduates prior to January 1, 2030

NCC will continue to accept 600 direct patient care clinical hours for all NNP and WHNP graduates who graduated prior to January 1, 2030; however, graduates who graduated on or after January 1, 2029, must take the certification within 5 years of graduation. To ensure a fair transition for those who have completed their education under the previous standards, the following will apply:

• Any candidate who graduates from an accredited NP program prior to January 1, 2030, remains eligible to sit for the certification examination under the 600-hour requirement.
• Five-Year Limitation for Eligibility: Candidates graduating after December 31, 2028, but before December 31, 2029, remain eligible under the 600-hour standard, but must be within five years of their graduation date. During this window, the candidate may apply or re-test using the 600-hour standard.
• Grace Period: Those graduating before January 1, 2029, have until December 31, 2033, to register for exams under the 600-hour standard, provided they are still within eight years of their graduation date. After December 31, 2033, they must be within 5 years of the graduation date.
• After December 31, 2033, all applicants for the APRN certification examinations will be required to have 750 hours of direct patient care clinical hours to sit for NCC certification, no matter the date of graduation, and must be within 5 years of graduation.
• Once the five-year post-graduation window has expired, the candidate must meet the new 750-hour eligibility requirement for all subsequent applications or re-tests, regardless of their original graduation date.

Re-Entry for Lapsed Certifications: NPs who fail to maintain their certification and allow it to lapse on or after January 1, 2030, must meet the new 750- hour eligibility criteria to regain status. However, to acknowledge ongoing clinical expertise:

• Lapsed candidates who graduated before January 1, 2030, may meet the 750-hour requirement through documented direct patient care clinical hours in the APRN role and scope, and these hours must have been earned within the two years immediately preceding their new application. They must meet all other eligibility criteria.
• Lapsed candidates who graduated after December 31, 2028, will need to be within 5 years of their graduation date.
• Lapsed candidates who graduated before January 1, 2029, will need to be within 8 years of graduation to meet eligibility to test. After December 31, 2033, they must be within 5 years of the graduation date.

Currently Certified NPS: NPs who maintain their current certified status are not affected by these changes. These provisions apply only to new applicants, those re-testing after the implementation date outside of the five-year window from graduation, or those seeking to regain a permanently lapsed status.

Periodic reviews: NCC will conduct periodic reviews of regulatory actions, availability of graduate nurse practitioner education, and number of nurse practitioner graduates to ensure that the implementation dates for requiring the 750 direct patient care clinical hours continue to be reasonable and justifiable. 

Assisting the educational process: NCC will continue its commitment to helping the nursing education community in identifying and encouraging the development of articulation programs that will help nurses and nurse practitioners achieve a transition to graduate education during the time prior to the implementation dates.

RATIONALE FOR Increasing APRN Clinical Hour Requirements to 750 Direct Patient Care Hours

The 2022 Standards for Quality Nurse Practitioner Education (6th Edition) was endorsed by the National Association of Neonatal Nurse Practitioners (NANNP), the National Association for Nurse Practitioners in Women’s Health (NPWH), the Accreditation Commission for Education for Nursing (ACEN), the American Association of Colleges of Nursing (AACN), among others. These 2022 standards advocated for increased APRN clinical hours (to 750+) due to the growing complexity of healthcare, states granting more full practice authority, and the need to better prepare graduates for independent roles, ensuring they develop robust clinical judgment and competency for diverse patient populations, aligning with increasing demands for advanced clinical skills. This change, supported by many faculty and employers, aims to enhance patient safety and quality of care by providing deeper, more varied experiences before licensure.

 Key Drivers for the Increase:

• Escalating Healthcare Complexity: The evolving nature of healthcare requires more comprehensive preparation for new NPs to manage high-acuity patients and complex care systems.
• Expansion of Full Practice Authority (FPA): As more states grant NPs independent practice, greater clinical depth is needed to ensure safe and effective care in autonomous environments.
• Enhanced Competency: Additional hours allow for deeper skill development in clinical judgment, patient management, and role competency across different patient populations.
• Stakeholders Consensus: Direct feedback from employers, faculty, and recent graduates highlighted the need for more substantial, hands-on clinical experience.

 Context & Considerations:

• Previous Standard: National benchmarks previously suggested 500 supervised clinical hours. NCC has maintained a high standard of a minimum of 600 supervised clinical hours since 1996.
• Concerns: The recent survey of APRN program directors sent out by the APRN certifiers demonstrated that some APRN programs have already transitioned to the 750-hour requirement, and many are currently planning or in the implementation phases.  
• Implementation: The goal is for certifying bodies and Boards of Nursing to adopt these standards, with a phased approach to allow for necessary program changes. 

The continued credibility of nurse practitioners in the new health care environment will require equal and consistent educational qualifications among the specialties. This will help ensure that nurse practitioners maintain their employment opportunities and that they will be recognized on an equal basis by regulatory agencies, third-party payors, health policy makers, health care colleagues, the public, and the nursing profession itself.

The year 2030 was chosen to provide adequate time for the development of the curriculums to meet the required hours. It provides an 8-year window from the initial publication of the NONPF document. This time frame will also ensure that during the transition there will be adequate numbers of nurse practitioners, preventing any disruption in nursing workforce numbers or public access to care. The timeline allows for a reasonable, justifiable shift that respects the needs of both educational institutions and the healthcare community.

Quick Reference

Requirements for the 750 direct patient care hours and the amount of time allowed for testing are entirely determined by the graduation date. Find the graduation date below to see exactly what is required.

• The 5-Year Testing Requirement: Starting January 1, 2029, all applicants must test within 5 years of their graduation date to be eligible for certification.
• The 750 Hour Requirement: All candidates who graduate after 12/31/2029 must have 750 direct patient care clinical hours to be eligible for certification. After December 31, 2033, all applicants, regardless of the graduation date, must have 750 direct patient care clinical hours and be within 5 years of graduation to be eligible for certification. Simulation hours cannot be counted in the required 750 direct patient care clinical hours.
• Doctor of Nursing Practice (DNP) Programs: If you are in a DNP program, your 750 direct patient care hours can count toward your program's 1,000-hour minimum requirement.
• Currently Certified NPs: If you already hold an active certification and maintain it, this policy does not affect you unless you allow your certification to lapse; at which time, to obtain certification, eligibility criteria must be met according to NCC policy