An advanced practice nurse (APN) is a nurse with post-graduate education in nursing. APNs are prepared with advanced didactic and clinical education, knowledge, skills, and scope of practice in nursing Advanced practice nursing defines a level of nursing practice that utilizes extended and expanded skills, experience and knowledge in assessment, planning, implementation, diagnosis and evaluation of the care required. Nurses practicing at this level are educationally prepared at the post-graduate level and may work in either a specialist or generalist capacity. However, the basis of advanced practice is the high degree of knowledge, skill and experience that is applied within the nurse-patient/client relationship to achieve optimal outcomes through critical analysis, problem solving and evidence-based decision making. APNs demonstrate effective integration of theory, practice and experiences along with increasing degrees of autonomy in judgments and interventions. Intensive post-graduate education is designed to teach an APN to use multiple approaches to decision-making, manage the care of individuals and groups, engage in collaborative practices with the patient or client to achieve best outcomes; provide a supportive environment for colleagues; manage the utilization of staff and physical resources; engage in ethically justifiable nursing practice; protect the rights of individuals and groups; engage in activities to improve nursing practice; develop therapeutic and caring relationships; fulfill the conduct requirements of the profession; act to enhance the professional development of self; and function in accordance with legislation and common law affecting nursing practice. While education, accreditation, and certification are necessary components of an overall approach to preparing an APN for practice, these roles are regulated by legislation and specific professional regulation. This allows for prescribing and referral, insurance reimbursement, and admitting privileges to health care facilities. In the US, the licensing boards are governed by state regulations and statutes and are the final arbiters of who is recognized to practice within a given state. While APNs are educated differently depending on their specific specialty, all APNs are now trained at the graduate level and are required to attain at least a master's degree, generally a Master of Science in Nursing in their field of concentration.