Purpose: A Nurse Practitioner Clinical Ladder (NPCL) Advancement Pro- gram was designed to recognize and reward advanced nursing practice and promote nurse practitioner (NP) retention at New York University Hospitals Center (NYUHC).

Data sources: Search of published and gray literature was conducted. Elec- tronic databases included CINAHL, Medline, PubMed, Cochrane Library of Systematic Reviews, and the Joanna Briggs Institute.
Conclusions: The NYUHC NPCL Advancement Program incorporated its cur- rent Staff Nurse Clinical Ladder, previous NP promotional program literature, and NP role competencies to support the Advanced Practice Nursing Clinical Ladder Program. The NPCL is supportive of professional development, perfor- mance evaluation, clinical practice excellence, job satisfaction, and NP reten- tion. Program outgrowths include a progressive model of NP clinical practice, a formal NP mentoring program, NP leadership, and research opportunities. Implications for practice: Organizational commitment to a structured NPCL Advancement Program is critical for NP professional development, evolving role responsibilities, and job satisfaction. The NPCL Advancement Program provides requisite structures and processes supportive of clinical excellence. The development of the NPCL has highlighted the need for structured NP ori- entation and mentorship, knowledge translation, and leadership programs to meet the professional needs of NPs in diverse clinical settings.