Perspectives for Advanced Practice Nursing in Brazil

Abstract

This is a reflective study aiming to analyze the implementation of Advanced Practice Nursing (APN) and provide perspectives regarding the role of these professionals in the Region of the Americas, particularly in Brazil. Several countries in the world have introduced advanced nursing roles to improve quality of care and reduce health care costs. However, these roles have not been fully implemented in Latin American countries, although some countries have held advanced discussions about it and proposed graduated courses. Brazil fulfills all conditions necessary for the implementation of the education of advanced practice nurses. The investment in advanced practice nurses will result in positive outcomes for the health of the population in a short period of time, with lower costs for governments than other possible actions. It is also a strategic way to address the persistent pressure on health services, whether related to the COVID-19 pandemic or other health needs of the population, and it can be a viable strategy for the provision of care to vulnerable populations and those living in remote areas.

Enfermagem em Prática Avançada no pronto atendimento: uma reflexão promissora

“…This contribution of EPA can be elucidated by the role of nurses in the practice scenarios of the profession, since this is the professional who promotes the first contact of patients with the health service, being a link with the population, and of extreme importance in the whole pro-cess of health promotion, prevention and rehabilitation (4) . Nurses with advanced practice (nurse practitioner) in emergency services are indicated by international literature, such as those that provide improvements in access, reduced permanence, improvement in quality in care and increase in the level of patient satisfaction, being strategic and fundamental parts for acting in these services (15) . Furthermore, this professional should be able to have logic reasoning, complex decision-making, advanced techniques, complex clinical care, use of technologies to complement assessments, and resolution in the shortest possible time, among other aspects that locate nurses from advanced practice as a differentiated professional within the multidisciplinary team in emergency services (9) .…”

“…The nurses who work in RUE are challenged daily with the high demands, the attendants that need to be faster and more precise, thus, these professionals are characterized by having an outcropped care practice, being endowed with great clinical skill, dominating health technologies, to have the spirit of leadership and the ability to make quick decisions, in addition to being the main responsible for promoting teamwork, with a collaborative vision taking care focused on the individual, but focused on the global health process (8) . It is noted in the nursing practice scenario in the 24-HOUR UPA that some nurses already have specific and qualified knowledge to act in urgency and emergency situations, as well as autonomy to make decisions and work together with the multiprofessional team, skills that are in line with what is expected of the advanced practice professional (15) . With as many discussions as we critics related to 24-HOUR UPA, the EPA's action in these locations may be timely, since the complexity of care requires nurses with critical thinking for assertive decision-making, based on scientific evidence, but they also have expanded skills and competencies in health management.…”

Enfermagem em Prática Avançada no pronto atendimento: uma reflexão promissora

“…This contribution of EPA can be elucidated by the role of nurses in the practice scenarios of the profession, since this is the professional who promotes the first contact of patients with the health service, being a link with the population, and of extreme importance in the whole pro-cess of health promotion, prevention and rehabilitation (4) . Nurses with advanced practice (nurse practitioner) in emergency services are indicated by international literature, such as those that provide improvements in access, reduced permanence, improvement in quality in care and increase in the level of patient satisfaction, being strategic and fundamental parts for acting in these services (15) . Furthermore, this professional should be able to have logic reasoning, complex decision-making, advanced techniques, complex clinical care, use of technologies to complement assessments, and resolution in the shortest possible time, among other aspects that locate nurses from advanced practice as a differentiated professional within the multidisciplinary team in emergency services (9) .…”

“…The nurses who work in RUE are challenged daily with the high demands, the attendants that need to be faster and more precise, thus, these professionals are characterized by having an outcropped care practice, being endowed with great clinical skill, dominating health technologies, to have the spirit of leadership and the ability to make quick decisions, in addition to being the main responsible for promoting teamwork, with a collaborative vision taking care focused on the individual, but focused on the global health process (8) . It is noted in the nursing practice scenario in the 24-HOUR UPA that some nurses already have specific and qualified knowledge to act in urgency and emergency situations, as well as autonomy to make decisions and work together with the multiprofessional team, skills that are in line with what is expected of the advanced practice professional (15) . With as many discussions as we critics related to 24-HOUR UPA, the EPA's action in these locations may be timely, since the complexity of care requires nurses with critical thinking for assertive decision-making, based on scientific evidence, but they also have expanded skills and competencies in health management.…”

Family Nurse Practitioners: an exploratory study

“…It is important to emphasize that APN education must include clinical skills and competencies to enable effective clinical judgment as well as creative and low-cost solutions for the population. Knowledge based on concrete evidence generates skills in nurses, making them capable of facing emerging health problems and demands ( 11 , 12 , 13 , 14 ) .…”