Advanced Nursing Practice: the next achievement of Brazilian nursing

Abstract

Nursing plays a fundamental role for the survival of health services, as its performance is aimed both at administrative aspects and direct care to patients, families, and communities, helping to prevent and to treat diseases in the most diverse health care conditions.Although nurses represent about 50% of the health workforce, the number of these professionals worldwide is scarce, especially in Southeast Asia and Africa (1) . Moreover, the performance of nursing professionals is limited by political, organizational, and regional aspects, and, therefore, the work characteristics and freedom of labor of this group are extremely variable in each country and, eventually, different within the same country.Thus, Advanced Nursing Practice (ANP)-which is performed by nurses who acquired, by specific training, specialized knowledge, clinical competency, and essential skills to autonomously make complex decisions-aims to expand the scope of this professionals' performance, meeting the need to respond quickly to the population's health problems, using the nursing workforce as a driving force to solve population health problems (2,3) . The COVID-19 pandemic showed the world the challenges faced by health professionals and the importance of the nurses' performance, with emphasis on solving complex situations based on ANP (4) .ANP has been successfully implemented in different countries and presents very satisfactory results, overcoming all challenges regarding professionals' training (2,5) . In Brazil, despite several implementations and many initiatives that approach Brazilian ANP development goals-such as the establishment of professional masters and doctorate courses and the increase of nurse residency programs-nurses and physicians do not fully understand ANP and present constant confusion regarding overlapping areas and the ethical and legal definition of this practice.ANP is not a strategy to supplant the medical need in health services, not even to encourage nurses to act as physicians, but it is an important supporter to relieve the health system and grant greater public access to health (5,6) , especially in more deprived areas of Brazil, accelerating processes and allowing nurses to provide a more resolutive care. As an example, more comprehensive nursing consultations regarding primary

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 ) .…”

Desafios do enfermeiro na atenção primaria à saúde: estudo reflexivo

“…Nesse sentido, ao discorrer acerca das Práticas Avançadas de Enfermagem (PAE), é relevante destacar a formação específica na qual é fundamentada, ou seja, nos conhecimentos especializados sobre determinada temática. Na APS este conhecimento gera competências clínicas para uma tomada de decisão ágil e com maior eficiência, auxiliando no direcionamento de pessoas que procuram o serviço de saúde de forma eficaz (Poveda;Nogueira, 2022).…”

“…Nesse sentido, respaldado por protocolos rigorosos e bem definidos, o enfermeiro ao realizar a consulta de enfermagem mais abrangente é capaz de detectar problemas de saúde e determinar a necessidade de encaminhamento de casos mais complexos ou propor soluções como administração e prescrição de medicamentos em casos mais leves, conferindo maior autonomia na sua práxis (Poveda;Nogueira, 2022).…”

“…No Brasil, apesar de algumas ações direcionadas ao desenvolvimento da PAE, como programas de residências, mestrado e doutorado profissionais, ainda não há clareza para os profissionais enfermeiros e médicos acerca desta prática, havendo controvérsias sobre o que ela constitui, conflito e falta de definição ético-legal (Poveda;Nogueira, 2022).…”