Advanced Practice Nursing Roles, Regulation, Education, and Practice: A Global Study

Abstract

Background and Objectives: Several subgroups of the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network (ICN NP/APNN) have periodically analyzed APN (nurse practitioner and clinical nurse specialist) development around the world. The primary objective of this study was to describe the global status of APN practice regarding scope of practice, education, regulation, and practice climate. An additional objective was to look for gaps in these same areas of role development in order to recommend future initiatives. Methods: An online survey was developed by the research team, and included questions on APN practice roles, education, regulation/credentialing, and practice climate. The study was launched in August 2018 at the 10 th Annual ICN NP/APNN Conference in Rotterdam, Netherlands. Links to the survey were provided there and via multiple platforms over the next year. Results: Survey results from 325 respondents, representing 26 countries, were analyzed through descriptive techniques. Although progress was reported, particularly in education, results indicated the APN profession around the world continues to struggle over titling, title protection, regulation development, credentialing, and barriers to practice. Conclusions and Practice/Policy Relevance: APNs have the potential to help the world reach the Sustainable Development Goal of universal health coverage. Several recommendations are provided to help ensure APNs achieve these goals.

Advanced Nursing Practice and Advanced Practice Nursing roles within low and lower‐middle‐income countries

“…As previous research has shown and this study confirms, there is significant variation in the education requirements for ANP and APN (Beauchesne et al, 2020; Heale & Rieck Buckley, 2015; Kim et al, 2021; Pulcini et al, 2010; Wheeler et al, 2022; Zug et al, 2016). This study found that APN roles in the majority of participating LICs and LMICs did not meet all the educational requirements of the ICN APN guidelines, mainly being at master's level or above.…”

“…Again, this variation of characteristics present may indicate the need for further education to address potential gaps in service. This variation has been described in other global studies (Heale & Rieck Buckley, 2015;Kim et al, 2021;Pulcini et al, 2010;Wheeler et al, 2022;Zug et al, 2016).…”

“…Other studies identifying ANP or APN role practice did not directly relate to all the nature of practice characteristics (Heale & Rieck Buckley, 2015; Kim et al, 2021; Pulcini et al, 2010; Wheeler et al, 2022; Zug et al, 2016). Within this study, about 50% of all the roles described addressed each of the characteristics of the nature of practice.…”

“…Kim et al 2021 review of ANP and APN roles in the Western Pacific and Asia collected data from 14 countries, of which seven were LMICs (Kim et al, 2021). Recently, Wheeler et al (2022) surveyed 23 countries in relation to APN education, practice, and regulation. The majority of responses within this global study again were from high income countries with only three from LMICs.…”

Developing and Implementing Entrustable Professional Activities to Prepare Global Nurses

“…Students who graduate from nursing programs will have more opportunities than ever to work in international health settings. Appropriately prepared nurses will be able to meet the increasing global demand for quality health care (Rosa et al, 2021; Wheeler et al, 2022). All nurses will provide global health care regardless of where they practice.…”