International Council of Nurses

International Council of Nurses


248 Pages


Advanced Nursing Practice addresses the key issues in practice, education, regulation, research and role/practice development, which are central to defining the distinctive nature of advanced nursing practice (ANP) and explores international developments in the field of ANP.

Advanced Nursing Practice has been developed in recognition of the key role nurses with advanced knowledge and skills play in developing health care services worldwide. The book tracks the evolution of new advanced practice nursing roles and innovative practice models, and examines the need for international guidelines. In exploring strategies for implementing ANP in the context of countries’ health care needs, Advanced Nursing Practice addresses legal and ethical challenges and commonalities and differences in advanced nursing practice, while examining the implications, obstacles, and facilitative strategies in maintaining, implementing and supporting the development of ANP.

This book provides guidance in decision-making, examines the implications for liaising with other health care professionals and encourages nurses to shape their role to the needs of their patients and practice.



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Published 12 February 2009
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EAN13 9781405172615
License: All rights reserved
Language English

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Foreword Preface Acknowledgements
Introduction Advanced nursing practice: a growing presence Advanced nursing practice: patterns of development Advanced nursing practice: a global picture Definition of the advanced practice nurse Conclusion References
Nature of practice Introduction Advanced practice nurse (APN) characteristics ICN official position on APN characteristics Country illustrations Labelling the role Titling Title protection Scope of practice What is scope of practice? What influences scope of practice? Points to consider when defining scope of practice Core competencies Competency: the basis for education and practice Creating a competency map Formulating competency statements Advanced tasks versus advanced roles Controversial practice topics Prescriptive authority The diagnosis debate Hospital privileges
ix xi xv
1 1 2 10 11 13 13
17 17 22 22 23 24 24 26 26 26 28 29 30 32 33 34 35 36 36 39 41
ICN: Advanced Nursing Practice
Domains of practice Practice settings Conclusion References
Role and practice development Introduction Striving for the ideal: transitional processes Assessing the opportunity and need for advanced nursing practice Scanning the environment Introducing and supporting advanced nursing practice Interfacing with nurses, physicians, organisations and the public Interface with nursing Interface with medicine Interface with organisational structures Interface with the public Socialisation: role support Strategies to support new APNs Ethical dimensions of the advanced nursing practice role Conclusion References
Regulation Introduction The regulatory/legislative framework Factors influencing the regulatory/legislative systems Credentialing advanced nursing practice Components of the credentialing framework The credentialee Credentialing mechanisms Credentialer Purpose Powers Standards Processes Term or duration Costs Effectiveness Mutual recognition agreements Model for a regulatory system for advanced nursing practice Exploring your regulatory environment Preparation Forming an overview of the regulatory/legislative systems Understanding regulatory and legal frameworks for advanced nursing practice
42 45 45 45
50 50 51 52 52 56 60 60 65 68 69 71 73 74 77 78
81 81 82 84 84 86 86 88 96 96 97 97 98 98 99 101 101 102 104 104 104
Advocating for regulatory/legislative change Document analysis Advocacy strategies Conclusion References
Education for advanced nursing practice Introduction Characteristics of advanced nursing practice education The case for master’s level education Debate around master’s level education Country variation in education philosophy, approach and development Paths of entry into programmes and length of study Vignettes of advanced nursing practice educational development Assessment of prior experience and bridging mechanisms Curriculum development A curriculum framework to promote flexibility Curriculum: course distribution Advanced practice clinical experience Settings for clinical experience Preceptors and quality of clinical placements Planning for the precepting experience Examples of APN student practicum in new settings Faculty background and preparation Professional development and continuing education Educational standards and programme accreditation Conclusion References
Research Theoretical perspective of advanced nursing practice Exploring the research perspective Promoting diverse and analytical research Research for advocacy Enhancing knowledge and skills in research The research culture Research competence Writing for publication Searching for research funding International Classification for Nursing Practice® (ICNP): A tool for collaborative nursing research An international research agenda for advanced nursing practice Conclusion References
106 107 107 109 109
112 112 113 114 114
115 118 118 120 121 122 124 125 126 127 128 128 130 132 133 133 134
137 137 139 140 140 141 142 142 143 146
147 149 152 152
ICN: Advanced Nursing Practice
7 Future prospects and critical challenges for advanced nursing practice Introduction Future prospects Preparing a health care workforce for the 21st century Primary health care services Chronic conditions and home care Technology and telehealth Nurse entrepreneurs Critical challenges Critical challenge 1: integrating advanced practice nurses into workforce planning Critical challenge 2: international consensus-building around definitions, scope of practice, core competencies and education Critical challenge 3: capacity building to strengthen advanced nursing practice in health systems internationally Critical challenge 4: defining the gaps and finding the evidence Conclusion References
Appendix 1
Appendix 2 Appendix 3 Appendix 4 Appendix 5
Appendix 6
Appendix 7
Appendix 8
Key Informant Survey on Advanced Nursing Practice (ANP) Self-Administered Questionnaire Scope of practice examples Strengths, Weaknesses, Opportunities, Threats (SWOT) Principles to guide standards development Samples of course descriptions in an advanced nursing practice curriculum Preceptor guidelines, student and preceptor evaluation form Checklist for authors preparing to submit an article for publication Example of statements in an ICNP® catalogue on adherence to treatment
Resources Bibliography from key informants Glossary Index
154 154 155 155 155 156 157 158 158
162 164 165 166
167 173 177 178
196 204 210 219