Introduction to Advanced Nursing Practice (eBook)

Madrean Schober, PhD, MSN,  ANP, FAANP is a nurse practitioner, educator, mentor, writer, lecturer and consultant with expertise in the development of advanced practice nursing roles, healthcare policy, curriculum design and programme development. She has been an international consultant with expertise in role development for 15 years, past-Chair of the ICN International Nurse Practitioner/Advanced Practice Nursing Network as well as International Relations Liaison for the American Academy of Nurse Practitioners. With a background in family health, family nursing and community healthcare, she has an aim to provide healthcare services to diverse populations along with strategic planning for improved access to all. These services include the promotion of advanced nursing practice in the provision of healthcare services. 

Foreword 6
Preface 8
Contents 10
1: Overview of Advanced Nursing Practice 14
1.1 Definition and Profile of an Advanced Practice Nurse 15
1.1.1 Definition 16
1.1.2 Characteristics of the Advanced Practice Nurse 16
1.1.3 Assumptions: The Foundation for Advanced Nursing Practice 17
1.2 Forging a New Nursing Role 18
1.2.1 Country Issues that Shape Development 18
References 18
2: A Growing Presence 20
2.1 Incentives and Motivation for Advanced Nursing Practice 21
2.2 Patterns and Drivers of Advanced Nursing Practice Development 22
2.2.1 Launching an Advanced Nursing Practice Initiative 22
2.2.2 Nursing Education as the Origin 23
2.2.2.1 Pakistan: Advancing Nursing Education 23
2.2.2.2 ANP Development in Switzerland: Visions and Reality 25
Definition of APN in Switzerland 25
Education for ANP 25
Swiss ANP Research 26
Swiss Policy on APN 26
Summary and Prospects 27
2.2.3 Shortage of Healthcare Professionals 27
2.2.3.1 Nurse Practitioners in the Netherlands: Response to a Physician Shortage 28
2.2.3.2 The United Kingdom: Easing the Workload of General Practitioners 30
2.2.4 Legislation, Policy, Healthcare Reform Promoting Momentum 31
2.2.4.1 Australia: A Healthcare Workforce Perspective 31
2.2.4.2 People’s Republic of China: Assessing the Landscape for Advanced Nursing Practice 33
2.2.4.3 Finland: A Newly Launched Advanced Nursing Practice Initiative Consistent with Social and Healthcare Reform 34
2.2.5 Enhancing the Status of Nursing: A Career Incentive 35
2.2.5.1 Singapore: Professional Potential in Clinical Nursing 35
2.2.5.2 Hong Kong: Career Advancement 36
2.3 International Influence 37
2.3.1 ICN (International Council of Nurses) 38
2.3.2 IFNA (International Federation of Nurse Anesthetists) 39
2.3.3 WHO (World Health Organization) 40
2.4 Country Profiles 41
2.4.1 Europe: Significant Advanced Nursing Practice Growth 41
2.4.1.1 European Federation of Nurses Association Involvement Contributes to Advanced Practice Nursing in Europe 42
Advance Practice Nursing 42
2.4.1.2 The Introduction of Advanced Nursing Practice in the French Health System 43
Advanced Nursing Practice Officially Introduced in France: A Decision After Years of Discussions 44
Advanced Practice Nurses Already Graduated in France: The Difficulties of Role Implementation 45
French APN: Profile and Role Implementation in the Future 45
2.4.1.3 Advanced Nursing Practice Development in Germany 46
2.4.1.4 Advanced Nursing Practice in Iceland 48
2.4.1.5 Advanced Nurse/Midwifery Practitioner in Ireland: Twenty Years Experience 49
2016 marks the 20th year of Advanced Nursing/Midwifery practice in Ireland 49
Scope of Practice: Integral to Development of the Role 50
2.4.1.6 United Kingdom: England, Northern Ireland, Scotland, Wales 51
England 51
Northern Ireland 51
Scotland 52
Wales 52
2.4.2 Canada: Two Advanced Nursing Practice Roles 53
2.4.3 Advanced Nursing Practice in Israel 54
2.4.4 Japan: Advanced Nursing Practice Development 56
2.4.5 Latin America: International Collaboration and the State of Advanced Practice Nursing 58
2.4.6 Oman: Development of the Advanced Practice Role 60
2.4.7 South Africa: Advanced Psychiatric Nursing, a New Specialty 62
2.4.7.1 Role Qualifications 63
2.4.7.2 Challenges for Advanced Psychiatric Registered Nurses in the South African Context 64
References 65
3: Nature of Practice 73
3.1 Titles 74
3.2 Role Characteristics 75
3.3 Scope of Practice 76
3.4 Controversial Issues 81
3.4.1 Prescriptive Authority 81
3.4.2 The Diagnosis Debate 85
3.4.3 Hospital Privileges 85
3.5 Competencies and Advanced Practice 86
3.5.1 Advanced Tasks Versus Advanced Critical Thinking 87
3.5.2 Task Reallocation and Task Shifting 87
References 89
4: Education 93
4.1 Characteristics of Advanced Nursing Practice Education 94
4.1.1 Identifying Competencies: A Guide for Education Development 94
4.2 Variations in Educational Philosophy and Approach 95
4.3 Curriculum Development 96
4.3.1 Curriculum Framework 97
4.3.2 Curriculum Design: Content Distribution 98
4.4 Program Planning 99
4.4.1 Student Criteria 99
4.4.1.1 Flexible Criteria Adapted to Context 99
4.4.1.2 Self-selection 100
4.4.1.3 External/Institutional Selection 100
4.4.2 Qualified Faculty, Educators, and Teaching Staff 101
4.4.2.1 Collaborative/Complimentary Educators and Teaching Staff 101
4.4.2.2 Nursing, Medicine, Other Healthcare Professionals 101
4.5 Teaching Methods 101
4.5.1 Simulation and e-Learning 102
4.5.1.1 Simulation 102
4.5.1.2 e-Learning 102
4.5.2 Clinical Practicum 103
4.5.2.1 Preceptors and Mentors: Developing APN Competence 104
4.5.2.2 Clinical Sites 104
References 105
5: Role and Practice Development 107
5.1 Introducing the Role and Function 108
5.1.1 The PEPPA Framework 108
5.1.1.1 PEPPA Framework Steps 109
5.1.2 Environmental Scanning and SWOT Analysis 110
5.2 Interconnectedness 111
5.2.1 Between and Within Institutional Environments 111
5.2.1.1 Strategies for Integrating APN Roles Within Organizational/Institutional Systems 112
5.2.2 Among Other Settings 112
5.2.3 Between Other Healthcare Professionals 113
5.2.3.1 Relations with Nursing 113
Strategies for Facilitating Relations with Other Nurses 114
5.2.3.2 Relations with Medical Colleagues 114
Strategies for Facilitating Positive Communication with Medical Colleagues 114
5.3 Role Support for the Advanced Practice Nurse 115
5.3.1 Strategies to Support Advanced Practice Nurses 115
5.4 Situational Ethics 116
5.5 Appendix 5.1. SWOT Analysis Matix Template 118
5.6 Appendix 5.2. SWOT Analysis Illustration 119
References 119
6: Professional Regulation 122
6.1 Frameworks and Models for Professional Regulation 123
6.1.1 The ICN Credentialing Framework: A Basis for ANP Professional Regulatory Structure 124
6.1.2 SSPP Model (Scope, Standards, Policies, and Procedures) 125
6.1.3 National Examples of Models and Frameworks 126
6.1.3.1 USA National Model. Consensus for Advanced Practice Registered Nurse Regulation: Licensure, Accreditation, Certification and Education 127
6.1.3.2 New Zealand: Adapting Professional Regulations 128
6.1.3.3 The Scottish Advanced Nursing Practice Framework: A Toolkit Approach 129
6.1.3.4 Ireland: A Dual Credentialing Framework 130
6.2 Credentialing 131
6.2.1 Accreditation, Certification, Licensure, Registration, Endorsement 132
6.3 Maintaining Competence 133
References 135
7: Challenges and Strategies 137
7.1 Professional Conflict 137
7.1.1 Nursing 139
7.1.2 Medicine 139
7.1.2.1 Interprofessional Education and Experience 140
7.2 Identifying APN Function in the Healthcare Workforce 141
7.3 Public Acceptance 142
7.3.1 How the Public Understands the Roles, Trends, and Multidisciplinary Collaboration Yet Overlapping Scopes of Practice 143
References 144
8: Career Paths, Clinical Career Ladders, and Professional Progression 147
8.1 Adaptation to the Role 148
8.1.1 Creating Career Ladders/Professional Development Structures 149
8.1.2 Diversity in Advanced Nursing Practice Clinical Career Structures 150
8.2 Linking Job Descriptions, Scopes of Practice, and Competencies 151
8.3 Performance Review and Evaluation 152
References 152
9: Research 154
9.1 Evidence-Based Practice 155
9.1.1 Joanna Briggs Institute Model 155
9.1.2 Additional Research Resources 157
9.2 Conduct of and Participation in Research 158
9.2.1 The Canadian Centre for Advanced Practice Nursing Research (CCAPNR) at McMaster University: A Resource and Model for Research Mentorship 158
9.2.1.1 Development and Components 159
9.2.1.2 Course Format and Content 160
9.2.1.3 Mentorship 160
9.2.1.4 Evaluation 161
References 161
10: The Future: Strengthening the Advanced Nursing Practice Agenda 163
10.1 National and International Organizational Views for the Future 164
10.2 Consensus Building Around Terminology 165
10.3 Integrating Advanced Nursing Practice into Healthcare Systems 166
10.4 Capacity Building 166
10.5 Additional Research 167
References 169
Index 171