International Council of Nurses

Madrean Schoberis an International Healthcare Consultant; past-Chair of the ICN International Nurse Practitioner/Advanced Practice Nursing Network; and International Relations Liaison for the American Academy of Nurse Practitioners. Fadwa A. Affara is Nurse Consultant, Education and Regulation Policy undertaking consultancy work for ICN, WHO and other agencies, particularly in the field of regulation. She helped set up the Regulation Network and International Nurse Practitioner/Advanced Practice Nursing Network while at the ICN.

• ContentsForeword ixPreface xiAcknowledgements xv1 Introduction 1Advanced nursing practice: a growing presence 1Advanced nursing practice: patterns of development 2Advanced nursing practice: a global picture 10Definition of the advanced practice nurse 11Conclusion 13References 132 Nature of practice 17Introduction 17Advanced practice nurse (APN) characteristics 22ICN official position on APN characteristics 22Country illustrations 23Labelling the role 24Titling 24Title protection 26Scope of practice 26What is scope of practice? 26What influences scope of practice? 28Points to consider when defining scope of practice 29Core competencies 30Competency: the basis for education and practice 32Creating a competency map 33Formulating competency statements 34Advanced tasks versus advanced roles 35Controversial practice topics 36Prescriptive authority 36The diagnosis debate 39Hospital privileges 41Domains of practice 42Practice settings 45Conclusion 45References 453 Role and practice development 50Introduction 50Striving for the ideal: transitional processes 51Assessing the opportunity and need for advanced nursing practice 52Scanning the environment 52Introducing and supporting advanced nursing practice 56Interfacing with nurses, physicians, organisations and the public 60Interface with nursing 60Interface with medicine 65Interface with organisational structures 68Interface with the public 69Socialisation: role support 71Strategies to support new APNs 73Ethical dimensions of the advanced nursing practice role 74Conclusion 77References 784 Regulation 81Introduction 81The regulatory/legislative framework 82Factors influencing the regulatory/legislative systems 84Credentialing advanced nursing practice 84Components of the credentialing framework 86The credentialee 86Credentialing mechanisms 88Credentialer 96Purpose 96Powers 97Standards 97Processes 98Term or duration 98Costs 99Effectiveness 101Mutual recognition agreements 101Model for a regulatory system for advanced nursing practice 102Exploring your regulatory environment 104Preparation 104Forming an overview of the regulatory/legislative systems 104Understanding regulatory and legal frameworks for advanced nursing practice 105Advocating for regulatory/legislative change 106Document analysis 107Advocacy strategies 107Conclusion 109References 1095 Education for advanced nursing practice 112Introduction 112Characteristics of advanced nursing practice education 113The case for master’s level education 114Debate around master’s level education 114Country variation in education philosophy, approach and development 115Paths of entry into programmes and length of study 118Vignettes of advanced nursing practice educational development 118Assessment of prior experience and bridging mechanisms 120Curriculum development 121A curriculum framework to promote flexibility 122Curriculum: course distribution 124Advanced practice clinical experience 125Settings for clinical experience 126Preceptors and quality of clinical placements 127Planning for the precepting experience 128Examples of APN student practicum in new settings 128Faculty background and preparation 130Professional development and continuing education 132Educational standards and programme accreditation 133Conclusion 133References 1346 Research 137Theoretical perspective of advanced nursing practice 137Exploring the research perspective 139Promoting diverse and analytical research 140Research for advocacy 140Enhancing knowledge and skills in research 141The research culture 142Research competence 142Writing for publication 143Searching for research funding 146International Classification for Nursing Practice® (ICNP): A tool for collaborative nursing research 147An international research agenda for advanced nursing practice 149Conclusion 152References 1527 Future prospects and critical challenges for advanced nursing practice 154Introduction 154Future prospects 155Preparing a health care workforce for the 21st century 155Primary health care services 155Chronic conditions and home care 156Technology and telehealth 157Nurse entrepreneurs 158Critical challenges 158Critical challenge 1: integrating advanced practice nurses into workforce planning 159Critical challenge 2: international consensus-building around definitions, scope of practice, core competencies and education 161Critical challenge 3: capacity building to strengthen advanced nursing practice in health systems internationally 162Critical challenge 4: defining the gaps and finding the evidence 164Conclusion 165References 166Appendix 1 Key Informant Survey on Advanced Nursing Practice (ANP) Self-Administered Questionnaire 167Appendix 2 Scope of practice examples 173Appendix 3 Strengths, Weaknesses, Opportunities, Threats (SWOT) 177Appendix 4 Principles to guide standards development 178Appendix 5 Samples of course descriptions in an advanced nursing practice curriculum 181Appendix 6 Preceptor guidelines, student and preceptor evaluation form 189Appendix 7 Checklist for authors preparing to submit an article for publication 192Appendix 8 Example of statements in an ICNP® catalogue on adherence to treatment 194Resources 196Bibliography from key informants 204Glossary 210Index 219

"This book is an invaluable resource for all professionals involved with advancing nursing practice...I would recommend this book to all advanced practitioners, to nurses wishing to advance their practice and to those involved in service provision and education."Louise Winfield, University of Plymouth