Global emergence of nurse practitioner/advanced practice nursing roles.
There is growing recognition worldwide that advanced nursing practice (ANP) in diverse clinical settings should be developed, acknowledged, and legitimized. Based on membership in the International Council of Nurses (ICN) Nurse Practitioner (NP)/Advanced Practice Nurse (APN) Network, over 90 countries indicate an interest in ANP; however, this does not represent an active presence of these roles. Circumstances that influence a willingness to explore ANP as an option for provision of health care services include physician shortages, health care reform, increased demand for highly specialized nurses, greater emphasis on primary care, expanded home based care, and a desire to enhance the professional status of nurses (Buchan, O'May, Dussault, 2013; Delamaire LaFortune, 2010; Schober, 2016) The predicted global deficit of 12.9 million physicians, nurses, and midwives by 2035 has accelerated a renewed examination of skill mix including options for introducing new types of health care professionals such as APNs (World Health Organization [WHO] 2013) When defining and redefining roles for health care professionals, enthusiasm and motivation to support a climate of advocacy for change are not enough. The evolving international dynamics necessitates clarity on who the APN is and the place of advanced nursing roles within the health care sector; however, diversity reigns as different countries and regions select a variety of titles, definitions, and scopes of practice when attempting to describe this new nursing discipline. Internationally, the terms APN, ANP and NP are often used interchangeably, contributing to confusion and lack of clarity in role definition. While recognizing that "NP" is the most prevalent advanced nursing role in the United States, for the purpose of this article, ANP is used as a comprehensive term referring to the discipline or field of advanced clinical nursing. Advanced practice nurse refers to the nurse practicing in an advanced clinical capacity (Schober, 2016)
Journal of the American Association of Nurse Practitioners