310 Chapter 12 DEMONSTRATING INDEPENDENT NURSING PRACTICE Ma. Brige N'e T. Lao-Nario Globo Jly. countries Llult arc in memhcri;hip with Lhe lntcrnnt ionnl Council of Nu,rses (JCN) are developing inn()vntive models: of c.,re that thrust nurses into new roles and responsibilities. 111ese new models create changes in the boundaries of nursing practice. Mm·h interest ha.-. been genernted in the development of advam;c nursing practice (A. NP) and nurse entrepreneurship which have different faces in v(lry:ing countries depending on the needs of the l>l!ople r CN has identified characteristics of ANT' by three (3) dimensions. namely: educational preparation. nature of pr. ictice and regulatory mechanism. ANPs have advanced level of an educational program and :'. I fom1al system of licensurc. registration and certification or credentialing (Schober and Affara 2006: 23). They :ilso demonstrate a high<'r npgree of :rntonomy and independen1 pr:ictice and ha,·e a<lvan<'cn ;is.-;cssment and decision-making skills,,;th recogni7. t!d adqmced dinic. 11 competencies. Aside from ca!<t! management. ther also have the ability to integrate research, education and clinkal mana~cment, perfonn case management, a J1d provide consultant services to other health professionals and are recogni7,ed as first point of entry for services. There are country-speci fic regulations that grant authorities for ANPs the right to prescribe medic..,tions and treatments and aut J1ority to refer to other professionals, admit lo hospitals and title protection. On the oilier hand., we bave the nurse entrepreneurs and intr:iprcneur who have Ll,e ability lo perform a wide range of acth-ilies and services wilh focus on healt J1 promotion, diseal-<' prevention. rehabilitation and management coni;:ultanc;ics. Based on the IC. "N definition. a nurse inlr::ipreneur is "a proprietor of a b11sin('. 'l S I hat offers nursing services of a direct care, educ. 1 Lfr,nal research, ;idm in isl r:J Hvr· or consu ltativc nature" (ICN 2004: 4). 111 this arr:ingemcn1. t J1c nur.-c is account1,1l,lc to the client to \,·horn the services arc offered. A nurse intraprencur as ICN <lcfines is ",J salaried nurse who develops, promote:. s and dcli\'Cr.. inncwativc health. 11ursing programm e or projects within a given health care setting" (JCN 2004:,i). In most countries. nurses are legally pcrmit1ed to offer nursing services tlrnt fa Jls ,,,,ithin the domain of the nursing pr3ct,ic-e-act. s or nttr. ;ing I. aw. They are at a liberty of offering i. ndependenl practfre tn areas of health promotion, disease prevention tmd rehabilitation. The,-ision of the go"emment as retleciod in the Medium Term Ocvcloprnent Plan of 2004-2n10 is to 11ttain.. He:ilth for All Filipino~-anti the mi-. sion i. <: to cn;;urc ncccssible and quality hca Jth care to improve the qualityoflife of all Filipinos espccial Jy the poor. (NOH 2005-2010 ; 35) This includes health sen·iccs that are responsive, accessible and affordable to the peopte. 