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International Council of Nurses: Advanced Nursing Practice



International Council of Nurses: Advanced Nursing Practice

Madrean Schober, Fadwa Affara

ISBN: 978-1-405-17261-5 February 2009 Wiley-Blackwell 248 Pages

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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.

Chapter 1: Introduction.

Advanced Nursing Practice: A Growing Presence.

Advanced Nursing Practice: Patterns of Development.

Definition of Advanced Practice Nurse.



Chapter 2: Nature of Practice.


Advanced Practice Nursing (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.

- Approaching APN Prescribing.

- The Diagnosis Debate.

- Approaching APN Diagnosing.

- Hospital Privileges.

- Approaching APN Hospital Privileges.

Domains of Practice.

Practice Settings.



Chapter 3: Role and Practice Development.


Striving for the Ideal: Transitional Processes.

Assessing the Opportunity and Need for Advanced Nursing Practice.

Scanning the Environment.

- Stakeholder Analysis.

- SWOT Analysis.

Introducing and Supporting Advanced Nursing Practice.

Interfacing with Nurses, Physicians, Organisations and the Public.

- Interface with Nursing.

- Collegial Respect and Encouragement.

- Strategies for Promoting Positive Nursing Interface.

- Interface with Medicine.

- Collaboration.

- Strategies for Promoting Positive Medicine Interface.

- Interface with Organisational Structures.

- Strategies for Interfacing with Organisational Structures.

- Interface with the Public.

- Strategies for Interfacing with the Public.

Socialisation: Role Support.

- Strategies to Support New APNs.

Ethical Dimensions of the Advanced Nursing Practice Role.



Chapter 4: Regulation.


The Regulatory/Legislative Framework.

Factors Influencing the Regulatory/Legislative Systems.

Credentialing Advanced Nursing Practice.

Components of the Credentialing Framework.

- The Credentialee.

- Credentialing mechanisms.

- Credentialing the Advanced Practice Nurse.

- Accrediting Educational institutions and Programmes.

- 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 Legislative/Regulatory Systems.

- Understanding Regulatory and Legal Frameworks for Advanced Nursing Practice Advocating For Regulatory/legislative Change.

- Document Analysis.

- Advocacy Strategies.



Chapter 5: Education for Advance Nursing Practice.


Characteristics of Advanced Nursing Practice Education.

- The Case for Masters Level Education.

- Debate Around Masters Level Education.

- Country Variation in Education Philosophy, Approach and Development.

Paths of Entry Into Programmes.

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.



Chapter 6: 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.

- Starting to Write.

- Writing.

- Manuscript Preparation.

Searching for Research Funding.

International Classification for Nursing Practice ® (ICNP): A Tool for Collaborative Nursing Research.

An International Research Agenda for Advanced Nursing Practice.



Chapter 7: Future Prospects and Critical Challenges for Advanced Nursing Practice.


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.



Appendix 1 Key Informant Survey on Advanced Nursing Practice (ANP) Self-Administered Questionnaire.

Appendix 2 Scope of Practice Examples.

Appendix 3 Strengthens, Weaknesses, Opportunities, Threats SWOT).

Appendix 4 Principles to Guide Standards Development.

Appendix 5 Samples of Course Descriptions in an Advanced Nursing Practice Curriculum.

Appendix 6 Preceptor Guidelines, Student and Preceptor Evaluation Form.

Appendix 7 Checklist for authors preparing to submit an article for publication.

Appendix 8 Example of statements in an ICNP® Catalogue on Adherence to Treatment.


Bibliography from Key Informants.


"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
* Explores key issues in advanced practice nursing
* Draws on the International Council of Nurses (ICN) definition and characteristics for advanced practice
* Addresses enhanced nursing roles within the international context
* Examines standards of practice, competencies and regulation
* Provides strategies for developing advanced practice nursing initiatives
* Includes global examples of successful models for initiating advanced nursing practice