As the only book of its kind, this publication provides students, clinicians, researchers, ministries of health, and others with a valuable, thorough, and focused understanding of the development of the nurse practitioner (NP) and nurse anesthetist (NA), two advanced practice nursing roles which have improved access to care and healthcare outcomes as bilateral role development has progressed internationally. As the two roles have significant clinical differences, the book will appraise each role separately within two sections utilizing different approaches. After a thorough platform of defining and describing each role, including history and origins, education, practice, regulation, and leadership, the book guides by example, utilizing unique country case studies divided by WHO regions as exemplars for international role development as well as an outlook for the future of advanced practice nursing on the global stage. The book expands on the tenets and principles as outlined in the ICN Guidelines on Advanced Practice Nursing for Nurse Practitioners (2020) and Nurse Anesthetists (2021), providing the reader with an internationally vetted and accepted comprehension of the roles, guiding and inspiring future role development to improve global health care.
Author(s): Sophia L. Thomas, Jackie S. Rowles
Series: Advanced Practice in Nursing
Publisher: Springer-ICN
Year: 2023
Language: English
Pages: 443
City: Geneva
Preface
Contents
Part I: The Role of the Nurse Practitioner
Evolution in Healthcare: The Journey from a US Demonstration Project to an International Concept
Introduction
History of Nurses in Public Health
Early Development of Expanded Role
A Demonstration Project
Geopolitical Factors Facilitating Healthcare Revolution
Expansion of Nurse Practitioner Programs
Challenges to Role Expansion
Nursing Opposition
Physician Opposition
Education
Certification
Titling
Scope of Practice
Landmark Studies
Regulation
Reimbursement
Prescriptive Authority
Real-Life Stories by Nurse Practitioners
Academic Medical Center
Private Pediatric Group Practice
Primary Care Community Center
Lack of Unity: The Formation of Nurse Practitioner Organizations
International Collaboration
Reaching Consensus in the United States
The Journey
Bibliography
The Global Emergence of the Nurse Practitioner Role
Introduction
The International Council of Nurses’ Nurse Practitioner Definition
Factors Influencing Consideration of the Nurse Practitioner Concept
Approaching Global Nurse Practitioner Development
Country Exemplars
Australia
Botswana
Canada
Republic of Ireland
Jamaica
New Zealand
UK (England, Northern Ireland, Scotland, Wales)
International Influence
International Council of Nurses (ICN)
World Health Organization (WHO)
Conclusion
References
Differentiation of International Advanced Practice Nursing Roles: NP and CNS
Introduction
Historical Background of the NP and CNS
Historical Background of the NP
Historical Background of the CNS
Terminology
Definition of Nurse Practitioner (NP)
Definition of Clinical Nurse Specialist (CNS)
Definitive Continuum for the NP and the CNS
ICN Position on the Clarification of Advanced Practice Nursing Designations
Conclusion
References
Nurse Practitioner Education and Curriculum: A US Focus
Introduction
History and Evolution of NP Education
Education for NPs
US Entry into Practice
Global Entry to Practice
NP Educational Path to Practice
NP Curriculum Development
Curriculum Design
Competency and Curriculum Mapping
Innovations in NP Education
DNP as an Entry to Practice
NP Education Delivery Methods
In-Person
Online and Hybrid
Supervised Clinical Practice
Instructional Design for Adult Learners
Interprofessional Education and Practice
Simulation
Conclusion
References
NP Practice Competencies
Introduction
How Are NP Competencies Developed?
How Are NP Competence Established?
Science of Practice
Care of an Individual and Population
Health Systems Practice
Leadership of Self and Other
How to Use Competencies Documents at the Institutional Level
Frameworks to Evaluation Competencies
Competency-Based Education
Conclusion
References
The Nurse Practitioner as a Leader
What Is Leadership?
The Nurse Practitioner as Leader
Vision of NP Leadership
A Global Lens
Conclusion
References
The NP and Research: A Global Perspective
Purpose
Background
Process
Findings
Limitations
Discussion
Conclusion
References
Nurse Practitioner Outcomes Evaluation
Introduction
Demonstrating Outcomes of NPs
Showcasing NP Impact
Exemplar: Highlighting the Impact of the NP Role During the COVID-19 Pandemic
Exemplar: Emphasizing the Impact of NP-Led Initiatives to Improve Patient Care Outcomes
Summary
References
Part II: NP Country Exemplars
The Nurse Practitioner in the USA: Role Exemplars
Introduction
Development of the NP Role in the USA
Legislative Efforts
Geographical and Demographical Concerns in the USA
Consensus Model
Nurse Practitioner Roles in the USA
Nurse Practitioner Programs
Nurse Practitioner Certification
Exemplar of the Acute Care NP
Exemplars of the Primary Care NP
Exemplars of the Psychiatric/Mental Health NP
Conclusion
References
The NP Role and Practice in Canada
Introduction
Historical Evolution of NP Role, Education, Regulation, and Practice
Current State of NP Roles, Education, Regulation, and Practice
Unique Canadian NP Leadership Examples
The Nurse Practitioner Association of Canada
The Principal Nursing Advisors Task Force
Nurse Practitioner-Led Clinics
Nursing Policy Secretariat
Nurse Practitioner Leaders in Chief/Executive/Director Roles
Unique Canadian Contributions to NP Role Development, Implementation, and Evaluation Globally
Canadian Centre for Advanced Practice Nursing Research
The PEPPA and PEPPA-Plus Frameworks
Conclusion
References
The Nurse Practitioner Role and Practice in Jamaica
Introduction
Historical Evolution of the NP Role, Regulation and Practice
NP Education
Scope of Practice
Areas of Practice
Family Nurse Practitioner
Mental Health/Psychiatric Nurse Practitioner
MHPNP Competencies
Nurse Educator
Prescribing
Practice
Leadership
Professional
Technical/Clinical
NP Impact/Role During the COVID-19 Pandemic
Conclusion
References
The Evolution of the Nurse Practitioner Role and Practice in the United Kingdom
Introduction
Evolution of the Nurse Practitioner Role in the United Kingdom
Nurse Practitioner Education
Nurse Practitioner Prescribing
Nurse Practitioner Regulation
Health Policy
England
Scotland
Wales
Northern Ireland
Definitions
Examples of Practice from the UK
Primary Care
Clinical Practice
Leadership and Management
Education
Research
Secondary Care
Clinical Practice
Leadership and Management
Education
Research
Conclusion
References
The NP Role and Practice in Finland
Background
Nursing Education in Finland
Regulation
Advanced Practice Nursing in Finland
Nurse Practitioner
Clinical Nurse Specialist
Nurses’ Limited Prescription Rights
Vision for the Future
References
The Nurse Practitioner Role in Ireland
Background
Professional Frameworks
Registration/Regulation
National Education Framework
Policy Directions
Conclusion
References
Nurse Practitioner Development in German-speaking Countries: Germany, Austria, and Switzerland
Introduction
The context of Nurse Practitioners in Germany
Role Distinction
NP Research Developments in Primary Health Care
The NP Role in Austria
History of APN in Austrian Health Care System
Current State of APN in Austrian Health Care System
The Way Forward
Advanced Nursing Practice in Switzerland
Conclusion
References
The Nurse Practitioner Role and Practice in Botswana
Introduction
Background
Country Profile
Health Care System
History of Nursing and the Nurse Practitioner Development in Botswana
Early Years
Nurse Practitioner Role Development
Nurse Practitioner Role and Scope of Practice in Botswana
Nurse Practitioners in Botswana
Licensure and Regulation of the Nurse Practitioner Role
Diploma Program Licensure
Master’s Degree Program Licensure
Nurse Practitioner Scope of Practice
Nurse Practitioner Prescriptive Authority
A Typical Workday for a Family Nurse Practitioner in Botswana
The Future of the Nurse Practitioner in Botswana: Challenges and Advancement
Conclusion
References
Nurse Practitioner Role in Kenya
Introduction
Kenyan Context
History of Nursing in Kenya
Drivers for Nurse Practitioner Role
Nurse Practitioner’s Scope of Practice in Kenya
Future of Nurse Practitioner Role in Kenya
Conclusion
References
The Nurse Practitioner Role in Tanzania
Introduction
Background
Current Situation
Nursing Practice
The Initiative
NP Educational Preparation
Challenges to the Implementation of the Advanced Practice Nursing
Recommendation
References
The Evolution and Future of Nurse Practitioners in New Zealand
Background
The Introduction of the Nurse Practitioner Role in New Zealand
Scope of Nurse Practitioner Practice
Nurse Practitioner Education
Growing the Primary Healthcare Nurse Practitioner Workforce
Positioning the Nurse Practitioner Workforce for the Future
Nurse Practitioners as Agents of Transformational Change
References
Transforming Healthcare: The Australian Nurse Practitioner Role
Introduction
Origins of the Australian Nurse Practitioner Role
Workforce
Impact of Funding on Workforce
Scope of Practice Considerations
Education and Regulation
The Future of the Australian Nurse Practitioner Workforce
Conclusion
References
The Nurse Practitioner (NP) Role in Sri Lanka
Introduction
Background to Sri Lanka
Healthcare System in Sri Lanka
History of Medicine and Nursing in Sri Lanka
Developing Professionalism in Nursing and Education Milestones
Establishment of Undergraduate Nursing Education
Recruitment and Credentials in Nursing Sri Lanka
Nurse Practitioner Role in Sri Lanka
Challenges and Issues
References
Advanced Nursing Practice in the Kingdom of Saudi Arabia
Introduction
Nursing in Saudi Arabia
Advanced Practice Nursing in Saudi Arabia
Next Steps
References
Why Pakistan Needs Advanced Nurse and Advanced Midwife Practitioners
Background
Poverty, Heavy Population, and High Number of Vulnerable Population
Challenging Geographies from High Mountains to Spread Deserts
Natural and Man-Made Disasters
Role of Nurses, LHVs, and Midwife Practitioners at Rural Health Settings in Pakistan
Contribution of LHV/Midwives/Nurse in Improving the Health Indicators
Why Pakistan Needs Advanced Nurse and Advanced Midwife Practitioners?
Way Forward
References
The Future for International NP Role Development
Introduction
Foundations for the Future of Nurse Practitioners
Forging the Nurse Practitioner Concept
Critical Challenges
Integrating NPs into the Healthcare Workforce
International Consensus-Building Around Professional Identity of the NP: Terminology, Definition, Scope of Practice, Core Competencies, and Education
Refining Descriptive Terminology
Research: Defining the Gaps and Finding the Evidence
Conclusion
References
Part III: The Role of the Nurse Anesthetist
Challenges to Global Access to Anesthesia and Surgical Care
Overview of Access to Anesthesia and Surgical Care
How is Access to Surgical and Anesthesia Care Defined?
Policy Initiatives to Promote Access to Anesthesia and Surgical Care
WHO Global Initiative for Emergency and Essential Surgical Care (GIEESC)
WHO: Safe Surgery Saves Lives
Institute of Medicine: The Future of Nursing Leading Change, Advancing Health
Sustainable Development Goals (SDGs)
World Health Assembly Resolution 68.15 Strengthening Emergency and Essential Surgical Care and Anaesthesia as a Component of Universal Health Coverage
United Nations Resolution Adopted by the General Assembly 2019, Universal Health Coverage: Moving Together to Build a Healthier World
Action Framework for Safe and Affordable Surgery in the Western Pacific Region (2021–2030)
Scope of Practice
Factors Delaying Access to Anesthesia and Surgical Care
Infrastructure for Hospitals in LMICs
Financing to Improve Access to Anesthesia and Surgical Care
Blood Supply for Surgery
Imaging Services to Improve Surgical Care
Travel as a Barrier to Surgical Care
Culture as a Barrier to Surgical Care
Anesthesia Workforce
Comparison of Anesthesia Workforce in High-Income and LMICs
Nurse Anesthetists in Rural Areas in LMICs
Recommendations to Increase the Anesthesia Work Force in LMICs
Access to Surgery and Anesthesia Care in a High-Income Country: Japan
Indicators of Access to Surgery and Anesthesia Care in LMICs
Next Steps to Improve Access to Anesthesia and Surgical Care
References
The International Federation of Nurse Anesthetists: Past, Present, and Future
Genesis
Foundation Steps
International Standards [1, 3]
International Study [4]: About Global Nurse Anesthesia Workforce
Continuing Professional Development
International Relationship and Collaboration
International Council of Nurses (ICN)
World Health Organization (WHO)
World Federation of Societies of Anesthesiologists (WFSA)
European Specialist Nurses Organization (ESNO)
European Societies of Anesthesiologists and Intensive Care (ESAIC) and European Board of Anesthesiology (EBA)
G4 Alliance for Surgical, Obstetric, Trauma and Anaesthesia Care
IFNA Achievements
Global Leadership
Conclusion
References
Global Development of Nurse Anesthesia Education from Mid-Nineteenth Century into Today’s Advanced Nursing Practice
Introduction
Nurse Anesthesia from the Mid-Nineteenth to the Mid-Twentieth Century
A Brief Historical Overview of Nurse Anesthesia in Some Selected IFNA’s Member Countries
The Beginning and Development of Formal Nurse Anesthesia Education in Selected IFNA Member Countries from the 1950s Till Date
Transformation into an Assisting Role in Anesthesia
Development into Today’s Nurse Anesthesia Role
Scandinavian Countries
Selected Continental European Countries
Africa and Asia
Harmonizing Nurse Anesthesia Education Worldwide by Using Global Standards
Competency-Based Education (CBE)
IFNA’s Anesthesia Program Approval Process (APAP)
Benefits of APAP
Development of APAP
Categories of Approval
Eligibility
Conclusion
References
Nurse Anesthesia Recognition: Practice Challenges, Credentialing, and Title Protection
The Evolution and Credentialing of the American Nurse Anesthetist
Major Legal Challenges Against Nurse Anesthetists in the United States
Formation of the National Association of Nurse Anesthetists
The Global Voice of Nurse Anesthesia: The International Federation of Nurse Anesthetists
Now That We Are Organized, What Do We Do?
Credentialing and the Quality Imperative
Regulation of the Global Nurse Anesthesia Workforce
International Council of Nurses and International Federation of Nurse Anesthetists
Release Guidelines for Nurse Anesthetists
Next Steps for IFNA
Summary
References
Universal Health Coverage and Nurse Anesthetists
Background
Anesthesia and Surgery Human Resources
Universal Health Coverage and the Universal Right to Health
Nurse Anesthetists Fulfill the Required Elements of Human Rights-Based UHC
Available
Accessible
Acceptable
Adequate Quality
UHC Benchmarks
Scope of the Impact
Nurse Anesthetists, UHC, and Health Governance
Nurse Anesthesia Advocacy Model to Advance UHC
References
Nurse Anesthetists in Action
Introduction
History
Research into Global Nurse Anesthesia Practice
International Guidelines
Role of Professional Organizations
Validation of Practice
Task Shifting Is Not Task Sharing
Nurse Anesthetists Rise to the Occasion: CV-19
Nurse Anesthetists in Action: Practice Summaries by the WHO Regions
Africa
Education/Scope of Practice/Challenges
Regulation
Positive Outcomes and Challenges
The Americas
Education/Scope of Practice/Challenges
Regulation
Positive Outcomes/Challenges
South-East Asia
Lao People’s Democratic Republic (Laos)
Thailand
Vietnam
Education/Scope of Practice
Regulation
Positive Outcomes and Challenges
Eastern Mediterranean
Practice
Education
Regulation
Positive Outcomes and Challenges
European Region
Practice
Education
Regulation
Positive Outcomes and Challenges
Western Pacific
Practice
Education
Regulation
Positive Outcomes and Challenges
Chapter Summary
Appendix 1: Nurse Anesthetists’ Scope of Practice, ICN Advanced Practice Nursing Guidelines: Nurse Anesthetist (2021) reprinted with permission [8] (pgs. 443–444)
Appendix 2: Examples of Nurse Anesthetists’ Contributions to Healthcare Services ICN Advanced Practice Nursing Guidelines: Nurse Anesthetist (2021) reprinted with permission [8] (p. 450)
References
Nurse Anesthetists: Sharing Our Caring
Introduction
Finland
United States of America
Laos
Somaliland
Iceland
France
Indonesia
Morocco
Mercy Ships
References
