Opinion

International outlook on advance practice nursing

Study confirms countries taking an active approach to gain advanced practive nursing.
Prescription

The development of advanced practice nursing roles in primary care is becoming popular in many countries and a recent study across 39 nations confirms this trend (Maier and Aiken 2016).

Nurse prescribing is well established in the UK Photo: Science Photo Library

The changes have been driven partly by shortages of doctors in primary care as well as the need to adapt to and deal with the rising numbers of patients with chronic conditions.

The study did show, however, there were significant differences in the scope of practice of nurses taking on expanded clinical roles.

In the US, Australia, Canada, New Zealand and the UK there has been extensive task shifting from doctors, including the introduction of nurse prescribing, whereas countries such as Spain have only recently changed laws to allow this.

Learning from early adopters

For those countries recently introducing

...

The development of advanced practice nursing roles in primary care is becoming popular in many countries and a recent study across 39 nations confirms this trend (Maier and Aiken 2016).

Prescription web
Nurse prescribing is well established in the UK
 Photo: Science Photo Library

The changes have been driven partly by shortages of doctors in primary care as well as the need to adapt to and deal with the rising numbers of patients with chronic conditions.

The study did show, however, there were significant differences in the scope of practice of nurses taking on expanded clinical roles.

In the US, Australia, Canada, New Zealand and the UK there has been extensive task shifting from doctors, including the introduction of nurse prescribing, whereas countries such as Spain have only recently changed laws to allow this.

Learning from early adopters

For those countries recently introducing advanced level roles, there is much to learn from early adopters like the US, the successes but also the unnecessary restrictions on practice from initial overcautious approach.

In Europe, despite having minimum standards for initial nurse education for many years across the EU, we are a long way from common education requirements or levels of practice linked to consistent titles for advanced nurse practitioners.  

But there has already been plenty of learning between nursing organisations on how to muster the arguments and evidence to persuade regulators and legislators to make expanded roles for nursing possible.

Poland is the latest country to take this route.

References

Maier C, Aiken L (2016) Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study, European Journal of Public Health. doi: doi.org/10.1093/eurpub/ckw098 


About the author

Susan Williams is senior international adviser at the RCN

 

 

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