An International Survey on Advanced Practice Nursing Education, Practice, and Regulation

Abstract

Purpose: To describe international trends on the developing role of the nurse practitioner‐advanced practice nurse (NP‐APN), including nomenclature, levels and types of NP‐APN education, practice settings, scope of practice, regulatory policies, and political environment. Design: A cross‐sectional, descriptive Web‐based survey sent in February and March 2008 to a total of 174 key informants and active members of the International Nurse Practitioner‐Advanced Practice Nursing Network of the International Council of Nurses. Methods: An international Web‐based survey preceded by a pilot survey. Findings: Ninety‐one nurses from 32 countries responded. Thirteen titles were identified on nomenclature for the NP‐APN in different countries. NP‐APN education was available in 71% of the 31 countries responding to this item, with 50% identifying the master's degree as the most prevalent credential. Twenty‐three countries had formal recognition of the NP‐APN role. Of these, 48% had licensure maintenance or renewal requirements for the NP‐APN, with most requiring continuing education or clinical practice. The greatest support for the NP‐APN role came from domestic nursing organizations (92%), individual nurses (70%), and the government (68%), while opposition came primarily from domestic physician organizations (83%) and individual physicians (67%). Conclusions: Interest in the NP‐APN role has been gaining ground worldwide. This study presents a snapshot of education, practice, and regulation for NP‐APNs as they develop their unique role in delivering health care in various countries. Areas that may require more support are highlighted. Clinical Relevance: The NP‐APN role in healthcare systems is expanding and will benefit from international networking and support.