Factors enabling advanced practice nursing role integration in Canada

Area of Science:

• Nursing
• Healthcare Policy
• Health Services Research

Background:

• Advanced practice nurses (APNs) have a long history in Canada, with proven safety and effectiveness.
• Despite evidence, APNs face challenges in full integration within the Canadian healthcare system.
• Understanding enabling factors for APN role development and implementation is crucial.

Purpose of the Study:

• To identify factors enabling the development and implementation of advanced practice nursing roles in Canada.
• To synthesize findings from a scoping review and key informant interviews for decision support.
• To inform policy and practice recommendations for APN integration.

Main Methods:

• Scoping review of Canadian literature from 1990 onwards.
• Interviews and focus groups with 81 key informants.
• Decision support synthesis to identify enabling factors for APN roles.

Main Results:

• Enabling factors for APN role development include a pan-Canadian approach, quality education, and legislative mechanisms at the federal/provincial/territorial (F/P/T) level.
• Implementation requires F/P/T actions like recruitment, funding, public awareness, and leadership support.
• Organizational factors include role clarity, setting support, and continuing education; inter-professional relations need action at both levels.

Conclusions:

• Systematic planning at F/P/T and organizational levels is essential for APN role development.
• Addressing recruitment, funding, public awareness, and inter-professional relations is key for APN role implementation.
• Policy and practice recommendations were formulated by a multidisciplinary roundtable to facilitate APN integration.