Evolvement of French advanced practice nurses

The purpose of this review is to chronicle the development of the advanced practice nurse (APN) in France and compare international APN indictors of quality care with French studies.

A review of the literature was performed by accessing the MEDLINE, Science Direct, and Cochrane Databases for studies of quality of care by APNs during 1965-2012. The author's participation on a national task force in collaboration with the French Ministry of Health provided additional information.

After applying limits of this search, 36 studies fulfilled inclusion and exclusion criteria. In both the French and international APN nursing literature, the most frequently described quality of care measures were level of patient satisfaction and other patient outcomes (clinical and laboratory measures) according to evidence-based guidelines. In three French studies (nephrology, neuro-oncology, and urology settings), nurses performed direct patient care and were legally permitted to take on some limited responsibilities usually held by French physicians, including clinical examinations, diagnosing, and prescribing.

Creation of the APN role in France can respond to public health challenges including the rising incidence of chronic diseases and an impending physician shortage. Future APN research should focus on rigorous, innovative design development including collaborative care models.