Advanced practice nurse roles in Europe: Implementation challenges, progress and lessons learnt.

Area of Science:

• Nursing
• Healthcare Policy
• Health Services Research

Background:

• Advanced practice nursing (APN) roles enhance healthcare access, quality, and timeliness.
• Significant disparities exist in APN role implementation across European countries.

Purpose of the Study:

• To investigate the implementation of APN roles across diverse European nations.
• To identify factors that either promote or impede the successful integration of APN roles.

Main Methods:

• A qualitative case study approach was employed to evaluate APN role implementation.
• Interviews were conducted with 28 key informants from government, regulatory bodies, nursing associations, and universities in eight European countries (four with developed APN roles, four with implemented roles).
• The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Main Results:

• Four key themes emerged: rationale for role development, influence, the evolutionary nature of role development, and evidence.
• A notable discrepancy was observed in the early-stage perceptions of role development across different countries.
• The implementation process for APN roles can span 15-20 years.

Conclusions:

• Successful APN role implementation hinges on a collaborative tripartite approach involving managers, practitioners, and educators.
• Policy and regulation typically follow the evolutionary development of APN roles.
• APN policy formulation should prioritize patient needs over workforce or professional demands.