Honduran nurses' perceptions of advanced nursing care competencies for adults in emergency and critical care: a...

In Central America, the implementation of APN is still in its early stages, with limited regulatory support, or structured training for advanced nursing practice in critical care. The absence of these roles leaves significant gaps in critical and emergency care quality, further exacerbating health disparities which need to be explore deeply.

To explore the Honduran Nurses' Perspectives on Advanced Nursing Care Competencies for Adults in Emergency and Critical Care.

A qualitative design was employed, using in-depth interviews with 15 Honduran critical care and emergency nurses from a public hospital in northern Honduras. Data were analyzed through participants' narratives, following Colaizzi's steps.

Three central themes, and eight subthemes emerged. Firstly, the perspectives on APN in critical and emergency care indicate a lack of clarity among nurses about what constitutes APN, often confusing it with CNS; Secondly, essential competencies for APN in critical care, which highlight the critical procedural and cognitive skills necessary for effective nursing care. Lastly, the barriers to autonomy and advancement in critical care APN, and it underscore the challenges posed by inadequate training, limited resources, and insufficient legal support, which hinder nurses' autonomy and professional growth.

The study reveals a fragmented understanding of APN roles, with participants recognizing the need for advanced competencies while highlighting the lack of formal recognition, certification, and institutional support. Participants emphasized the importance of postgraduate education, leadership, and procedural autonomy but noted that their clinical roles remain limited by systemic, educational, and regulatory barriers. These insights underscore the urgency of developing clear frameworks, training pathways, and policy support to promote APN as a viable and distinct professional roles.