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Bridging Levels of Influence: Insights on Policies for Integrating Nurse Practitioners Into Health Systems Comment on
Efrat Shadmi1, Ruth Palan Lopez2
1The Cheryl Spencer Dapartment of Nursing, The Azrieli Advanced Nursing Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Abstract:
A taxonomy of policy interventions for integrating nurse practitioners (NPs) into health systems is a valuable tool for addressing implementation barriers across macro (policy), meso (organizational), and micro (clinical) levels. In this commentary we highlight how academic institutions serve as vital conduits between policy, education, and clinical implementation. We explore the role of universities in aligning NP workforce development with system needs through research, interprofessional training, and policy engagement. We highlight macro-meso mismatches, particularly when educational capacity outpaces organizational readiness to employ NPs. Advancing NP roles requires coordinated efforts across sectors, and academia, through evidence generation, cross-level engagement, and training innovation, plays a central role in operationalizing the taxonomy and strengthening the contribution of advanced nurses to healthcare systems. Nonetheless, we recognize that academic institutions can at times be inflexible and therefore suggest considering hybrid academic-professional training structures. We conclude with a set of recommendations for research and policy.
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