Nursing actions indicative of autonomy and authority compatible with Advanced Nursing Practice in Brazil
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Updated: Oct 31, 2026

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Published on: April 7, 2026
Emerson Willian Santos de Almeida1, Simone de Godoy1, Maria Alice Barbosa Fortunato2
1Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.
Objective:
this study analyzed representative actions indicating autonomy and clinical authority among nurses in primary health care, compatible with Advanced Nursing Practice in Brazil.
Method:
the ecological study used secondary data from 2023 from the Brazilian Ministry of Health's information system, covering all 26 states and the Federal District. Indicators related to consultations, medication prescriptions, diagnostic tests, and clinical referrals were examined.
Results:
the results reveal a wide range of activities performed by nurses in areas characteristic of Advanced Nursing Practice, while also showing significant geographical inequality, predominantly in the Southeast and South regions.
Conclusion:
the analysis reveals the effective exercise of advanced competencies, even without specific regulations, and highlights the need for public policies that promote specialized training, regulatory standardization, and the legal recognition of Advanced Nursing Practice to improve the quality and equity of health care.
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