2020 has been named The International Year of the Nurse and Midwife by the World Health Organization. It celebrates both the professionals who provide a broad range of essential health services to people everywhere as well as the bicentenary of the birth of Florence Nightingale. However, the International Council of Nurses (ICN) recognises that this year needs to be more than just a celebration. It needs to be a time of action and commitment by governments, health systems and the public to support the capacity, capability and empowerment of the nursing profession to meet the growing demands and health needs of individuals and communities. Without the nursing profession, millions of people around the world will not be able to access quality, safe and affordable healthcare services. As the largest group of healthcare workers providing the vast majority of care, particularly in the primary care setting, it is not surprising that the nursing workforce investment can yield significant improvement in patient outcomes.
Advanced Practice Nursing, as discussed in this paper, refers to enhanced and expanded healthcare services and interventions provided by nurses who, in an advanced capacity, influence clinical healthcare outcomes and provide direct healthcare services to individuals, families and communities (CNA 2019; Hamric & Tracy 2019). An Advanced Practice Nurse (APN) is one who has acquired, through additional education, the expert knowledge base, complex decision-making skills and clinical competencies for expanded nursing practice, the characteristics of which are shaped by the context in which they are credentialed to practice (ICN 2008a). The Clinical Nurse Specialist (CNS)1 and Nurse Practitioner (NP) are two types of APNs most frequently identified internationally (APRN 2008; Begley 2010; Carryer et al 2018; CNA 2019; Finnish Nurses Association 2016; Maier et al. 2017, Miranda Neto et al. 2018). This guidance paper begins by providing overarching assumptions of Advanced Practice Nursing. In addition, core elements of the CNS and NP are presented in Chapters Two and Three, together with ICN’s positions on these nursing roles. In order to facilitate dialogue to distinguish two types of APNs (CNSs and NPs), practice characteristics of the CNS and NP are presented and differentiated in Chapter 4. Country exemplars provided in the Appendices depict the diversity of CNS and NP practice.
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