Advanced nursing practice: a global perspective.
OBJECTIVE
To review the titles, roles and scope of practice of Advanced Practice Nurses internationally.


BACKGROUND
There is a worldwide shortage of nurses but there is also an increased demand for nurses with enhanced skills who can manage a more diverse, complex and acutely ill patient population than ever before. As a result, a variety of nurses in advanced practice positions has evolved around the world. The differences in nomenclature have led to confusion over the roles, scope of practice and professional boundaries of nurses in an international context.


METHODS
CINAHL, Medline, and the Cochrane database of Systematic Reviews were searched from 1987 to 2008. Information was also obtained through government health and professional organisation websites. All information in the literature regarding current and past status, and nomenclature of advanced practice nursing was considered relevant.


RESULTS
There are many names for Advanced Practice Nurses, and although many of these roles are similar in their function, they can often have different titles.


CONCLUSIONS
Advanced Practice Nurses are critical for the future, provide cost-effective care and are highly regarded by patients/clients. They will be a constant and permanent feature of future health care provision. However, clarification regarding their classification and regulation is necessary in some countries.
Duffield
Christine
C
Centre for Health Services Management, University of Technology, Sydney, Australia. Christine.Duffield@uts.edu.au
Gardner
Glenn
G
Chang
Anne M
AM
Catling-Paull
Christine
C
D044362:Australasia; D006801:Humans; D038622:Internationality; D009656:North America; D009720:Nurse Clinicians; D009722:Nurse Practitioners; D024802:Nurse's Role; D006113:United Kingdom