title: Advanced practice nursing in Canada: overview of a decision support synthesis.
abstract: The objective of this decision support synthesis was to identify and review published and grey literature and to conduct stakeholder interviews to (1) describe the distinguishing characteristics of clinical nurse specialist (CNS) and nurse practitioner (NP) role definitions and competencies relevant to Canadian contexts, (2) identify the key barriers and facilitators for the effective development and utilization of CNS and NP roles and (3) inform the development of evidence-based recommendations for the individual, organizational and system supports required to better integrate CNS and NP roles into the Canadian healthcare system and advance the delivery of nursing and patient care services in Canada. Four types of advanced practice nurses (APNs) were the focus: CNSs, primary healthcare nurse practitioners (PHCNPs), acute care nurse practitioners (ACNPs) and a blended CNS/NP role. We worked with a multidisciplinary, multijurisdictional advisory board that helped identify documents and key informant interviewees, develop interview questions and formulate implications from our findings. We included 468 published and unpublished English- and French-language papers in a scoping review of the literature. We conducted interviews in English and French with 62 Canadian and international key informants (APNs, healthcare administrators, policy makers, nursing regulators, educators, physicians and other team members). We conducted four focus groups with a total of 19 APNs, educators, administrators and policy makers. A multidisciplinary roundtable convened by the Canadian Health Services Research Foundation formulated evidence-informed policy and practice recommendations based on the synthesis findings. This paper forms the foundation for this special issue, which contains 10 papers summarizing different dimensions of our synthesis. Here, we summarize the synthesis methods and the recommendations formulated at the roundtable.
authors.affiliation: Ontario Training Centre in Health Services & Policy Research, Nursing and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON.
authors.forename: Alba
authors.initials: A
authors.lastname: DiCenso
authors.forename: Ruth
authors.initials: R
authors.lastname: Martin-Misener
authors.forename: Denise
authors.initials: D
authors.lastname: Bryant-Lukosius
authors.forename: Ivy
authors.initials: I
authors.lastname: Bourgeault
authors.forename: Kelley
authors.initials: K
authors.lastname: Kilpatrick
authors.forename: Faith
authors.initials: F
authors.lastname: Donald
authors.forename: Sharon
authors.initials: S
authors.lastname: Kaasalainen
authors.forename: Patricia
authors.initials: P
authors.lastname: Harbman
authors.forename: Nancy
authors.initials: N
authors.lastname: Carter
authors.forename: Sandra
authors.initials: S
authors.lastname: Kioke
authors.forename: Julia
authors.initials: J
authors.lastname: Abelson
authors.forename: R James
authors.initials: RJ
authors.lastname: McKinlay
authors.forename: Dianna
authors.initials: D
authors.lastname: Pasic
authors.forename: Brandi
authors.initials: B
authors.lastname: Wasyluk
authors.forename: Julie
authors.initials: J
authors.lastname: Vohra
authors.forename: Renee
authors.initials: R
authors.lastname: Charbonneau-Smith
mesh_terms: D057179:Advanced Practice Nursing / Q000145:classification / Q000379:methods* / Q000458:organization & administration*; D002170:Canada; D020000:Decision Support Systems, Clinical / Q000145:classification / Q000458:organization & administration*; D017144:Focus Groups; D019538:Health Care Surveys; D006291:Health Policy; D006801:Humans; D007857:Leadership; D009720:Nurse Clinicians / Q000145:classification / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000145:classification / Q000458:organization & administration*; D010506:Periodicals as Topic / Q000706:statistics & numerical data; D011643:Publishing / Q000706:statistics & numerical data