title: The role of nursing leadership in integrating clinical nurse specialists and nurse practitioners in healthcare delivery in Canada.
abstract: Supportive nursing leadership is important for the successful introduction and implementation of advanced practice nursing roles in Canadian healthcare settings. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe and explore organizational leadership in planning and implementing advanced practice nursing roles. Leadership strategies that optimize successful role integration include initiating systematic planning to develop the roles based on patient and community needs, engaging stakeholders, using established Canadian role implementation toolkits, ensuring utilization of all dimensions of the role, communicating clear messages to increase awareness about the roles in the organization, creating networks and facilitating mentorship for those in the role, and negotiating role expectations with physicians and other members of the healthcare team. Leaders face challenges in creating and securing sustainable funding for the roles and providing adequate infrastructure support.
authors.affiliation: Junior Faculty, CHSRF/CIHR Program in Advanced Practice Nursing, McMaster University, Hamilton, ON.
authors.forename: Nancy
authors.initials: N
authors.lastname: Carter
authors.forename: Ruth
authors.initials: R
authors.lastname: Martin-Misener
authors.forename: Kelley
authors.initials: K
authors.lastname: Kilpatrick
authors.forename: Sharon
authors.initials: S
authors.lastname: Kaasalainen
authors.forename: Faith
authors.initials: F
authors.lastname: Donald
authors.forename: Denise
authors.initials: D
authors.lastname: Bryant-Lukosius
authors.forename: Patricia
authors.initials: P
authors.lastname: Harbman
authors.forename: Ivy
authors.initials: I
authors.lastname: Bourgeault
authors.forename: Alba
authors.initials: A
authors.lastname: DiCenso
mesh_terms: D057179:Advanced Practice Nursing / Q000458:organization & administration*; D001364:Awareness; D002170:Canada; D003695:Delivery of Health Care / Q000458:organization & administration*; D017144:Focus Groups; D006291:Health Policy; D006295:Health Resources; D006801:Humans; D008611:Mentors; D009720:Nurse Clinicians / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D012933:Social Identification