title: The acute care nurse practitioner role in Canada.
abstract: The acute care nurse practitioner (ACNP) role was developed in Canada in the late 1980s to offset rapidly increasing physician workloads in acute care settings and to address the lack of continuity of care for seriously ill patients and increased complexity of care delivery. These challenges provided an opportunity to develop an advanced practice nursing role to care for critically ill patients with the intent of improving continuity of care and patient outcomes. For this paper, we drew on the ACNP-related findings of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing. The synthesis revealed that ACNPs are working in a range of clinical settings. While ACNPs are trained at the master's level, there is a gap in specialty education for ACNPs. Important barriers to the full integration of ACNP roles into the Canadian healthcare system include lack of full utilization of role components, limitations to scope of practice, inconsistent team acceptance and funding issues. Facilitators to ACNP role implementation include clear communication about the role, with messages tailored to the specific information needs of various stakeholder groups; supportive leadership of healthcare managers; and stable and predictable funding. The status of ACNP roles continues to evolve across Canada. Ongoing leadership and continuing research are required to enhance the integration of these roles into our healthcare system.
authors.affiliation: Department of Nursing, Université du Québec en Outaouais, CHSRF/CIHR Program in Advanced Practice Nursing, St-Jérôme, QC.
authors.forename: Kelley
authors.initials: K
authors.lastname: Kilpatrick
authors.forename: Patricia
authors.initials: P
authors.lastname: Harbman
authors.forename: Nancy
authors.initials: N
authors.lastname: Carter
authors.forename: Ruth
authors.initials: R
authors.lastname: Martin-Misener
authors.forename: Denise
authors.initials: D
authors.lastname: Bryant-Lukosius
authors.forename: Faith
authors.initials: F
authors.lastname: Donald
authors.forename: Sharon
authors.initials: S
authors.lastname: Kaasalainen
authors.forename: Ivy
authors.initials: I
authors.lastname: Bourgeault
authors.forename: Alba
authors.initials: A
authors.lastname: DiCenso
mesh_terms: D000208:Acute Disease; D057179:Advanced Practice Nursing / Q000193:education / Q000458:organization & administration* / Q000592:standards; D002170:Canada; D002983:Clinical Competence; D003479:Curriculum; D003695:Delivery of Health Care / Q000458:organization & administration*; D004521:Educational Measurement; D004522:Educational Status; D017144:Focus Groups; D006291:Health Policy; D006801:Humans; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration* / Q000592:standards; D024802:Nurse's Role; D011792:Quebec