Table 6.
Existence of advanced nursing practice, set criteria, capabilities and its regulations by country of origin
| Country name | Existence of advanced practice nursing role: Y/N | RegulationY/N | LegislationY/N | Form of legislation/ regulatory bodies | Criteria of Advanced Nurse Practice | Roles and Capabilities | References |
|---|---|---|---|---|---|---|---|
| Australia | Y | Y | Y | Health practitioner regulatory agency | Must possess core competencies and assist in indicating the scope of nursing practice | Autonomous practitioner Prescriber |
Austrian Nursing and Midwifery Council (ACNM 2009) https://www.anmac.org.au/standards-and-review/nurse-practitioner |
| Canada | Y | Y | Y | Provincial Responsibility | Pan-Canadian framework- core competencies to autonomously diagnose, order and interpret diagnostic tests, independent proscribing | Autonomous primary care practitioner role Limited prescribing rights |
Canadian Nurses Association, Nurses Practitioners’ Association of Ontario https://www.cna-aiic.ca/en/nursing-practice/the-practice-of-nursing/advanced-nursing-practice |
| Denmark | N | N | N | Bachelor's degree in nursing regulated by Ministry of Education but advanced practice nurse role in development | Nurses specialists | Advanced nursing roles in nursing management, nursing education and public health nursing No prescribing rights |
Organisation of Economic, Co-operation and Development (OECD, 2012) and Danish Nurses Organisation, 2008) https://internationalapn.org/2014/06/29/denmark/ |
| France | N | N | N | Regulation of first level nurses is approved by the ministry of Health. Minimum qualification to advanced practice nurse has been master's level of education since 2010. |
advanced nurse practitioner role expansion is in its early stage of development | Uncertain role development Uncertain prescriptive authority |
French nursing organisation was initiated by a group of Advanced practice educated nurses in France in 2010. The French Nursing Council (2009) OECD (2006) (ICN 2008 a, b) https://internationalapn.org/2014/06/29/france/ |
| Finland | Y | N | N | Professional nursing regulated by law | Existence of registered nurse specialisation rather than advanced practice nurse role. The First advanced practice nurse graduated in 2006 |
Autonomous health care practitioner with a potentially wider scope of practice Limited prescribing authority |
https://internationalapn.org/category/europe/finland/ (Robinson and Griffiths, 2007) (Delamaire and Lafortune, 2010) |
| Germany | N | N | N | General nurse education regulated by The National Nursing Act and Ordnance of 1985 | Nationally defined professional competence and responsibilities of nurses Advanced practice nurse role will not be established in near future |
No advanced nurse practitioner role but specialist nursing role existed with no prescribing authority | OECD (2006) https://internationalapn.org/category/europe/germany/ (Sheer and Wong, 2008) |
| Hongkong | Y | Y | Y | The Nursing Council of Hongkong 1997- recognition of nurse specialist role and advanced practice nurse role | Clinical nurse specialists has been the birth of advanced practice nurse and nurse practitioners in the Hong Long health care system with greater acceptance in in-patient wards within acute hospital as well as outpatient nurse-led clinics but master's level of education has been as minimum requirement. | Varying autonomous practitioner Uncertain prescribing authority |
https://internationalapn.org/category/asia/hong-kong/ (Vernon and Jinks, 2013) |
| Ireland | Y | Y | Y | The Nurses and Midwives Act (2011) The Nursing and Midwifery Board of Ireland formerly known as An Bord Altranais |
The role is known as Registered Advanced Nurse Practitioner (Radvanced nurse practitioner for those master's degree has been a minimum requirement | Autonomous practitioner Certain treatment and prescribing authority |
https://internationalapn.org/category/europe/ireland/ (Delamaire and Lafontaine, 2010; Sheer and Wong, 2008). |
| Italy | N | N | N | Provincial College of Nursing | Role implementation is currently under development and may not be in the near future. No central control/ validation process for degree courses of nursing profession |
Role in development stages as well as treatment and prescribing |
https://internationalapn.org/category/europe/italy/ (OECD, 2006) |
| Japan | N | N | N | Japanese Nursing Association, JNA, 2006 | Two levels of nurse: registered nurse (First) & Licensed Practice Nurse (second level)-the latter is legislated by JNA- Nurse practitioner program is underway |
Role existed as practice nurse but no permitted to practise autonomously, nor treatment/ prescribing authority | https://internationalapn.org/category/asia/japan/ |
| Netherlands | Y | Y | Y | Specialist training programmes been recognised by both nursing associations and employers |
The role of advanced nurse practitioner/ APN is nurse practitioner in the Netherlands- requires a Master of Advanced Nursing Practice degree. Role introduced in 1997-predominantly incorporated within primary care |
Role existed as autonomous practitioner with treatment/ prescribing authority |
https://internationalapn.org/category/europe/netherlands/ (OECD, 2006) (Storedur and Leonard, 2010) |
| New Zealand | Y | Y | Y | Nursing Council of New Zealand Health Practitioners Competence Assurance Act |
Advanced clinician role was initiated as nurse practitioner role, introduced in 2001-minimum requirement as master's degree for nurse practitioner scope of practice | Autonomous practitioner Certain treatment/ prescribing authority |
https://international.aadvanced nurse practitioner.org/Content/docs/New_Zealand.pdf |
| Norway | Y | Y | Y | Ministry of Education and Research | Master's degree as minimum entry to become nurse practitioner | Autonomous practitioner Varying treatment/ prescribing rights |
https://www.oecd.org/els/health-systems/Item-2a-Nurses-advanced-roles-Maier-University-Technology.pdf |
| Singapore | Y | Y | Y | Singapore Nursing Board which maintains Advanced Practice Nurses Register | Role comprising Clinical Specialist Nurses and Nurse Practitioners | Variable autonomous practitioner Treatment authority permitted Prescribing right allowed under acute care protocols |
https://internationalapn.org/category/asia/singapore/ (Sheer and Wong, 2008; Tan Tock Seng Hospital, 2013). Singapore Nursing Board on https://www.healthprofessionals.gov.sg/snb |
| Spain | Y | Y | Y | General Council of Nursing Ministry of Education and Science |
Nurse practitioners Specialist Nurses Minimum requirement of master's degree |
Autonomous practitioner with treatment and prescribing authority | https://fhs.mcmaster.ca/globalhealthoffice/documents/AdvancedPracticeNurseinSpain.pdf |
| Sweden | Y | N | In development | National Board of Health and Welfare | Role existed as Nurse Specialists and Advanced Clinical Nurse specialists Master's degree |
Roles existed as advance clinical nurse specialists but not treatment/ prescribing rights nor autonomous practice |
https://internationalapn.org/category/europe/sweden/ (Lindblad, Hallman, Gillsjo, Lindblad, and Fagerstom, 2010). |
| Switzerland | Y |
N | N | Federal Level for all First level nurses | Role existence in Advanced Practice Nurse and Nurse anaesthetist Master's degree |
Role existed but no treatment/ prescribing authority nor autonomous practice |
https://internationalapn.org/2013/09/10/switzerland/ (Sprig, Schwendimann, Spichiger, Cignacco, and De Geest, 2009). |
| United Kingdom | Y | N | Emerging: Individual Health-care organisations Accredited through professional bodies |
Nursing and Midwifery Council Royal College of Nursing |
Role existence in Advanced Nurse Practitioner (advanced nurse practitioner) / Advanced Care Practitioners advanced nurse practitioner role greatly focused on Masters level of education |
Roles existed as advanced car/ clinical practitioner with prescribing authority – non -medical prescribing right Autonomous practitioner |
https://internationalapn.org/category/europe/united-kingdom/ (Morgan, 2010). (RCN, 2012) (Pulcini et al., 2009). |
| United States | Y | Y | Y | Licensed in all states and District of Columbia | Role existence in Nurse practitioners (NP), Advanced Practice Registered Nurses (APRNs), Clinical Nurse Specialists including nurse anaesthetists Role utilised in all health care settings |
Roles existed as APRN, with prescribing and treatment authority |
https://international.aadvanced nurse practitioner.org/Content/docs/USA.pdf The American Nurse Association - http://www.nursingworld.org The National Organization of Nurse Practitioner Faculty - https://nonpf.site-ym.com/ The American Association of Nurse Practitioners - https://www.aadvanced nurse practitioner.org/ |