DiCenso, Martin-Meisener, Bryant- Lukosius, et al., 2010 ), a process different from the one used to advance APN roles in the United States. This process included a review of 468 published and unpublished articles and interviews conducted with 62 key informants and four focus groups that included a variety of stakeholders. The purpose of this work was to “describe the distinguishing characteristics of CNSs and NPs relevant to Canadian contexts,” identify barriers and facilitators to effective development and use of APN roles, and inform the development of evidence-based recommendations that individuals, organizations, and systems can use to improve the integration of APNs into Canadian health care. Section Summary: Implications for Advanced Practice Nursing Conceptualizations From this overview of organizational statements that clarify and advance APN practice, it is clear that nationally and internationally, stakeholders are engaged in a more active dialogue about advanced practice nursing and progress has been made in this area since the last edition. Progress includes global agreement that there is a type of clinical nursing practice that is advanced and builds on basic nursing education, requiring additional education and characterized by additional competencies and responsibilities. In the United States, the consensus on an approach to APRN regulation was critical for the following reasons: (1) clarifying what is an APN and the role of graduate education and certification in licensing APRNs; (2) ensuring that APNs are fully recognized and integrated in the delivery of health care; (3) reducing barriers to mobility of
APNs across state lines; (4) fostering and facilitating ongoing dialogue among APN stakeholders; and (5) offering common language regarding regulation. Although there may not be agreement on the DNP as the requirement for entry into advanced practice nursing, the promulgation of the document fostered dialogue nationally and within APN organizations on the clinical doctorate (whether or not it is the DNP) as a valid and likely path for APNs to pursue. As a result, each APN organization has taken a stand on the role of the clinical doctorate for those in the role and has developed or is developing doctoral level clinical competencies. In doing so, it appears that the needs of their patients, members, other constituencies, and contexts have been considered. Until the time when a clinical doctorate becomes a requirement for entry into practice for all APN roles, the development of doctoral level competencies for APN roles will help stakeholders distinguish between master's- and doctorate-prepared APNs with regard to competencies. MacDonald, Herbert, & Thibeault (2006) have suggested that a common identity for advanced practice nurses is worth pursuing. It will most likely be through regulatory mechanisms that a consistent definition of advanced practice nursing and authority to practice, in particular APN roles, will be established in the United States. However, it will be important to heed the caution
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- Winter '17
- Nursing, advanced practice nursing