International Organizations and Conceptualizations of Advanced Practice Nursing

In this section, issues of a common language and conceptual framework for advanced practice nursing are addressed. International perspectives on advanced practice nursing are covered more extensively in Chapter 5.

The Role of the ICN in Advanced Practice Nursing

The ICN Nurse Practitioner/Advanced Practice Nursing Network (2020) defines a nurse practitioner/advanced practice nurse as “a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice.” A master’s degree is recommended for entry-level (ICN Nurse Practitioner/Advanced Practice Nursing Network, 2020). Key concepts include educational preparation, the nature of practice, and regulatory mechanisms. The statement is necessarily broad, given the variations in health systems, regulatory mechanisms, and nursing education programs in individual countries.

CNA’s Contribution to Advanced Nursing Practice

In 2008, the Canadian Nurses Association (CNA) published “Advanced Nursing Practice: A National Framework,” which defined advanced nursing practice, described educational preparation and regulation, identified the two APRN roles (Clinical Nurse Specialist [CNS] and Nurse Practitioner [NP]), and specified competencies in clinical practice, research, and leadership. The CNA also issued position statements on advanced nursing practice that affirm the key points in the national framework document and define and describe the roles and contributions to health care of NPs and CNSs.

Key Concepts and Frameworks by the CNA

In 2010, the CNA published a Core Competency Framework for NPs, which included the incorporation of theories of advanced practice nursing. This framework is vital for understanding the competencies required by advanced practice nurses in Canada and aligning them with global standards set by organizations such as the ICN.

The CNA’s 2019 publication, the Pan-Canadian framework for advanced practice nursing, not only distinguishes the role of the CNS from that of the NP but also strengthens it and aligns it with ICN competencies. This alignment ensures that Canadian advanced practice nurses meet both national and international standards.

Evidence-Based Approach in Canada

Leaders in Canadian nursing have undertaken an evidence-based, patient-centered, coordinated effort (called a decision support synthesis) to develop, implement, and evaluate the advanced practice nursing roles of the CNS and NP in Canada. This process differs from the approach used in the United States, focusing on a comprehensive review of literature and stakeholder engagement.

The European Perspective: ESNO’s Competency Framework

The European Specialist Nurses Organisations (ESNO) has also made significant contributions to the conceptualization of advanced practice nursing. In 2015, ESNO defined 10 core (generic) competencies of CNS practice in Europe. These competencies cover various aspects, including clinical role, patient relationship, patient teaching/coaching, mentoring, research, organization and management, communication and teamwork, ethics and decision making, leadership/policymaking, and public health.

These competencies were developed to clarify the role of the CNS and include advanced knowledge in anatomy, physiology, pathophysiology, and pharmacology, similar to the APRN Consensus Model. The emphasis is on collaboration with other health professionals to deliver high-quality patient care, ensuring safety, quality of care, and equity of access to promote health and prevent disease.

FAQ on International Organizations and Conceptualizations of Advanced Practice Nursing

Q: What is the role of the ICN in advanced practice nursing?
A: The ICN plays a crucial role in defining and promoting the standards for advanced practice nursing worldwide. They develop global competencies, advocate for nursing roles, and influence health policies internationally.

Q: How does the CNA’s framework differ from other international standards?
A: The CNA’s framework is tailored to the Canadian context but aligns with global standards, such as those set by the ICN. It emphasizes competencies specific to Canadian healthcare while ensuring that Canadian nurses meet international benchmarks.

Q: What are the core competencies defined by ESNO for CNS practice in Europe?
A: ESNO has defined 10 core competencies for CNS practice, covering areas such as clinical role, patient relationship, mentoring, research, communication, and leadership. These competencies are designed to ensure high standards of care and collaboration across healthcare systems in Europe.

The Global Impact on Advanced Practice Nursing

International organizations like the ICN, CNA, and ESNO play a pivotal role in shaping the conceptualization and practice of advanced practice nursing. Their frameworks and competencies ensure that advanced practice nurses are equipped with the knowledge and skills necessary to meet the demands of diverse healthcare environments, ultimately improving patient outcomes worldwide.