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Advanced practice nursing roles are developing globally, and opportunities for advanced practice nursing are expanding worldwide due to the need for expert nursing care at an advanced level of practice. Yet it is well recognized that barriers exist with respect to APRNs being able to practice to the full extent of their education and training. Addressing barriers to APRN practice worldwide and ensuring that APRNs are able to practice to the full extent of their education and training can help to promote optimal role fulfillment as well as assessment of the impact of the APRN role.

Advanced practice nursing (APN) and advanced practice midwifery (APM) in Kenya are critical in healthcare system strengthening by expanding access to quality care, particularly in underserved regions. Globally, the International Council of Nurses (ICN) defines APN as a level of nursing practice that requires a minimum of a master's degree, along with advanced clinical training and competency. Similarly, APM involves midwives with advanced training to provide specialized maternal and neonatal care. In Kenya, the APN and APM concepts were launched in 2020 and are still nascent, and their practice is determined by the context as provided by the country credentialing the practice. Despite the strides made in developing the advanced roles, there is an eminent gap in understanding stakeholders' perceptions of the roles, scope of practice, and regulation. To explore stakeholders' perceptions of the roles and regulations of APN and APM in Kenya. An exploratory qualitative study was undertaken as part of a larger formative research conducted between January 2022 and November 2023, utilizing a multimethod design that included a gap analysis of the scopes of practice for APN and APM in Kenya. Data collection was conducted among purposively sampled participants using a total of 7 focus group discussions (FGDs), with three of them conducted among 14 APN and APM students and 4 FGDs among 16 members of the Kenyan-based nursing and midwifery associations. Seven key informant interviews (KIIs) were also held with 2 medical doctors (OBGYN), two faculty, and 3 students (practicing APN). A thematic analysis approach was employed, and reporting was done according to the Standards for Reporting Qualitative Research. Participant's perspectives were reflected in 5 themes: definition of APN/APM and scope; entry qualifications into APN/APM practice; roles of APN/APM; barriers to enacting APN/APM roles; the national policy and regulatory landscape for advanced practice roles. There were varied viewpoints on how APNs/APMs are defined in the Kenyan context. Similarly, views on the entry level qualifications into APN/APM were diverse. Many participants emphasized the importance of licensure, autonomy of practice, ability to manage patients independently, training, and competency. Well-defined policies and regulations can create an enabling environment for practice.

Purpose: To describe international trends on the developing role of the nurse practitioner‐advanced practice nurse (NP‐APN), including nomenclature, levels and types of NP‐APN education, practice settings, scope of practice, regulatory policies, and political environment. Design: A cross‐sectional, descriptive Web‐based survey sent in February and March 2008 to a total of 174 key informants and active members of the International Nurse Practitioner‐Advanced Practice Nursing Network of the International Council of Nurses. Methods: An international Web‐based survey preceded by a pilot survey. Findings: Ninety‐one nurses from 32 countries responded. Thirteen titles were identified on nomenclature for the NP‐APN in different countries. NP‐APN education was available in 71% of the 31 countries responding to this item, with 50% identifying the master's degree as the most prevalent credential. Twenty‐three countries had formal recognition of the NP‐APN role. Of these, 48% had licensure maintenance or renewal requirements for the NP‐APN, with most requiring continuing education or clinical practice. The greatest support for the NP‐APN role came from domestic nursing organizations (92%), individual nurses (70%), and the government (68%), while opposition came primarily from domestic physician organizations (83%) and individual physicians (67%). Conclusions: Interest in the NP‐APN role has been gaining ground worldwide. This study presents a snapshot of education, practice, and regulation for NP‐APNs as they develop their unique role in delivering health care in various countries. Areas that may require more support are highlighted. Clinical Relevance: The NP‐APN role in healthcare systems is expanding and will benefit from international networking and support.

The aim of this pilot study was to test the feasibility of a clinical trial to evaluate the impact of an advanced practice nurse (APN) intervention on blood pressure (BP) control versus usual care in hypertension management, and to provide initial trends. This pilot study was designed as a prospective, open‐label, randomized 1:1, controlled, and monocentric superiority trial, conducted in a French‐labeled European Society of Hypertension excellence center. The APN intervention consisted of an in‐depth therapeutic education and an assessment of therapeutic strategies with adjustments if needed. The study sample included 437 participants (n = 229 in the experimental group; n = 208 in the “usual care” group). Considering the selection bias identified for baseline systolic BP, statistical analyses were adjusted on this parameter. The APN intervention significantly reduced adjusted systolic BP in the experimental group compared with the “usual care” group (−2.72 mm Hg, p = 0.04) and showed a trend toward a decrease in adjusted diastolic BP (−1.85 mm Hg, p = 0.07) and improved BP control with the APN intervention (−8.5%, p = 0.08). The experimental group was significantly more likely to adhere to the HBPM protocol compared with the control group (OR = 1.82, 95% CI [1.22–2.71], p = 0.003). This pilot study confirmed the feasibility of the clinical trial and offered the first data about APNs in hypertension management in France. Initial significant or borderline significant results are encouraging and suggest the benefit of an APN intervention on BP control in hypertension management. Further studies are needed to confirm these results. Trial registration: This clinical trial was registered on ClinicalTrials platform (NCT06227884).

Background . According to projections based on current trends, it can be anticipated that from 2024 onward, approximately 70% of all cancer cases will be diagnosed in individuals 65 years and older. Given this complex intersection between population ageing and cancer incidence, it is of great importance to address this issue from a comprehensive care perspective. Here comes the importance of advanced practice nurse into play. However, this figure is still not sufficiently valued in many countries. Its roles are also not clearly defined at the international level. For this reason, a systematic review of the scientific literature was carried out to analyze the impact of advanced practice nurse on the quality of life of older adults with cancer. Methods . Searches were carried out in PubMed, Web of Science (WoS), Scopus, CINAHL, LILACS, and ScienceDirect databases. They were limited to studies conducted in the last 7 years. Only open‐access articles were selected. To analyze the chosen articles and assess their quality, the criteria of the PRISMA and CASPe statements were applied. All authors participated in both the selection of the articles and their analysis. Results . Of the initial 58 articles selected, a total of 10 articles were finally included, as they met the eligibility criteria established after further analysis. The results show a positive relationship between the advanced practice nurse intervention and quality of life in older adults with cancer. Conclusions . Advanced practice nurse (APN) plays a key role in the care of older adults with cancer, significantly improving their quality of life and contributing to the comprehensive care of these patients. The findings evidenced in this work support the integration of APNs in cancer care teams to improve patient experience and overall well‐being.

Background The advanced nursing practice course is a core course for graduate nursing students, aimed at enhancing their comprehensive clinical competence and professionalism. The Attention-Relevance-Confidence-Satisfaction motivation model provides a theoretical framework for instructional innovation by using systematic strategies to stimulate and sustain learning motivation. Instructional design innovations play a crucial role in enhancing graduate nursing students’ learning motivation, self-learning ability, and critical thinking. Objective The objective is to implement the instructional design based on the Attention-Relevance-Confidence-Satisfaction motivation model in the advanced nursing practice course and evaluate its influence on the learning motivation, self-learning ability, and critical thinking of graduate nursing students. Methods This study employed a mixed-methods approach, combining a single-group pre-test/post-test quasi-experimental design with descriptive qualitative research. From March to May 2024, 31 first-year graduate nursing students received a 9-week Attention-Relevance-Confidence-Satisfaction model-based instructional reform. Quantitative methods were used to assess learning motivation, self-learning ability, critical thinking, and academic performance, with comparisons made using paired t-tests. The qualitative component included a descriptive qualitative study with semi-structured individual interviews. This mixed-methods study aimed to objectively measure effectiveness through quantitative data and gain in-depth insights into students’ experiences and benefits via qualitative data. Results The learning motivation and self-learning ability, as well as critical thinking of students exposed to Attention-Relevance-Confidence-Satisfaction model, were all improved. In addition, students achieved better test scores, expressed recognition and satisfaction with the course, and improved professional value recognition. Conclusion Applying the Attention-Relevance-Confidence-Satisfaction model-based motivational instructional design in advanced nursing practice course is feasible and has proved to be effective in increasing learning motivation, promoting self-learning ability, and cultivating critical thinking among graduate nursing students. In addition, the study found that the strategy had a positive effect on students’ learning gains, learning inspiration, and course feedback.

Background The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care. Aim The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master’s students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience. Methods A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data. Results The highest mean score was found for the competence area ‘Value-based nursing care’. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in ‘Nursing care’, while students ≥33 years reported significantly higher competence in ‘Nursing care’ and ‘Value-based nursing care’. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses. Conclusions The findings from this study might help to further develop curricula in advanced practice nursing master’s programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master’s programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master’s programme. Higher age, having children at home and working while studying should not be considered causes for concern.

Developing political engagement among nurses who care for rural and underserved communities can help mitigate health inequities. An experiential learning opportunity informed by Lobby Day was developed to prepare primary care advanced practice nursing students with the policy skills needed to actively serve as advocates for their patients and communities.

OBJECTIVEThis study addressed how recently graduated doctor of nursing practice (DNP) nurses describe their current practice, how their supervisors describe the DNPʼs current practice, and whether nurse and supervisor descriptions of the practices reflect the American Association of Colleges of Nursing (AACN) DNP Essentials and, if so, how? BACKGROUNDIntroduced in 2004, the goal of DNP programs was to educate advanced practice RNs for effective leadership in complex healthcare environments. The value of the DNP degree for nurses in healthcare systems is evolving. METHODSWe used conventional content analysis to inductively describe how DNP graduates from 7 different schools and their supervisors described the practice of the recently graduated DNPs. Interviews were reviewed to assess whether the AACN DNP Essentials were enacted in practice. RESULTSThe overarching theme was “becoming morere-envisioning self as an agent of change.” CONCLUSIONSResults support the claim that DNP education prepares advanced practice nurses for leadership across complex healthcare systems. Evidence of the DNP Essentials is realized when graduates perceive themselves as equal to other leaders and capable of driving change using evidence and effective collaboration.