Abstract:
Aim. This paper reports a study to develop a research-informed model of the service
parameters and an analysis framework for advanced practice nursing roles.
Background. Changing patterns of health care are forcing service planners to
examine new service delivery models. Apparent is the call for nursing service that
incorporates expanded levels of autonomy, skill and decision-making. A number of
nursing roles conform to this description under the generic title of advanced practice
nurse. However, there is confusion in the health service community internationally
about nomenclature, role and scope for advanced practice nursing roles. An emerging
priority in response to recent developments in the nurse practitioner role is to
establish service parameters for advanced practice nursing and to differentiate
operationally between advanced practice and practitioner nursing roles.
Methods. We conducted an interpretive, qualitative examination of the practice of a
random sample of nine advanced practice nurses working in three acute care hospitals
in south east Queensland, Australia in 2006. Data collection involved individual
in-depth interviews, which were deductively analysed and tested against
published advanced practice nursing models.
Results. The data most comprehensively supported the Strong Model of Advanced
Practice as representing the practice experiences of the research participants. This
model supports definition of the service parameters and the design of an operational
framework for implementation and evaluation of advanced practice nursing roles.
Conclusion. The findings differentiate advanced practice nurse and nurse practitioner
roles, and offer an operational framework to identify, establish and evaluate
advanced and extended nursing positions. Subject to further validation, this outcome
can provide operational information for implementing innovative nursing
roles appropriate to consumer needs and specific health service models.
