An international survey on advanced practice nursing education, practice, and regulation

J Nurs Scholarsh. 2010 Mar;42(1):31-9. doi: 10.1111/j.1547-5069.2009.01322.x.


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.

MeSH terms

  • Advanced Practice Nursing / education
  • Advanced Practice Nursing / standards
  • Advanced Practice Nursing / trends*
  • Credentialing
  • Cross-Sectional Studies
  • Humans
  • Nurse Practitioners / education
  • Nurse Practitioners / standards
  • Nurse Practitioners / trends*
  • Nurse's Role
  • Professional Practice
  • Specialties, Nursing