Time to clarify--the value of advanced practice nursing roles in health care

J Adv Nurs. 2012 Mar;68(3):677-85. doi: 10.1111/j.1365-2648.2011.05790.x. Epub 2011 Jul 27.


Aim: This article presents a discussion of the importance of providing meaningful advanced practice nursing role definition and clarity to improve international standards of nursing titles and scopes of practice.

Background: A plethora of international literature exists discussing advanced practice nursing roles and their contribution to healthcare delivery in various countries. However, lack of consistency around title, role definition and scope of practice remains.

Data sources: CINAHL and Medline databases were searched using 'nurse practitioner', 'nurse practitioner role', 'nurse practitioner practice', 'nurse practitioner in public health', 'advanced practice nursing roles' and 'development of new nursing roles' with articles limited to years 1995-2010. Citations used in those articles were also explored. All cited articles were in the English language.

Discussion: This article supports the need to strengthen the Nurse Practitioner role in health care and professional clarity is identified as a strategy to enhance this. Themes around role clarity, professional identity, ability to enhance healthcare provision and inter-professional issues are examined. The need to more clearly articulate advanced nursing roles in light of the evolution of the Nurse Practitioner role is highlighted. Much work has already occurred in this domain and a means of adapting and broadening these developments for a wider, more global audience whilst maintaining local context is discussed.

Conclusion: Although evidence exists that advanced practice nursing roles are increasing internationally, uncertainty around role clarity remains. This is problematic because the valuable contribution of nursing roles is lost, if the ability to clearly express their function does not exist.

MeSH terms

  • Advanced Practice Nursing / organization & administration*
  • Advanced Practice Nursing / standards
  • Attitude of Health Personnel
  • Databases, Bibliographic
  • Delivery of Health Care*
  • Female
  • Health Care Reform / organization & administration
  • Humans
  • Internationality*
  • Nurse Clinicians
  • Nurse Practitioners*
  • Nurse's Role*
  • Practice Patterns, Nurses'
  • Professional Autonomy*