An international perspective of advanced practice nursing regulation

Int Nurs Rev. 2015 Sep;62(3):421-9. doi: 10.1111/inr.12193. Epub 2015 Jun 8.


Background: There is no common understanding about the role of the advanced practice nurse across the globe and there is wide variation in the regulation of advanced practice nursing roles as well as their educational, licensing and credentialing requirements.

Aim: The goal of this research was to examine the status of advanced practice nursing regulation globally.

Methods: An online survey link was emailed to National Nursing Associations and nursing health policy makers worldwide from June to December 2011. Questions focused on regulation, education, scope of practice, and barriers and opposition. Analysis included frequency statistics and descriptive data for survey questions and content analysis for two open-ended questions.

Limitations: The survey was offered online and only in English. Therefore, technology and language barriers may have influenced the results.

Results: There is wide variation in educational requirements, regulation and scope of practice of advanced practice nurses. The barriers to advanced practice nursing are often linked to the status of legislation and credentialing in specific jurisdictions.

Conclusion: A database of advanced practice nursing regulation and issues related to practice has the potential to become a valuable resource for individual countries.

Implications for nursing and health policy: Each country has unique challenges related to health policy for advanced practice nursing roles. International nursing organizations have established programmes for regulation development; however, a stronger focus on monitoring regulation and more effective dissemination of information about available supports may have a bigger impact on the development and revision of health policy related to advanced practice nursing.

Keywords: Advanced Practice; Advanced Practice Nursing; Credentialing; Nursing; Nursing Legislation; Nursing Regulation; Nursing Roles; Registration.

MeSH terms

  • Advanced Practice Nursing / legislation & jurisprudence*
  • Credentialing
  • Humans
  • Internationality*
  • Licensure, Nursing
  • Nurse's Role*
  • Surveys and Questionnaires