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

Joyce Pulcini, Monika Jelic, Raisa Gul, Alice Yuen Loke

Research output: Contribution to journalArticlepeer-review

204 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)31-39
Number of pages9
JournalJournal of Nursing Scholarship
Issue number1
Publication statusPublished - Mar 2010
Externally publishedYes


  • Advanced practice nursing
  • Education
  • International
  • Policy
  • Practice
  • Regulation


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