The document discusses the role of advanced practice nursing (APN) internationally, highlighting educational preparation, regulatory mechanisms, and the integration of APNs into healthcare systems. It provides data on the impact of APNs on patient care, emphasizing improved outcomes such as increased patient satisfaction and reduced hospitalizations. Recommendations for collaborative practice, legislative strategies, and addressing healthcare challenges, particularly for chronic conditions, are also outlined.

1. dr. Petrie F. Roodbol, Hanze University of Applied Science, UMCG Netherlands, Chair ICN APN/NP Advanced practice nursing; an expanded nursing role on an international level

2. Content APN in context of the ICN- scope and definitions APN Worldwide Netherlands Future

3. International Council of Nurses

4. Regulation Socio-economic welfare Professional practice ICNP Lederschip in change APN

5. APN: an umbrella term

6. RN APN Specialization BACHELOR APN RN NP CNS Midwife Anesth.

7. Characteristics Educational preparation Nature of practice Regulatory mechanism

8. Educational preparation Educational preparation on advanced level Formal recognition of educational programs A formal system of licensure, registration certification or credentialing

9. Nature of practice Integration research, education, clinical management Independency, autonomy Advanced assessment, decision-making skills Recognized advanced clinical competencies Recognized first point of service Consultation

10. Http://www.youtube.com/watch?v=WmYBxOVo4oc -

11. Right to diagnose Authority to prescribe Authority to refer to other professionals Authority to admit to hospitals Title protection Legislation specific to advanced practice Regulatory Mechanism (country specific)

12. NP HOW Patient service Staff Input Process outcome Review N=70 effectiveness, efficiency, and quality

13. Patient Satisfaction equal or increase (special groups) Increase compliance Less antibiotics, shorter hospitalized Self management

14. Quality Health: equal or increased (assessment, treatment, less complications) Safety; equal or increased

15. Service Shorter waiting times, faster access Rural areas, vulnerable populations Less hospitalization Equal mortality Cost effective Equal number of consultations for patients longer consultancies

16. Impact on the staff Substitution Increase coordination and organization

17. Disease, illness Consequences of diseases, illnesses

18. Starting an APN……. A definition of the ANP role Recommendations for collaborative practice A curriculum Recruitment, retention and deployment strategies Recommendations for legislation and regulation Strategies to reduce barriers to practice

20. Country Physicians Nurses Netherlands 3,8 13,73 South Africa 0,77 4,08 UK 2,2 9,9 Italy 3,8 7,79 Greece 5 4,2 Germany 3,9 9,2 Mexico 1,9 2,3 US 2,4 10,5 Hong Kong 1,7 5,28 Korea 2,0 3,58

27. Asia Taiwan Hong Kong Japan Singapore Macau Thailand Korea

29. European Nations UK (England, Wales, Scotland, Northern Ireland) Sweden, Finland Netherlands, Belgium France Germany, Switzerland

31. Characteristics 16.4 Million inhabitants Life expectancy 77.3 – 80.4 HDI no.6 Healthy 81,2% Required insurance

32. Health Care typology Affordable, accessible Solidarity Focus on primary care Government determines

33. Healthcare problems Chronically ill (1 million diabetes!) Hearth diseases, cancer Child obesity Elderly (frailty)

34. History NP 1997 (CNS: 1986) Hospital based Individual initiative Answer on human resource problems Fast, uncontrolled grow Governmental (financial) support 2002

36. 2011 Program in nine cities National competency profile Association Number +/- Legislation Independency Prescriptive authority Registration (previously acquired skills)

37. Positive effects (1) Bridging the cap: physicians/nurses Integration cure and care (Cost) effective care Self management Patient centred care Easily accessible Innovation, quality driven

38. Experienced, motivated nurses Increasing continuity Role models in holistic care Organizational innovation Positive research results Positive effects (2)

39. Negative effects Medical socialization Medical classification Money driven Diverse perception Unverified grow

40. Acceptance Government +++ Public ++ Physicians + RN ++ (overcapacity of physicians; Physician assistants less acceptance)

41. Healthy Aging: statistics

42. Prevalence of selected chronic diseases 65+

43. Key strategies Healthy life style behavior Injury prevention Delivery of culturally clinical preventive services Immunization and preventive screenings Self management for chronically ill

46. Fit as possible Dementia

48. Advanced nursing practice