Nurse Practitioners and Nurse Anesthetists: The Evolution of the Global Roles

Preface
Contents
Part I: The Role of the Nurse Practitioner
	Evolution in Healthcare: The Journey from a US Demonstration Project to an International Concept
		Introduction
		History of Nurses in Public Health
		Early Development of Expanded Role
		A Demonstration Project
		Geopolitical Factors Facilitating Healthcare Revolution
		Expansion of Nurse Practitioner Programs
		Challenges to Role Expansion
		Nursing Opposition
		Physician Opposition
		Education
		Certification
		Titling
		Scope of Practice
		Landmark Studies
		Regulation
		Reimbursement
		Prescriptive Authority
			Real-Life Stories by Nurse Practitioners
				Academic Medical Center
				Private Pediatric Group Practice
				Primary Care Community Center
		Lack of Unity: The Formation of Nurse Practitioner Organizations
		International Collaboration
		Reaching Consensus in the United States
		The Journey
		Bibliography
	The Global Emergence of the Nurse Practitioner Role
		Introduction
		The International Council of Nurses’ Nurse Practitioner Definition
		Factors Influencing Consideration of the Nurse Practitioner Concept
		Approaching Global Nurse Practitioner Development
		Country Exemplars
			Australia
			Botswana
			Canada
			Republic of Ireland
			Jamaica
			New Zealand
			UK (England, Northern Ireland, Scotland, Wales)
		International Influence
			International Council of Nurses (ICN)
			World Health Organization (WHO)
		Conclusion
		References
	Differentiation of International Advanced Practice Nursing Roles: NP and CNS
		Introduction
			Historical Background of the NP and CNS
				Historical Background of the NP
				Historical Background of the CNS
			Terminology
				Definition of Nurse Practitioner (NP)
				Definition of Clinical Nurse Specialist (CNS)
			Definitive Continuum for the NP and the CNS
			ICN Position on the Clarification of Advanced Practice Nursing Designations
		Conclusion
		References
	Nurse Practitioner Education and Curriculum: A US Focus
		Introduction
		History and Evolution of NP Education
		Education for NPs
			US Entry into Practice
			Global Entry to Practice
			NP Educational Path to Practice
			NP Curriculum Development
				Curriculum Design
				Competency and Curriculum Mapping
			Innovations in NP Education
			DNP as an Entry to Practice
			NP Education Delivery Methods
				In-Person
				Online and Hybrid
				Supervised Clinical Practice
			Instructional Design for Adult Learners
			Interprofessional Education and Practice
			Simulation
		Conclusion
		References
	NP Practice Competencies
		Introduction
		How Are NP Competencies Developed?
		How Are NP Competence Established?
		Science of Practice
			Care of an Individual and Population
			Health Systems Practice
			Leadership of Self and Other
		How to Use Competencies Documents at the Institutional Level
		Frameworks to Evaluation Competencies
		Competency-Based Education
		Conclusion
		References
	The Nurse Practitioner as a Leader
		What Is Leadership?
		The Nurse Practitioner as Leader
		Vision of NP Leadership
		A Global Lens
		Conclusion
		References
	The NP and Research: A Global Perspective
		Purpose
		Background
		Process
		Findings
		Limitations
		Discussion
		Conclusion
		References
	Nurse Practitioner Outcomes Evaluation
		Introduction
		Demonstrating Outcomes of NPs
		Showcasing NP Impact
		Exemplar: Highlighting the Impact of the NP Role During the COVID-19 Pandemic
		Exemplar: Emphasizing the Impact of NP-Led Initiatives to Improve Patient Care Outcomes
		Summary
		References
Part II: NP Country Exemplars
	The Nurse Practitioner in the USA: Role Exemplars
		Introduction
		Development of the NP Role in the USA
		Legislative Efforts
		Geographical and Demographical Concerns in the USA
		Consensus Model
		Nurse Practitioner Roles in the USA
		Nurse Practitioner Programs
		Nurse Practitioner Certification
		Exemplar of the Acute Care NP
		Exemplars of the Primary Care NP
		Exemplars of the Psychiatric/Mental Health NP
		Conclusion
		References
	The NP Role and Practice in Canada
		Introduction
		Historical Evolution of NP Role, Education, Regulation, and Practice
		Current State of NP Roles, Education, Regulation, and Practice
		Unique Canadian NP Leadership Examples
			The Nurse Practitioner Association of Canada
			The Principal Nursing Advisors Task Force
			Nurse Practitioner-Led Clinics
			Nursing Policy Secretariat
			Nurse Practitioner Leaders in Chief/Executive/Director Roles
		Unique Canadian Contributions to NP Role Development, Implementation, and Evaluation Globally
			Canadian Centre for Advanced Practice Nursing Research
			The PEPPA and PEPPA-Plus Frameworks
		Conclusion
		References
	The Nurse Practitioner Role and Practice in Jamaica
		Introduction
		Historical Evolution of the NP Role, Regulation and Practice
		NP Education
		Scope of Practice
		Areas of Practice
			Family Nurse Practitioner
			Mental Health/Psychiatric Nurse Practitioner
				MHPNP Competencies
			Nurse Educator
		Prescribing
			Practice
		Leadership
			Professional
			Technical/Clinical
		NP Impact/Role During the COVID-19 Pandemic
		Conclusion
		References
	The Evolution of the Nurse Practitioner Role and Practice in the United Kingdom
		Introduction
		Evolution of the Nurse Practitioner Role in the United Kingdom
		Nurse Practitioner Education
		Nurse Practitioner Prescribing
		Nurse Practitioner Regulation
		Health Policy
		England
		Scotland
		Wales
		Northern Ireland
			Definitions
		Examples of Practice from the UK
			Primary Care
				Clinical Practice
				Leadership and Management
				Education
				Research
			Secondary Care
				Clinical Practice
				Leadership and Management
				Education
				Research
		Conclusion
		References
	The NP Role and Practice in Finland
		Background
		Nursing Education in Finland
		Regulation
		Advanced Practice Nursing in Finland
			Nurse Practitioner
			Clinical Nurse Specialist
			Nurses’ Limited Prescription Rights
		Vision for the Future
		References
	The Nurse Practitioner Role in Ireland
		Background
		Professional Frameworks
		Registration/Regulation
		National Education Framework
		Policy Directions
		Conclusion
		References
	Nurse Practitioner Development in German-speaking Countries: Germany, Austria, and Switzerland
		Introduction
		The context of Nurse Practitioners in Germany
		Role Distinction
		NP Research Developments in Primary Health Care
		The NP Role in Austria
			History of APN in Austrian Health Care System
			Current State of APN in Austrian Health Care System
			The Way Forward
		Advanced Nursing Practice in Switzerland
		Conclusion
		References
	The Nurse Practitioner Role and Practice in Botswana
		Introduction
		Background
			Country Profile
			Health Care System
		History of Nursing and the Nurse Practitioner Development in Botswana
			Early Years
			Nurse Practitioner Role Development
		Nurse Practitioner Role and Scope of Practice in Botswana
			Nurse Practitioners in Botswana
			Licensure and Regulation of the Nurse Practitioner Role
				Diploma Program Licensure
				Master’s Degree Program Licensure
			Nurse Practitioner Scope of Practice
			Nurse Practitioner Prescriptive Authority
			A Typical Workday for a Family Nurse Practitioner in Botswana
			The Future of the Nurse Practitioner in Botswana: Challenges and Advancement
		Conclusion
		References
	Nurse Practitioner Role in Kenya
		Introduction
		Kenyan Context
		History of Nursing in Kenya
		Drivers for Nurse Practitioner Role
		Nurse Practitioner’s Scope of Practice in Kenya
		Future of Nurse Practitioner Role in Kenya
		Conclusion
		References
	The Nurse Practitioner Role in Tanzania
		Introduction
		Background
		Current Situation
		Nursing Practice
		The Initiative
		NP Educational Preparation
		Challenges to the Implementation of the Advanced Practice Nursing
		Recommendation
		References
	The Evolution and Future of Nurse Practitioners in New Zealand
		Background
		The Introduction of the Nurse Practitioner Role in New Zealand
		Scope of Nurse Practitioner Practice
		Nurse Practitioner Education
		Growing the Primary Healthcare Nurse Practitioner Workforce
		Positioning the Nurse Practitioner Workforce for the Future
		Nurse Practitioners as Agents of Transformational Change
		References
	Transforming Healthcare: The Australian Nurse Practitioner Role
		Introduction
		Origins of the Australian Nurse Practitioner Role
		Workforce
			Impact of Funding on Workforce
			Scope of Practice Considerations
		Education and Regulation
		The Future of the Australian Nurse Practitioner Workforce
		Conclusion
		References
	The Nurse Practitioner (NP) Role in Sri Lanka
		Introduction
			Background to Sri Lanka
		Healthcare System in Sri Lanka
		History of Medicine and Nursing in Sri Lanka
		Developing Professionalism in Nursing and Education Milestones
		Establishment of Undergraduate Nursing Education
		Recruitment and Credentials in Nursing Sri Lanka
		Nurse Practitioner Role in Sri Lanka
		Challenges and Issues
		References
	Advanced Nursing Practice in the Kingdom of Saudi Arabia
		Introduction
		Nursing in Saudi Arabia
		Advanced Practice Nursing in Saudi Arabia
		Next Steps
		References
	Why Pakistan Needs Advanced Nurse and Advanced Midwife Practitioners
		Background
		Poverty, Heavy Population, and High Number of Vulnerable Population
		Challenging Geographies from High Mountains to Spread Deserts
		Natural and Man-Made Disasters
		Role of Nurses, LHVs, and Midwife Practitioners at Rural Health Settings in Pakistan
		Contribution of LHV/Midwives/Nurse in Improving the Health Indicators
		Why Pakistan Needs Advanced Nurse and Advanced Midwife Practitioners?
		Way Forward
		References
	The Future for International NP Role Development
		Introduction
			Foundations for the Future of Nurse Practitioners
			Forging the Nurse Practitioner Concept
		Critical Challenges
			Integrating NPs into the Healthcare Workforce
			International Consensus-Building Around Professional Identity of the NP: Terminology, Definition, Scope of Practice, Core Competencies, and Education
				Refining Descriptive Terminology
			Research: Defining the Gaps and Finding the Evidence
		Conclusion
		References
Part III: The Role of the Nurse Anesthetist
	Challenges to Global Access to Anesthesia and Surgical Care
		Overview of Access to Anesthesia and Surgical Care
			How is Access to Surgical and Anesthesia Care Defined?
		Policy Initiatives to Promote Access to Anesthesia and Surgical Care
			WHO Global Initiative for Emergency and Essential Surgical Care (GIEESC)
			WHO: Safe Surgery Saves Lives
			Institute of Medicine: The Future of Nursing Leading Change, Advancing Health
			Sustainable Development Goals (SDGs)
			World Health Assembly Resolution 68.15 Strengthening Emergency and Essential Surgical Care and Anaesthesia as a Component of Universal Health Coverage
			United Nations Resolution Adopted by the General Assembly 2019, Universal Health Coverage: Moving Together to Build a Healthier World
			Action Framework for Safe and Affordable Surgery in the Western Pacific Region (2021–2030)
		Scope of Practice
		Factors Delaying Access to Anesthesia and Surgical Care
			Infrastructure for Hospitals in LMICs
			Financing to Improve Access to Anesthesia and Surgical Care
			Blood Supply for Surgery
			Imaging Services to Improve Surgical Care
			Travel as a Barrier to Surgical Care
			Culture as a Barrier to Surgical Care
		Anesthesia Workforce
			Comparison of Anesthesia Workforce in High-Income and LMICs
			Nurse Anesthetists in Rural Areas in LMICs
			Recommendations to Increase the Anesthesia Work Force in LMICs
		Access to Surgery and Anesthesia Care in a High-Income Country: Japan
		Indicators of Access to Surgery and Anesthesia Care in LMICs
		Next Steps to Improve Access to Anesthesia and Surgical Care
		References
	The International Federation of Nurse Anesthetists: Past, Present, and Future
		Genesis
		Foundation Steps
		International Standards [1, 3]
		International Study [4]: About Global Nurse Anesthesia Workforce
		Continuing Professional Development
		International Relationship and Collaboration
			International Council of Nurses (ICN)
			World Health Organization (WHO)
			World Federation of Societies of Anesthesiologists (WFSA)
			European Specialist Nurses Organization (ESNO)
			European Societies of Anesthesiologists and Intensive Care (ESAIC) and European Board of Anesthesiology (EBA)
			G4 Alliance for Surgical, Obstetric, Trauma and Anaesthesia Care
		IFNA Achievements
		Global Leadership
		Conclusion
		References
	Global Development of Nurse Anesthesia Education from Mid-Nineteenth Century into Today’s Advanced Nursing Practice
		Introduction
		Nurse Anesthesia from the Mid-Nineteenth to the Mid-Twentieth Century
			A Brief Historical Overview of Nurse Anesthesia in Some Selected IFNA’s Member Countries
		The Beginning and Development of Formal Nurse Anesthesia Education in Selected IFNA Member Countries from the 1950s Till Date
			Transformation into an Assisting Role in Anesthesia
			Development into Today’s Nurse Anesthesia Role
				Scandinavian Countries
				Selected Continental European Countries
				Africa and Asia
		Harmonizing Nurse Anesthesia Education Worldwide by Using Global Standards
			Competency-Based Education (CBE)
		IFNA’s Anesthesia Program Approval Process (APAP)
			Benefits of APAP
			Development of APAP
			Categories of Approval
			Eligibility
		Conclusion
		References
	Nurse Anesthesia Recognition: Practice Challenges, Credentialing, and Title Protection
		The Evolution and Credentialing of the American Nurse Anesthetist
		Major Legal Challenges Against Nurse Anesthetists in the United States
		Formation of the National Association of Nurse Anesthetists
		The Global Voice of Nurse Anesthesia: The International Federation of Nurse Anesthetists
		Now That We Are Organized, What Do We Do?
		Credentialing and the Quality Imperative
		Regulation of the Global Nurse Anesthesia Workforce
		International Council of Nurses and International Federation of Nurse Anesthetists
			Release Guidelines for Nurse Anesthetists
			Next Steps for IFNA
		Summary
		References
	Universal Health Coverage and Nurse Anesthetists
		Background
		Anesthesia and Surgery Human Resources
		Universal Health Coverage and the Universal Right to Health
		Nurse Anesthetists Fulfill the Required Elements of Human Rights-Based UHC
			Available
			Accessible
			Acceptable
			Adequate Quality
			UHC Benchmarks
		Scope of the Impact
		Nurse Anesthetists, UHC, and Health Governance
		Nurse Anesthesia Advocacy Model to Advance UHC
		References
	Nurse Anesthetists in Action
		Introduction
		History
		Research into Global Nurse Anesthesia Practice
		International Guidelines
		Role of Professional Organizations
		Validation of Practice
		Task Shifting Is Not Task Sharing
		Nurse Anesthetists Rise to the Occasion: CV-19
		Nurse Anesthetists in Action: Practice Summaries by the WHO Regions
			Africa
				Education/Scope of Practice/Challenges
				Regulation
				Positive Outcomes and Challenges
			The Americas
				Education/Scope of Practice/Challenges
				Regulation
				Positive Outcomes/Challenges
			South-East Asia
				Lao People’s Democratic Republic (Laos)
				Thailand
				Vietnam
				Education/Scope of Practice
				Regulation
				Positive Outcomes and Challenges
			Eastern Mediterranean
				Practice
				Education
				Regulation
				Positive Outcomes and Challenges
			European Region
				Practice
				Education
				Regulation
				Positive Outcomes and Challenges
			Western Pacific
				Practice
				Education
				Regulation
				Positive Outcomes and Challenges
		Chapter Summary
		Appendix 1: Nurse Anesthetists’ Scope of Practice, ICN Advanced Practice Nursing Guidelines: Nurse Anesthetist (2021) reprinted with permission [8] (pgs. 443–444)
		Appendix 2: Examples of Nurse Anesthetists’ Contributions to Healthcare Services ICN Advanced Practice Nursing Guidelines: Nurse Anesthetist (2021) reprinted with permission [8] (p. 450)
		References
Nurse Anesthetists: Sharing Our Caring
	Introduction
	Finland
	United States of America
	Laos
	Somaliland
	Iceland
	France
	Indonesia
	Morocco
	Mercy Ships
	References