Oldenburger David, De Bortoli Cassiani Silvia Helena, Bryant-Lukosius Denise, Valaitis Ruta Kristina, Baumann Andrea, Pulcini Joyce, Martin-Misener Ruth
McMaster University, Global Health Office, Hamilton, Ontario, Canada.
Pan American Health Organization, Washington, D.C., United States of America.
Rev Panam Salud Publica. 2017 Jun 8;41:e40. doi: 10.26633/RPSP.2017.40.
SYNOPSIS Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing.
摘要 高级实践护理（APN）是一个用于描述在高级实践水平上运作的各种可能护理角色的术语。从历史上看，APN角色是出于改善高危和弱势群体以及生活在服务不足的农村和偏远社区的人群获得医疗保健服务的需求而非正式地演变而来的。为了满足健康需求，尤其是与初级卫生保健相关的需求，护士通过实践经验获得了额外的技能，随着时间的推移，他们的实践范围得到了扩大。最近，通过建立研究生教育项目，APN角色得到了更正式的发展，以满足商定的实践能力和标准。APN角色的引入预计将推动拉丁美洲和加勒比地区的初级卫生保健发展，而该地区此类角色很少。本文的目的是概述一项实施战略，以指导和支持在拉丁美洲和加勒比地区引入初级卫生保健APN角色。该战略包括改编现有框架、利用最新研究证据以及应用APN和初级卫生保健专家的知识。该战略包括九个步骤。每个步骤都包括一个国家视角，重点是各国直接参与卫生人力规划和发展以及实施工作。此外，每个步骤都纳入了一个国际视角，即鼓励已设立APN项目和职位的国家与没有高级实践护理的国家在卫生人力发展方面开展合作。
