Advanced practice nursing roles: development, implementation and evaluation
Advanced practice nursing roles: development, implementation and evaluation
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DOI：
10.1111/j.1365-2648.2004.03234.x
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发表时间：
2004-12-01
影响因子：
3.8
通讯作者：
Pinelli, J
中科院分区：
文献类型：
--
作者：
Bryant-Lukosius, D;DiCenso, A;Pinelli, J
瞄准！本文的目的是讨论影响高级实践护理（APN）角色引入的六个问题：APN术语混淆，未能明确定义角色和目标，角色强调医生替代/支持，所有APN角色域未充分利用，未能解决破坏角色的环境因素，以及基于证据的方法的使用有限，以指导其发展，执行和评价。许多国家的医疗保健结构调整导致APN角色的不同类型和数量大幅增加。这些角色在多大程度上真正反映了先进的护理实践往往是不清楚的。滥用APN术语、不一致的头衔和教育准备以及对这些作用的目的的误导性解释，阻碍了充分发挥其潜力和对健康的影响。角色冲突、角色过载和可变涉众接受度是与引入APN角色相关的常见问题。讨论。与APN角色的引入相关的挑战表明，需要更加关注和一致使用高级护理实践，高级护理实践和高级护理实践的术语。高级护理实践是指护士在角色中所做的工作或工作，对于定义引入新APN角色的特定性质和目标非常重要。先进性的概念进一步定义了先进护理实践的多维范围和任务，并与其他类型的护理角色区分开来。高级实践护理是指整个领域，涉及各种这样的角色和他们存在的环境。通过更好地规划和努力解决高级护理实践所需的环境因素，结构和资源，可以避免实现这些角色的全部潜力的许多障碍。从本文中可以得出未来引入APN角色的建议。这些包括需要一个协作的，系统的和循证的过程，旨在提供数据，以支持需要和目标明确定义的APN的作用，支持护理方向先进的做法，促进充分利用所有的角色域，创造环境，支持角色的发展，并提供持续的评估这些角色相关的预定目标。
Aim. The aim of this paper is to discuss six issues influencing the introduction of advanced practice nursing (APN) roles: confusion about APN terminology, failure to define clearly the roles and goals, role emphasis on physician replacement/support, underutilization of all APN role domains, failure to address environmental factors that undermine the roles, and limited use of evidence-based approaches to guide their development, implementation and evaluation.Background. Health care restructuring in many countries has led to substantial increases in the different types and number of APN roles. The extent to which these roles truly reflect advanced nursing practice is often unclear. The misuse of APN terminology, inconsistent titling and educational preparation, and misguided interpretations regarding the purpose of these roles pose barriers to realizing their full potential and impact on health. Role conflict, role overload, and variable stakeholder acceptance are frequently reported problems associated with the introduction of APN roles.Discussion. Challenges associated with the introduction of APN roles suggests that greater attention to and consistent use of the terms of the terms advanced nursing practice, advancement and advanced practice nursing is required. Advanced nursing practice refers to the work or what nurses do in the role and is important for defining the specific nature and goals for introducing new APN roles. The concept of advancement further defines the multi-dimensional scope and mandate of advanced nursing practice and distinguishes differences from other types of nursing roles. Advanced practice nursing refers to the whole field, involving a variety of such roles and the environments in which they exist. Many barriers to realizing the full potential of these roles could be avoided through better planning and efforts to address environmental factors, structures, and resources that are necessary for advanced nursing practice to take place.Conclusions. Recommendations for the future introduction of APN roles can be drawn from this paper. These include the need for a collaborative, systematic and evidence-based process designed to provide data to support the need and goals for a clearly defined APN role, support a nursing orientation to advanced practice, promote full utilization of all the role domains, create environments that support role development, and provide ongoing evaluation of these roles related to predetermined goals.