Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care

Bertrand Fougère, John E. Morley, Frédérique Decavel, Fati Nourhashémi, Patricia Abele, Barbara Resnick, Marilyn Rantz, Claudia Kam Yuk Lai, Wendy Moyle, Maryse Pédra, Bruno Chicoulaa, Emile Escourrou, Stéphane Oustric, Bruno Vellas

Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors and growing health care demand. The development of new nursing roles varies greatly from country to country. The United States and Canada established "nurse practitioners" (NPs) in the mid-1960s. The United Kingdom and Finland also have a long experience in using different forms of collaboration between doctors and nurses. In other countries, such as Australia, NPs were endorsed more recently in 2000. In France, Belgium, or Singapore, the formal recognition of advanced practice nurses is still in its infancy, whereas in other countries, such as Japan or China, advanced practice nurses are not licensed titles. The aims of this article were to define precisely what is meant by the term "advanced practice nurse (APN)," describe the state of development of APN roles, and review the main factors motivating the implementation of APN in different countries. Then, we examine the main factors that have hindered the development of APN roles. Finally, we explain the need for advanced practice roles in geriatrics.