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Thursday, March 11, 2010  
Advanced Nursing Practice
 
 
 
The AANPE does not dictate definitions of Advanced Nursing Practice, Advanced Clinical Nursing Practice, or the specifics of role titles such as Advanced Nurse Practitioner.
 
In contrast the AANPE notes the diversity and scope of advanced nursing practice, whilst observing statutary and professional regulatory frameworks and guidance.   

We also refer all AANPE members to the competency domains detailed by the NMC as UK wide standard statements. 
 
 
 
 
 
 
ADVANCED NURSING PRACTICE
 
A registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A Master's degree is recommended for entry level.
 
International Council of Nurses 2001
 
 
 
 
Career Framework for Health
 
Advanced Practitioners - Level 7
Experienced clinical professionals who have developed their skills and
theoretical knowledge to a very high standard. They are empowered to
make high-level clinical decisions and will often have their own caseload.
Non-clinical staff at Level 7 will typically be managing a number of service
areas.
 
Skills for Health 2007
 
 
 
 
Underpinning Principles of Advanced Practice
 
Autonomous practice
 
Advanced Practitioners practice autonomously, have the freedom to exercise
judgement about actions, in turn accepting responsibility and being held to
account for them.
 
Critical Thinking
 
Practising autonomously requires “self-regulatory judgement that results in
demonstrating the ability to interpret, analyse, evaluate and infer” (Mantzoukas et al, 2007; 33). Critical thinking allows advanced practitioners to explore and analyse evidence, cases and situations in clinical practice, enabling a high level of judgement and decision making.
 
High Levels of Decision Making & Problem Solving
 
It would be expected that an advanced practitioner can demonstrate expertise in complex decision making in relation to their current role. This includes determining what to include in the decision making process, and making a decision based on judgement and critical thinking/problem solving. This in turn affects the ability to practice autonomously.
 
Values Based Care
 
At this level of practice, individuals require to have a high level of awareness of their own values and beliefs. Care is negotiated with patient/carers as an equal partner. ‘Working in a positive and constructive way with difference and diversity. Putting the values, views and understanding of individual service users and careers at the centre of everything we do’
 
Improving Practice
 
It is important that advanced practitioners deliver advanced practice which is
evidence based within service, whilst acting as a positive role model that enables change regardless of their “job title”. To determine the impact of individual practitioners on development and service delivery concurrent evaluation of the pilot succession planning development pathway will be undertaken.
 
Underpinning Principles of Advanced Practice – Adapted from NES (2007)
Advanced Nurse Practitioners - Defined

The following definition of the Advanced Nurse Practitioner was made available to the AANPE by the NMC in February 2006.



“Advanced nurse practitioners are highly experienced and educated members of the care team who are able to diagnose and treat your healthcare needs or refer you to an appropriate specialist if needed.”


Advanced nurse practitioners are highly skilled nurses who can:

  • take a comprehensive patient history
  • carry out physical examinations
  • use their expert knowledge and clinical judgment to identify the potential diagnosis
  • refer patients for investigations where appropriate
  • make a final diagnosis
  • decide on and carry out treatment, including the prescribing of medicines, or refer patients to an appropriate specialist
  • use their extensive practice experience to plan and provide skilled and competent care to meet patient’s health and social care needs, involving other members of the health care team as appropriate
  • ensure the provision of continuity of care including follow-up visits
  • assess and evaluate, with patients, the effectiveness of the treatment and care provided and make changes as needed
  • work independently, although often as part of a health care team
  • provide leadership
  • make sure that each patient’s treatment and care is based on best practice


The NMC states that only nurses who have achieved the competencies set by the NMC for a registered ANP are permitted to call themselves by this title.

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