Advanced Practice Nursing in Japan


APN Role Exists in Country Today:

Nurse Midwife
Public Health Nurse
Certified Nurse
Certified Nurse Specialist

Nationally Certified:

Recognize Foreign Licensure:

Treatment Authority:

Prescribing Authority:

Practice Autonomously:

Japanese Nursing Association


Advanced Practice Nursing in Japan has been historically a reflection of a higher ratio of doctors and a low ratio of nurses per capita (Delamaire & Lafortune, 2008).

There are varying roles of advancement for nurses beyond that of the registered nurse and include: Nurse Midwife, Public Health Nurse, Certified Nurse Specialist, Certified Nurse, and Certified Nurse Administrator.  The Nurse Midwife and Public Health Nurse roles, primarily resemble extensions of nursing practice, giving nurses a specialization in the subject.

In Japan, the roles that most closely resemble Advanced Practice Nursing are that of Certified Nurses and Certified Nurse Specialists.  The role of certified nurses reflects that of nurses who are educators, consultants for nursing care, and excellent care providers (JNA, n.d.).

The role of However, the APNs in Japan primarily resemble the role of clinical nurse specialists, as nurses can gain specific specialist knowledge on a subject (Japanese Nurses Association [JNA], n.d.).  According to the JNA, the role of the Certified Nurse Specialist (CNS) is to, “contribute to the development of healthcare and welfare as well as to improve nursing science by forwarding CNSs with specific advanced nursing knowledge and skills into society to provide high-level nursing care efficiently for individuals, families and groups having complex and intractable nursing problems.”

As a result, the role of the CNS in Japan reflects the following (JNA, n.d.):

  • Excellent nursing practice
  • Coordination with patients, families, and concerned individuals for healthcare
  • Consultation with nurses and physicians
  • Ethics coordination
  • Education of personnel, and
  • Clinical research

Currently there is no comparable role to that of a Nurse Practitioner (NPs) in Japan, but efforts have been underway to determine if such a role would be appropriate for the advancement of nursing practice in Japan and a pilot program to introduce Nurse Practitioners is underway (Bugle Newspapers, 2013; Kondo, 2013).  While physicians appear to be welcoming of the potential new role of an advanced nurse counterpart, the greatest barrier to such a role development is that of perceived lack of evidence that NPs should be able to practice autonomously (Kondo, 2013).

Education and Certification

There is national certification for registered nurses, public health nurses, and midwives in Japan, by which individuals can take the exam after completion of an appropriate school (Japanese Nursing Association, n.d.).  Education requirements vary according to the specialty, but individuals will be required to have an additional year of training to become a midwife or public health nurse (JNA, n.d.).  As Japan has both 3-year nursing certificate and 4-year bachelor degree options to become a registered nurse, some programs offer a dual nursing and midwife or public health nurse bachelor option as a 4-year program.

To become a CNS, an individual is required to be educated at the master level (JNA, n.d.).  National certification is available through the JNA (n.d.) for the CNS’s, which is available to individuals after they have completed an accredited masters program and achieved a specified level of experience.


The various specialties of Advanced Practice Nurses currently certified in Japan are the following (JNA, n.d.):

  • Cancer nursing
  • Psychiatric Mental Health Nursing
  • Community Health Nursing
  • Gerentological Nursing
  • Child Health Nursing
  • Women’s Health Nursing
  • Chronic Care Nursing
  • Critical Care Nursing
  • Infection Control Nursing
  • Family Health Nursing
  • Home Care Nursing

The various specialties Certified Nurses are (JNA, n.d.):

  • Emergency Nursing
  • Wound, Ostomy, and Continence Nursing
  • Intensive Care
  • Palliative Care
  • Cancer Chemotherapy Nursing
  • Cancer Pain Management Nursing
  • Visiting Nursing
  • Infection Control
  • Diabetes Nursing
  • Infertility Nursing
  • Neonatal Intensive Care
  • Dialysis Nursing
  • Perioperative Nursing
  • Breast Cancer Nursing
  • Dysphagia Nursing
  • Pediatric Emergency Nursing
  • Demential Nursing
  • Stroke Rehabilitation Nursing
  • Radiation Therapy Nursing
  • Chronic Respiratory Nursing
  • Chronic Heart Failure Nursing

Have information to add to this page?

Bugle Newspapers (2013, October 1).  Japanese Nursing Association Visits St. Francis.  Retrieved from:

Delamaire, M. & Lafortune, G. (2010). Nurses in advanced roles: A description and evaluation of experiences in 12 developed countries.  OECD Health Working Papers, 54, OECD Publishing.

Japanese Nurses Association (n.d.).  Nursing in Japan.  Retrieved October 1, 2013 from:

Kondo, A. (2013).  Advanced practice nurses in Japan: Education and Related Issues.  Journal of Nursing Care, S5(4),1-6.  doi:10.4172/2167-1168.S5-004


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