Author Archives: Tim Kruth, DNP, RN, FNP-C

Advanced Practice Nursing in India

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Snapshot

APN Role Exists in Country Today:
No

Title:
Nurse Practitioner

Contact:
Indian Nursing Council

Role

With 72% of the Indian population residing in rural areas and 75% of medical providers residing in urban areas, India is currently experiencing significant shortages of physicians, particularly in rural areas (Penn Nursing Science, 2013).  In addition, the overall country has a shortage of nurses and physicians, so much so that is it estimated that there is only one physician for every 1700 people (Kumar, 2013).  While the normal standards for nurse to physician ratios often reflect between a 2.0 to 3.0 nurses per physician, India has an alarmingly low nurse to physician ratio estimated around 1.22 nurses per physican (Munjanja, Kibuka, & Dovlo, 2005).  With alarmingly low health care professionals in the country, there is significant need for advancement of those few who have the education as a nurse may well be the exclusive healthcare professional in a rural area.

Recently the region of West Benghal started training Advanced Practice Nurses, identified as Nurse Practitioners (Kumar, 2013).  While this role has just begun, India has found significant resistance to developing an advanced nursing role primarily based on strong pressures by medical organizations to not increase the scope of practice of nurses.  This is primarily related to the country’s health system that has traditionally held very limited roles for nursing and maintained physicians as sole individuals to provide advanced healthcare (Penn Nursing Science, 2013).

Meanwhile, in the region of Kerala, some have reported that graduate level Nurse Practitioner courses are already offered from the Kerala Institute of Medical Sciences (shahinshahul, ClinicalResearchSociety.org, 2012, May 28).  While such programs are offered through various independent schools throughout the country, there is yet a standard identified for a Nurse Practitioner or specific advanced practice role.

Education and Certification

Education standards in India vary from diploma programs for general nursing, bachelor programs consistent with international standards, and masters and PhD programs in nursing (CurrentNursing.com, 2013).  While these programs do offer education allowing individuals to learn advanced practice nursing concepts, the current healthcare structure in the country does not provide ample opportunities for nursing advancement at the bachelor level, let alone at the masters and PhD levels, leading to many individuals leaving their areas and country to pursue more adventitious employment (Baumann & Blythe, 2008; Penn Nursing Science, 2013).  While many of the individuals who practice nursing in India are not bachelor educated, according to Nochols, Davis and Richardson (2009), India has begun to phase out their non-bachelor programs.

Midwifery is a standard of general nursing practice in India.  Regulation varies according to state and in the country no nurse is allowed to have permission to practice in more than one state at a time.  In some states, it is illegal for males to perform midwifery and obstetrics care and as it is a part of general education, there is a greater shortage of nurses in those regions (Nichols, Davis, & Richardson, 2009).

Individuals interested in attaining permission to practice in India require permission by the Equivalency Council at selected charities for a limited duration (Indian Nursing Council, 2013).  Such provisional permission to practice in India is granted for diploma, bachelor, and master prepared nurses and granted permissions.

While an individual of foreign education may have a master degree in nursing, the provisional permissions currently in India allow them to work in the administration, but no part of the application requires specific education on patient care, indicating an individual can likely not practice at any Advanced Nursing level without exclusive permission by the nursing council (as has been granted to Penn State in the region they are attempting to initiate Nurse Practitioner education) (Indian Nursing Council, 2013).

Specialties

  • Critical Care

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References:

Baumann, A. & Blythe, J. (2008). Globalization of higher education in nursing.  The Online Journal of Issues in Nursing, 13(2), manuscript 4.  doi: 10.3912/OJIN.Vol13No02Man04

CurrentNursing.com (2013).  Nursing Education In India.  Retrieved October 2, 2013 from: http://currentnursing.com/nursing_education/nursing_education_in_india.html

Kumar (2013, September 23).  India has just one doctor for every 1700 people.  The New Indian Express.  Retrieved from: http://newindianexpress.com/magazine/India-has-just-one-doctor-for-every-1700-people/2013/09/22/article1792010.ece

Indian Nursing Council (2013).  Home.  Retrieved October 2, 2013 from: http://www.indiannursingcouncil.org/

Khanna, R. (2018). Personal Communication.

Munjanja, O.K., Kibuka, S., & Dovlo, D. (2005).  Issue Paper 7: The Nursing Workforce In Sub-Saharan Africa.  International Council of Nurses.  Retrieved from: www.ghdonline.org/

Nichols, B.L., Davis, C.R., & Richardson, D.R. (2011).  Appendix J: International models of nursing.  The Future of Nursing: Leading Change, Advancing Health.  Institute of Medicine.  Retrieved from: http://www.nap.edu/catalog/12956.html

Penn Nursing Science (2013).  Utilizing APNs to Solve Provider Shortage in Rural India.  Retrieved October 2, 2013 from: http://www.nursing.upenn.edu/gha/Pages/UtilizingAPNstoSolveProviderShortageinRuralIndia.aspx

[Updated 2022, May 07]

Advanced Practice Nursing in Japan

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Snapshot

APN Role Exists in Country Today:
Yes

Title:
Nurse Midwife
Public Health Nurse
Certified Nurse
Certified Nurse Specialist

Nationally Certified:
Yes

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Uncertain

Prescribing Authority:
No

Practice Autonomously:
No

Contact:
Japanese Nursing Association

Role

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.

Specialties

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?

References:
Bugle Newspapers (2013, October 1).  Japanese Nursing Association Visits St. Francis.  Retrieved from: http://www.buglenewspapers.com/joliet/article_01ee4386-2ad7-11e3-a331-0019bb30f31a.html

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.http://dx.doi.org/10.1787/5kmbrcfms5g7-en

Japanese Nurses Association (n.d.).  Nursing in Japan.  Retrieved October 1, 2013 from: http://www.nurse.or.jp/jna/english/nursing/

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

Advanced Practice Nursing in Poland

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Snapshot

APN Role Exists in Country Today:
Yes

Title:
Nurse Specialist
Nurse Midwife

Nationally Certified:
No

Recognize Foreign Licensure:
RN and Midwife Nursing licensure is recognized from EU

Treatment Authority:
Varies according to specialty

Prescribing Authority:
No

Practice Autonomously:
No

Contact:
Ministerstwo Zdrowia (Poland Ministry of Health)

Role

Development of the Advanced Practice Nurse Role in Poland has been greatly driven by the financial benefit that APNs can provide equal care at a lesser cost than that of physicians (Delamaire & Lafortune, 2010).  According to Strózik (2006), Poland has almost 2 nurses per every doctor in the country, and has about 2.3 physicians per 1000 individuals, not significantly lacking.  However, there is also reportedly slower waits to see physicians and consultants (more experienced and knowledgable physicians) and in the emergency rooms than most of the EU (europe-cities.com, 2013).

The expanded roles of nurses in specialty positions perform advanced physiologic and psychologic assessment.  The role of APNs as nurse specialists in Poland are not uniform according to specialty, but are based on the healthcare needs within the country for more urgent care and intensive management.  As a result, such expanses of scope of practice include management of some chronic illnesses (i.e. diabetes and end-stage renal disease), perform triage for patient prioritization, or some emergency procedures (i.e. emergency intubation or tracheotomy) (Delamaire & Lafortune, 2010).  APNs in Poland however do not have prescriptive authority (Delamaire & Lafortune, 2010).

According to Delamaire & Lafortune (2010), the chief barriers to advancing nursing practice in Poland is four fold:

  • Medical association opposition
  • Lack of government funding for new roles
  • Legislation
  • Methods of compensation for physicians

Education and Certification

Nurses are trained regularly at the bachelor level based on a 3 year post high school education.  They can opt for an extended track that allows for midwifery practice, totaling a 5 years of post graduate coursework (Rechel, Dubois, & McKee, 2006).  Coursework is directed and approved by the Poland Ministry of Health and a post graduation licensure exam is required to practice (Nichols, Davis, & Richardson, 2011; Strózik, 2006).

Specialties

Nurses have opportunities to obtain post bachelor graduate education in midwifery, pediatric, psychiatric, and additional opportunities (Strózik, 2006).  While these specializations offer further education and knowledge application, information is lacking on the extent, if any that the scope of practice may be expanded.

Have information to add to this page?

References:
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.http://dx.doi.org/10.1787/5kmbrcfms5g7-en

europe-cities.com (2013).  Healthcare in Poland.  Retrieved from: http://www.europe-cities.com/en/633/poland/health/

Nichols, B.L., Davis, C.R., & Richardson, D.R. (2011).  Appendix J: International models of nursing.  The Future of Nursing: Leading Change, Advancing Health.  Institute of Medicine.  Retrieved from: http://www.nap.edu/catalog/12956.html

Strózik, M. (2006). Chapter 7: Poland. The Health Care Workforce in Europe: Learning from experience.  World Health Organization: Copenhagen, Denmark.  Retrieved from: http://www.euro.who.int/__data/assets/pdf_file/0008/91475/E89156.pdf

Advanced Practice Nursing in Switzerland

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Snapshot

APN Role Exists in Country Today:
Yes

Title:
Advanced Practice Nurse
Nurse Anesthetist

Nationally Certified:
Yes

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Uncertain

Prescribing Authority:
No

Practice Autonomously:
No

Contact: 
University of Basel

Role

The role of the Advanced Practice Nurse in Switzerland has been developing since 2000 with the first advanced practice nursing program.  While there is no current scope of practice that is identified in the country, Switzerland has been developing the role of APNs that most closely resemble Clinical Nurse Specialists (Sprig, Schwendimann, Spichiger, Cignacco, & De Geest, 2009).  Often individuals who are prepared at the APN level will function not at the clinical level, but rather in leadership, quality, and process improvement levels (Sprig et al., 2009).  Additionally, APNs in Switzerland have been working with more advanced assessment and specialized patient care as well, but is more done so on an organizational-based program (Imhof, Naef, Wallhagen, Schwartz, & Mahrer-Imhof, 2012).  Because the development of APNs in Switzerland has been more driven on creating new healthcare models and improved outcomes rather than a physician shortage, there is little regulation at this time that defines a clear scope of practice (De Geest et al., 2008).

The Nurse Anesthetist role is also in existence in Switzerland (International Federation of Nurse Anesthetists [IFNA], n.d.).  Reportedly there are approximately 1900 Nurse Anesthetists in Switzerland today, more than that of anesthesiologists in the country (INFA, n.d.).  Regulations vary according to region, but in general Nurse Anesthetists administer general anesthesia under the supervision of an anesthesiologist (INFA, n.d.).

Education and Certification

Education for the APN in Switzerland is provided at the masters level after an individual achieves a bachelor degree in nursing (Sprig et al., 2009).  The programs for APNs in Switzerland require an individual to have English proficiency, 2 years of clinical professional experience in nursing, and have a degree in nursing (Sprig et al., 2009).  Additionally, individuals in nursing have also graduated at the doctorate level (PhD) in nursing (Sprig et al., 2009).

Education for a Nurse Anesthetist in Switzerland requires a nurse after obtaining a four-year nursing diploma an additional 400 hours of classroom education and approximately 200 hours of clinical time (INFA, n.d.).

Specialties

While there are various specializations that APNs may function within Switzerland, those observed in the literature were of HIV/AIDS, gerontology, and general practice (primary health care) (Imhof et al., 2012; Sprig et al., 2004).

Have information to add to this page?

References:
De Geest, S., Moons, P., Callens, B., Gut., C., Lindpainter, L., & Sprig, R. (2008).  Introducting advanced practice nurses/nurse practitioners in health care systems: A framework for reflection and analysis.  Swiss Med Weekly, 138(43-44),621-628.

Imhof, L., Naef, R., Wallhagen, M.I., Schartz, J., & Mahrer-Imhof, R. (2012).  Effects of an advanced practice nurse in-home health consultation program for community-dwelling persons aged 80 and older.  Journal of the American Geriatrics Society. 60(12),2223-2231.  doi: 10.1111/jgs.12026

International Federation of Nurse Anesthetists [IFNA] (n.d.). Switzerland Country Page.  Retrieved from: http://ifna-int.org/ifna/page?38

Sprig, R., Nicca, D., Voggensperger, J., Unger, M., Werder, V. & Niepmann, S. (2004).  The advanced nursing practice team as a model for HIV/AIDS caregiving in Switzerland.  Journal of the Association of Nurses in AIDS Care.  15(3),47-55.  doi:10.1177/1055329003261960

Sprig, R., Schwendimann, R., Spichiger, E., Cignacco, E., & De Geest, S. (2009).  The leadership role of the Institute of nursing Science, University of Basel in launching advanced practice nursing in the German speaking European countrires.  Universitat Basel.  Retrieved from: http://nursing.unibas.ch/fileadmin/pflege/redaktion/Institut/090206_ANP_ICN_Website.pdf

Advanced Practice Nursing in China

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Snapshot

APN Role Exists in Country Today:
Yes

Title:
Nurse Specialist

Nationally Certified:
Uncertain

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Uncertain

Prescribing Authority:
No

Practice Autonomously:
Uncertain

Contact:
Ministry of Health

Role

Nursing in China today has been pursuing the development of Advanced Practice Nursing roles (Wong et al., 2010).  While this initiative has begun there are several key influencing hurdles that will need to be addressed if such a role will be developed: 1. there are twice as many physicians in the country as that of nurses (Wong et al., 2010).  As a result much of the more advanced patient care that is currently provided in other developed nations is provided by physicians (Wong et al., 2010).  Additionally, nursing in China is a female-driven profession in a male-driven society, causing a gender-centric perspective (Wong et al., 2010).

The nursing role in China today has been developing as well.  Traditionally, the majority of nurses are educated at the diploma-level (64.5%) which incorporated 12 years of specialized primary and secondary schooling (Wong et al., 2010).  Another 24.3% have degrees at the associates level, which have been compared to nursing diploma schools in the United States, and approximately 1.3% hold bachelor degrees in nursing (Nichols, Davis, & Richardson, 2011; Wong et al., 2010).

An initiative by China’s Health Ministry has set to double their nurses to 4.45 million by 2020 (Xiang, 2011).  Registration and licensure of nurses has also been a recent initiative of China and since mid 2009 all nurses are required to pass the Chinese licensure exam (Nichols, Davis, & Richardson, 2011).  While the current education level of nursing in China has been lesser than that of other nations, China has been increasing in the exportation of nurses on the international level and as a result more programs are providing education focusing on passing the NCLEX exam necessary for more international regulation (Nichols, Davis, & Richardson, 2011; Wong et al., 2010).  With increased education provided in China, the advancement of nursing will also increase in quality.

Because of these strong factors that influence the nursing role in China, the emerging APN role resembles more the clinical nurse specialist, allowing nurses to gain expertise in content areas rather than that of a similar role to physicians (Wong et al., 2010).

Education and Certification

The current education provided for the few individuals who seek advancement in their nursing is provided at the masters level (Wong et al., 2010).  Reportedly, there are more than 30 master-level programs and 4 doctoral programs available in Mainland China as of 2005 (Yan, n.d.).

Specialties

The specialties recognized by China are (Yan, n.d.): 1. Intensive care, 2. Emergency nursing, 3. Organ transplantation, 4. Operating room, and 5. Oncology.

Have information to add to this page?

References:
Nichols, B.L., Davis, C.R., & Richardson, D.R. (2011).  Appendix J:  International models of nursing [pp. 565-642].  The Future of Nursing: Leading Change, Advancing Health.  Institute of Medicine.

Wong, F.K., Peng, G., Kan, E.C. (2010).  Description and evaluation of an initiative to develop advanced practice nurses in Mainland China.  Nurse Educator Today, 30, 344-349.

Xiang, Z. (Ed.) (2011, April 28).  China to double number of nurses by 2010: Health Ministry.  China Weekly English News.  Retrieved from: http://news.xinhuanet.com/english2010/china/2011-04/28/c_13850662.htm

Yan (n.d.).  Advanced nursing practice development in Mainland China [PowerPoint Presentation].  Retrieved from:  http://www.psdas.gov.hk/content/doc/2005-2-03/Yan%20Hu%20-%202005-2-03.pdf

Advanced Practice Nursing in Greece

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Snapshot

APN Role Exists in Country Today:
No

Contact:
Hellenic Nurses’ Association

Role

The nursing role in Greece struggles with great job dissatisfaction today.  According to the OECD 2012 health review, Greece’s nurses report a European high of 56% stating they desire to leave their job position.  Once great contributing factor is that there are more physicians that nurses in the country, leading to a shortage of nurses to provide care (Lavdaniti et al., 2008; OECD, 2012).  As a result, there is very little support for advancing the nursing role in the country.

However, there is motivation to expand the nursing role in Greece as there is currently education and seeking out of governance of Nurse Anesthetists in the country (Hellenic Nurses’ Association, 2013).

Education and Certification

Currently, the nursing education system offers master degrees in nursing for educators and individuals in director positions in healthcare (Robinson & Griffiths, 2007).  Additionally, some doctoral degrees are also being pursued, taught and supervised by the medical schools in the country (Robinson & Griffiths, 2007).   There is currently no certification or registration for Advanced Practice Nursing in the country.  Nurses can however seek 3 additional years of training to pursue nurse midwifery.

Specialties

While the role is not particularly expanded for nurses in Greece, individuals can regard themselves as a nurse-specialist.  There are several groups of nurse-specialists recognized by the Hellenic Nurses’ Association (2013):

  • Oncology
  • Anesthesiology
  • Administration
  • Emergency and Intensive Care
  • Education
  • Primary Health Care and Community
  • Mental Health
  • Pediatric

See something and want to add to this page?

References:
Dimitriadou, A., Lavdanti, M., Theofanidis, D., Psychogiou, M., Minasidou, E. … Sapountzi-Krepia, D. (2008).  Interprofessional collaboration and collaboration among nursing staff members in Northern Greece.  International Journal of Caring Sciences. 1(3),140-146

Hellenic Nurses’ Association (2013).  Notice nursing department of anesthesiology ESNE.  Retrieved from: http://www.esne.gr/

OECD (2012). Health At a Glance: Europe 2012 (2nd ed.).  OECD Publishing.  doi: 10.1787/9789264183896-en

Robinson, S. & Griffiths, P. (2007).  Nursing education and regulation: International profiles and perspectives [online publication].  Retrieved from: http://eprints.soton.ac.uk/348772/1/NurseEduProfiles.pdf

Advanced Practice Nursing in Mexico

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Snapshot

APN Role Exists in Country Today:
No Role is Officially Identified

Contact:
Secretería de Salud
Asociación Mexicana de Enfermeras Especializadas en Medicina Crítica y Terapia Intensiva (Mexican Association of Specialized Nurses in Critical and Intensive Care [AMEEMCTI])

Role

Currently there is no specific advanced practice nursing role in Mexico.  Nurses are offered the ability to specialize in intensive and critical care, but to date, nursing has not taken a leader role in health care (AMEEMCTI, n.d.; Secretería de Salúd, 2013).  The 20th ANEC conference in Mexico later this year will include the readdressing of the nursing role in Mexico and will be influenced and collaborated with the International Council of Nurses, allowing for more focused role development appropriate to the country’s healthcare needs (Secretería de Salúd, 2013).

In the meantime, Mexico’s health care system provides significant opportunity and potential for development of the Advanced Practice Nursing role (Pérez-Cuevas, Muñoz Hernández, & Gutiérrez Trujillo, 2010).

Have information to add to this page?

References:
Asociación Mexicana de Enfermeras Especializadas en Medicina Crítica y Terapia Intensiva (n.d.).  AMEEMCTI.  Retrieved from: http://www.ameemcti.org/

Pérez-Cuevas, R., Muñoz Hernández, O., & Gutiérrez Trujillo, G. (2010).  Nurses: The “front gate” to provide effective pediatric preventive care.  Boletín Médico del Hospital Infantil de México, 67(4).  Retrieved from: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-11462010000400010&lng=pt&nrm=iso

Secretería de Salúd (2013). Congreso Nacional de Enfermería, XX ANEC.  Retrieved from: http://www.salud.gob.mx/unidades/cie/cms_cpe/index.php?Id_URL=400despliegue&anio=2013&Id_Nota=222

[Updated: 2013, October 29]

Advanced Practice Nursing in Colombia

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Snapshot

APN Role Exists in Country Today:
No Role is Officially Identified

Treatment Authority:
Some registered nurses do have treatment authority

Prescribing Authority:
Uncertain

Contact:
Asociación Nacional de Enfermeras de Colombia
Asociación Colombiana de Facultades de Enfermería

Role

Colombia does not currently have an APN role recognized.  While some nurses may function in an advanced practice capacity by diagnosing, treating, and monitoring with minimal supervision of medical doctors, this role does not appear to be expanding due to no medical provider shortage, and possible surplus in the nation (CartagenaSurgery, Personal communication, 2013 August 14).

However, there is still a recognition in the current Colombian health system to push for more preventive care rather than diagnosing and treating and as mentioned by Atehortúa Rada et al. (2014), there is need and interest in advancing the nursing role to champion preventive medicine.

Have information to add to this page?

References:
Atehortúa Rada, G.M., Soto Chaquir, M., López Villegas, M.E. & Buitrago Malaver, L.A. (2014). La práctica avanzada en enfermería: una oportunidad para la promoción de la salud y la prevención de la enfermedad en Colombia.  Revista Cultura del Cuidado 11(1). Retrieved from: http://repositorio.unilibrepereira.edu.co:8080/pereira/bitstream/handle/123456789/223/6%20EPA%20pp.%2060-69.pdf?sequence=1

[Updated 2017, April 7]

Advanced Practice Nursing in South Korea

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Snapshot

APN Role Exists in Country Today:
Yes

Title:
Advanced Practice Nurse

Nationally Certified/Registered:
Yes

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Uncertain

Prescribing Authority:
Uncertain

Practice Autonomously:
No

Contact:

Role

Advanced Practice Nurses in South Korea date back to the 1950s (Sheer & Wong, 2008).  There are various roles of APNs in South Korea including (Sheer & Wong, 2008):

  • Nurse Midwife
  • Community Health Nursing
  • Nurse Anesthetist
  • Mental Health Nurse

While the advanced practice nurses have also existed in their country for more than 20 years, a strong value of the physician role has inhibited the professional respect to allow advanced practice nurses their own autonomy and peer collaboration.  Lack of local support in Korea further is represented as there is only one hospital in the nation that hires APNs in the nurse practitioner role, and even then the position reflects more of a senior nursing position than that of a medical provider (Maryland Nurses’ Association, 2012).

Education & Certification

Advanced Practice Nurses in South Korea are educated at the masters level of graduate education (Kang, 2005; Sheer & Wong, 2008).  The Advanced Practice Nurse role in South Korea is governed and certified by the Ministry of Health (Sheer & Wong, 2008).

Specialties

Advanced Practice Nurses in South Korea have various specialties (Kang, 2005; Sheer & Wong, 2008):

  • Anesthesia
  • Community Health
  • Critical Care
  • Emergency Medicine
  • Gerontology
  • Home Care
  • Infectious Disease
  • Industrial Health
  • Palliative/Hospice
  • Psychiatric/Mental Health

Have information to add to this page?

References:
Kang, Y. (2005).  Development of advanced practice nurses in South Korea.  Applied Nursing Research, 18(4), 226-227.

Maryland Nurses’ Association (2012).  A trip by Korean nurse practitioners to observe the U.S. nurse practitioner’s practice.  Maryland Nurse.  Retrieved from: http://www.thefreelibrary.com/A+trip+by+Korean+nurse+practitioners+to+observe+U.S.+nurse…-a0293416966

Savrin, C. (2009). Growth and development of the nurse practitioner role around the globe.  Journal of Pediatric Health Care 23, (5),310-314.

Sheer, B. & Wong, F.K.Y. (2008).  The development of advanced nursing practice globally.  Journal of Nursing Scholarship, 40(3),204-211.

Advanced Practice Nursing in Paraguay

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Snapshot

APN Role Exists in Country Today:
No

Contact:
Ministry of Health – Paraguay

Role

There is minimal regulation of the role of health care professionals and their scope of practice available online (Hanratty & Meditz, 1988).  Currently nurses are trained up to the bachelor level in the country, but more detailed nursing role and specialization is not available.  However, the Ministry of Health in Paraguay will consider allowed expanded scopes of practice for individuals trained further outside of Paraguay (Republic of Paraguay, n.d.).

Meanwhile, nursing has expanded in Paraguay, with organized nursing dating back to the 1930’s.  Graduate education has also been offered since the 1980’s and has continued to expand promising future possibilities of the advanced nursing practice in the future (Paraguay Times, n.d.).

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References:
Hanratty, D.M. & Meditz, S.W. (1988).  Paraguay: A country study. Washington, D.C.: GPO for the Library of Congress.  Retrieved from:  http://countrystudies.us/paraguay/36.htm

Paraguay Times (n.d.).  Nursing jobs in Paraguay – An increasing demand.  Retrieved from: http://www.paraguaytimes.com/business-finance/business/nursing-jobs-in-paraguay-an-increasing-demand.html

Republic of Paraguay (n.d.). Del ejercicio de la enfermería el congreso de la nación Paraguaya sanciona con fuerza de ley, No 3206.  Retrieved from: http://www.enfermeria.uc.edu.py/node/53