Advanced Practice Nursing in the Russian Federation (Russia)

Snapshot

APN Role Exists in Country Today:
No

Contact:
Russian Nurses Association (RAMS)
US-Russian Nursing Conference Cruise

Role

There is no current role of advanced practice nurses in Russia today.  According to the World Bank, in 2010 the Russian Federation had approximately 8.5 nurses per thousand individuals, a number showing adequacy of the nursing workforce (WHO, 2013).  Additionally, there were more than four doctors per thousand individuals, also significantly adequate for healthcare today (WHO, 2013).  While these numbers are impressive, the healthcare standards in Russia have been observed to be inadequate; however, there has been consistent improvement over the last several years (Davydov & Shepin, 2010; Tashlein-Van Hueveln, 2009).

In recent years, the Russian Nurses Association (2013) in assistance with the International Council of Nurses has been updating and identifying national nursing standards since 2007 and hope to have a uniform set of standards implemented by 2015.  As the role of nursing is beginning to be established in Russia, development of Advanced Practice Nursing roles will take more time for future establishment.

Specialties

While there are no specific Advanced Practice Nursing roles present in Russia today, on 2012, the Russian Nurses Association defined several nursing specialties including (Russian Nurses Association, 2012):

  • Dietary Nursing
  • Operating Nursing
  • Anesthesia Nursing
  • Pediatric Nursing
  • Psychiatric Nursing
  • Massage Nursing
  • Specialist in Nursing Statistics

In addition, it was established that the title of “Bachelors of Nursing” would be established for senior nurses prepared at the bachelor level, a role implemented earlier in 2013 (Russian Nurses Association, 2012).

Have information to add to this page?

References:
Davydov, M.I. & Shepin, O.P. (2010).  The Russian healthcare system.  Medical Solutions.  Retrieved from: http://www.healthcare.siemens.com/healthcare-magazine

Tashlein Van-Hueveln, D. (2009, August 3).  Russian healthcare: Observing nurses a world way.  Carolina Nursing News.  Retrieved from: http://carolinanursingnews.com/2009/08/03/russian-healthcare-observing-nurses-a-world-away/

Russian Nurses Association (2012).  Professional standards [Google translated version].  Retrieved from: http://translate.google.com/translate?hl=en&sl=ru&tl=en&u=http%3A%2F%2Fwww.medsestre.ru%2Ffiles%2Ffile%2Fstandart%2F0_uvedomlenie.pdf

Russian Nurses Association (2013).  Negotiations in leadership [Google translated version].  Retrieved from: http://www.medsestre.ru/new/info/36

World Bank, The (2010).  Nurses and midwives (per 1,000 people).  Retrieved from: http://data.worldbank.org/indicator/SH.MED.NUMW.P3

World Health Organization [WHO] (2013).  Aggregated Data: Density per 1000 by country.  Retrieved from: http://apps.who.int/gho/data/node.main.A1444?lang=en

Advanced Practice Nursing in Hong Kong

Snapshot

APN Role Exists in Country Today:
Yes

Titles:
Nurse Specialist
Advanced Practice Nurse

Nationally Certified:
Yes

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Yes

Prescribing Authority:
Uncertain

Practice Autonomously:
Varies

Contact:
The Provisional Hong Kong Academy of Nursing Limited (PHKAN)
Hong Kong Society for Nursing Education Limited
Nursing Council of Hong Kong

Role

Advanced Practice Nurses began as Nurse Specialists in Hong Kong in 1994 (Sheer & Wong, 2008).  This role was primarily created to allow for career development for nurses who had significant expertise in a specific specialty.  In the Hong Kong health system, the Hospital Authority, the national entity responsible for health care in Hong Kong, utilizes Nurse Specialists frequently as consultants in the inpatient hospital system (Chan, Thompson, & Wong, 2006).  These individuals often carry their own patient load, but may also see patients on other wards that have specialty needs.  The roles of these specialists within the hospital systems vary according to hospital and specialty (Chan, Thompson, & Wong, 2006). The role of Nurse Specialist on an outpatient basis is in nurse-led clinics.  This effort was created by the Hospital Authority to help manage individuals on an outpatient basis.

Similarly to several parts of Asia, Hong Kong’s health system does not have a significant entity of primary health care, and individuals will usually first be seen for a significant ailment in the emergency department.  Once diagnosed with some condition and stabilized to no longer need inpatient treatments, they will then be referred to see a specialty clinic on an outpatient basis.  Due to the lack of such clinics, the Hospital Authority of Hong Kong developed the concept of nurse-led clinics with specialty nurses providing care and management to individuals with that ailment (Chan, Thompson, & Wong, 2006).  For example, for an individual with Chronic Obstructive Pulmonary Disease (COPD), an individual would go to a COPD clinic.

Since inception, these nurse-led clinics, run by Nurse Specialists, have been continuing to expand and have demonstrated good improvement to healthcare in Hong Kong today (Shiu, Lee, & Chau, 2012).  The nurses in these clinics can manage up to 90% of patients for outpatient disease-specific care and also take a more holistic approach and rarely prescribe medications (Wong, 2002).  Most often the nurses in these clinics will practice either independent or supervised adjustments of medications and initiating diagnostics or treatments according to protocols (Wong & Chung, 2006).  In some circumstances however, the CNS/NSs will prescribe medication, as nicotine patches for smoking cessation for COPD patients (Wong, 2010). An additional role developed in 2002 was the Advanced Practice Nurse (APN).  This title was designated for individuals who practice in a more promoted position based on nurses being very experienced (Chan, Thompson, & Wong, 2006).  This role most similarly reflects that of the Clinical Nurse Specialist in other nations, and have significant expertise and experience.  Much of the role of APN development in Hong Kong has been in inpatient settings and includes advanced clinical assessment, education, research, and consultation with physicians (Sheer & Wong, 2008).

Another role in development is that of the Nurse Practitioner.  This role is in development today, and a potential additional position to be incorporated in the increasing health care needs in Hong Kong.

In general, the roles of advanced practice nurses in Hong Kong have been developing greater acceptance, greatly due to improved perceptions of the increase in health care quality and safety (Christiansen, Vernon, & Jinks, 2013).  Meanwhile, the greatest perceived challenge of the advancement of APNs in Hong Kong is that of other health care workers’ acceptance of the position (Christiansen, Vernon, & Jinks, 2013).  Another considerable factor is that of ‘brain-drain’ leading to a now 10-year shortage of nursing in Hong Kong (Lee, 2014).  Low financial compensation seems to be a valid concern reducing the number of nurses desiring to stay within the country and therefore able to seek career advancement.

Education and Certification

The role of the Advanced Practice Nurse or Nurse Specialist requires a minimum education of a masters degree (Sheer & Wong, 2008).  To be a Nurse Practitioner in Hong Kong, one would be required to have a master degree with a focus on clinical experience (Loke, 2004). Most recently, desire to standardize clinical care and preparation, there have been efforts to establish accreditation and registration for Nurse Specialists in Hong Kong.  One such effort is being a fellow of the Provisional Hong Kong  Academy of Nursing Limited (2012) and another the College of Nursing, Hong Kong (n.d.).  Such organizations like these have been striving to create standardized care and registration for individuals working in the capacity as a Nurse Specialist (Sheer & Wong, 2008).

Specialties

Various roles associated with the Nurse Specialist include (Chan, 2012; Schober & Affara, 2006):

  • Advanced Medical Nursing
  • Advanced Pediatric Nursing
  • Advanced Surgical Nursing
  • Anesthetic and Recovery Nursing
  • Breast Care
  • Cardiac Care Nursing
  • Cardiac Surgical Nursing
  • Community Nursing
  • Community Psychiatric Nursing
  • Continence Nursing
  • Diabetes Nursing
  • Emergency Nursing
  • Gerentological Nursing
  • HIV/AIDS Nursing
  • Intensive Care Nursing
  • Neonatal Intensive Care Nursing
  • Orthopedics & Traumatology Nursing
  • Pediatric Intensive Care Nursing
  • Peri-operative Nursing
  • Primary Health Care Nursing
  • Psychiatric Rehabilitation Nursing
  • Rehabilitation Nursing
  • Renal Nursing
  • Respiratory Nursing
  • Rheumatology Nursing
  • Substance Abuse Nursing
  • Transplant Nursing
  • Wound/ostomy Nursing
  • Urology Nursing

Have information to add to this page?

References:
Chan, E. (2012).  Hong Kong perspective on nursing workforce planning, development, and education [PowerPoint presentation].  Retrieved from: http://www.ha.org.hk/haconvention/hac2012/proceedings/downloads/S8.3.pdf

 

Christiansen, A., Vernon, V., & Jinks, A. (2013).  Perceptions of the benefits and challenges of the role of advanced practice nurses in nurse-led out-of-hours care in Hong Kong: a questionnaire study.  Journal of Clinical Nursing.  22(7-8),1173-1181.  doi: 10.1111/j.1365-2702.04139.x

College of Nursing, Hong Kong (n.d.).  Clinical nurse specialist accreditation.  Retrieved from: http://www.cnhk.org.hk/eng/Files/Courses/Clinical_Nurse_Specialist_Accreditiation_Leaflet_101101_4.pdf

Kannusamy, P. (2006).  A longitudinal study of advanced practice nursing in Singapore.  Critical Care Nursing Clinics of North America. 18,545-551.  doi:10.1016/j.ccell.2006.08.001

Lee, K. (2014, June 25).  Nurses looking for cure to staff shortages.  The Standard.  Retrieved from: http://thestandard.com.hk

Loke, A. (2004).  Hong Kong scenario: The development of nurse practitioner education program.  Retrieved from: http://international.aanp.org/pdf/LokeHKNP.pdf

Chan, S., Thompson, D.R., & Wong, T. (2006).  Chapter 14: Nurses as agents of quality improvement.  In Leung, G.M. & Bacon-Shone, J. (Eds.), Hong Kong’s health system: Reflections, perspectives and visions [Google e-reader version].  Aberdeen, Hong Kong:  Hong Kong University press.  Retrieved from: http://books.google.com/

Provisional Hong Kong Academy of Nursing Limited, The (2012).  Introduction of PHKAN.  Retrieved from: http://www.hkan.hk/

Schober, M. & Affara, F.A. (2006).  International Council of Nurses: Advanced Nursing Practice [Kindle e-reader version].  Blackwell Publishing Ltd.

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

Shiu, A.T., Lee, D.T., & Chau, J.P. (2012).  Exploring the scope of expanding advanced nursing practice in nurse-led clinics: A multiple-case study.  Journal of Advanced Nursing, 68(8),1780-1792.  doi: 10.1111/j.1365-2648.2011.05868.x

Twinn, S. (2003, December 14).  Advanced nursing practice in public health nursing.  Hong Kong Society for Nursing Education Newsletter.  Retrieved from: http://www.hksne.org.hk/newsletter/200312-04.htm

Wong, F.K. (2002). Development of advanced nursing practice in Hong Kong: a celebration of ten years’ work [PowerPoint presentation]. Retrieved from: international.aanp.org/pdf/fwongicnanpdev_2406031.ppt

Wong, F.K.Y. & Chung, L.C.Y. (2006).  Establishing a definition for a nurse-led clinic: Structure, process, and outcome.  Journal of Advanced Nursing, 53(3),358-369.  doi: 10.1111/j.1365-2648.2006.03730.x

[Updated: Jun 29, 2014]

Advanced Practice Nursing in Singapore

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Advanced Practice Nurse

Nationally Certified:
Yes

Recognize Foreign Licensure:
Yes

Treatment Authority:
Yes

Prescribing Authority:
Limited under acute care protocols

Practice Autonomously:
Varies

Contact:
Singapore Nursing Board

Role

An Advanced Practice Nurse (APN) in Singapore is recognized as an APN.  In Singapore, the title “Advanced Practice Nurse” is protected and only allowed to be used by individuals certified by the Singapore Nursing Board (Fee, 2012).  The development of the APN role in Singapore, has been a proactive response to alleviate increased workforce stress due to an aging population with greater health care needs, while also providing career advancement opportunities for nurses (Kannusamy, 2006; Premarani, n.d.).  As a result, Singapore initially developed a master of nursing program training individuals in advanced clinical skills in 2003 and had its first graduates in 2004 (Sheer and Wong, 2008).  Since the development of the APN role, Singapore plans on increasing the APN number to more than 200, approximately 1.4% of the nursing population, by 2014 (Sheer and Wong, 2008; Tan Tock Seng Hospital, 2013).  While this is the goal that has been set for Singapore, the Singapore Ministry of Health (2011) identified currently 88 APNs registered to practice in the country in 2012.

The role of the APN in Singapore is best described as a hybrid of the Clinical Nurse Specialist and the Nurse Practitioner (Fee, 2012; Bee, 2012).  APNs are trained in the advancement of the registered nurse profession to add the role skills of diagnosis and management of common ailments and chronic illnesses (Singapore Nursing Board, 2012).  The scope of practice for the APN in Singapore includes the following (Singapore Nursing Board, 2012; Tan Tock Seng Hospital, 2013):

  • Advanced physical assessment
  • Develop diagnosis and differential diagnoses
  • Interpret laboaratory and diagnostic testing
  • Management of care
  • Performing procedures
  • Collaboration with other healthcare professionals including doctors
  • Advancement of nursing through development and implementation of Evidence Based Practice into current healthcare

APNs in Singapore work in all settings, including primary, secondary, and tertiary care as well as peer and nursing education (Singapore Nursing Board, 2012).  Pharmaceutical prescribing and management is under current investigation and standardization (Tan Tock Seng Hospital, 2013).  While prescribing is recognized to be traditionally under the medical domain, it is acknowledged that by preventing prescribing rights, this prevention would inhibit the effectiveness of the role (Tan Tock Seng Hospital, 2013).  As a result, APNs currently are allowed to provide (furnish) medication prescription privleges in certain acute care settings according to pre-identified protocols (Singapore General Hospital, 2013; Tan Tock Seng Hospital, 2013).

As APNs have only recently developed an established role in Singapore, the Singapore Nursing Board (2012) also requires the hiring institution to identify the specific scope of practice and role for the APN.

Education and Certification

Registration was first established in Singapore in 2006 (Sheer and Wong, 2008).  To be an APN in Singapore, an individual must be registered with the Singapore Nursing board and have at least 3 years of post registration experience in their specialty (Singapore Nursing Board, 2012).  There is currently one program in Singapore recognized by the Board, the Master of Nursing program at the Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine at the National University of Singapore.   Applications for registration must be made in person.  Once an individual graduates for an accredited program and has submitted for registration, they are required to perform one year of supervised clinical practice with a minimum of 1280 hours of direct patient care at an advanced level (Singapore Nursing Board, 2012).

Specialties

Currently, APNs in Singapore may be qualified as one of four specializations (Singapore Nursing Board, 2012):

  • Acute Care APN
  • Medical/Surgical APN
  • Community Care APN
  • Mental Health APN

The roles of the APN in acute care specializations includes current APNs or interns in (Singapore General Hospital, 2013; Tan Tock Seng Hospital, 2013):

  • Anesthesiology
  • Cardiology
  • Diabetes and Endocrinology
  • Family Medicine Continuing Care
  • Gasteroenterology and Nutrition
  • Gerentology
  • Intensive Care
  • Neurology
  • Neurology Intensive Care
  • Oncology
  • Orthopedics
  • Pelvic Floor Disorders
  • Palliative Care
  • Rehabiliation Medicine
  • Renal and
  • Vascular Surgery

Have information to add to this page?

References:
Bee, T.S. (2012).  Advanced practice nursing in Singapore – Clinical outcomes [PowerPoint presentation].  Retrieved from: http://www.hksne.org.hk/course/DrTanSiokBeeAPNCareOutcomes.pdf

Fee, L.S. (2012).  Pioneering moments of APN in an acute tertiary hospital in Singapore [PowerPoint presentation].  Retrieved from: http://www.hksne.org.hk/course/MsLimSuFeePioneeringMomentsofAPN.pdf

Kannusamy, P. (2006).  A longitudinal study of advanced practice nursing in Singapore.  Critical Care Nursing Clinics of North America. 18,545-551.  doi:10.1016/j.ccell.2006.08.001

Premarani, K. (n.d.).  Advanced practice in Singapore [PowerPoint Presentation].  Retrieved from: https://international.aanp.org/pdf/P13.ppt

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

Singapore General Hospital (2013).  Advanced practice nurse.  Retrieved from: http://www.sgh.com.sg/clinical-departments-centers/nursing/nursingprofession/pages/advanced-practice-nurse.aspx

Singapore Ministry of Health (2011).  Health manpower.  Retrieved from: http://www.moh.gov.sg/content/moh_web/home/statistics/Health_Facts_Singapore/Health_Manpower.html

Singapore Nursing Board (2012).  Advanced practice nurse.  Retrieved from: http://www.healthprofessionals.gov.sg/content/hprof/snb/en/leftnav/advanced_practice_nurse.html

Tan Tock Seng Hospital (2013).  Advanced practice nurses.  Retrieved from: http://www.ttsh.com.sg/APN/

Advanced Practice Nursing in India

Snapshot

APN Role Exists in Country Today:
No

Title:
Nurse Practitioner (in development)

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

Not applicable at this time.

See something and want to add to this page?

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/

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 2013, October 30]

Advanced Practice Nursing in Japan

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 China

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 South Korea

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.