Advanced Practice Nursing in Argentina

Snapshot

APN Role Exists in Country Today:
No

Contact:
Minsterio de Salud y Ambiente de Argentina (Ministry of Health in Argentina)

Role

There is no current Advanced Practice Nursing (APN) role in Argentina today.  The role of nurses in Argentina is also in its development, as nurses have only recently in 2008 established a national licensing registry for nurses (Ministerio de Salud, n.d.).  Only once the nursing role is established to consistent standards, will the nurses be in a position to incorporate an established role of advanced practice.

The health care system in Argentina also presents some difficulties in developing an Advanced Practice Nurse educational programs and system to incorporate them in employment.  As of 2008, according to the Ministerio de Salud (2008), there were 1.5 doctors per every one nurse, and only 1.55 nurses  per every thousand individuals.  Once incorporating nursing related assistive professionals, the country only has 2.21 nursing type workers per thousand habitants in Argentina (Ministerio de Salud, 2008).  While these numbers were reported by the Ministry of Health in Argentina, the World Health Organization (WHO, 2013) reports from 2004 that Argentina had a closer ratio of 4-5 doctors per nursing and midwifery professional in the country, further confirming the desperate shortage of nurses in Argentina.

Because of this significant nursing shortage in Argentina, the Ministry of Health has proposed a plan to improve working conditions and benefits for nurses to increase the number of nurses to at least one per every doctor and hopes to develop a high ration of 4.0 nurses per 1,000 individuals (Durante, 2012; Ministerio de Salud, 2008).  Meanwhile, according to Durante (2012), the country has not had nearly the success it has hoped in increasing the nursing numbers as desired.  One great struggle with this issue is the lack of nursing educators and a significant dropout rate for students in nursing schools of nearly 70% in the first cycle, a lower level of nursing in the country (Durante, 2012).

Specialties

Not applicable at this time.

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References:
Durante, S. (2012, Junio 26). Noticias de enfermería – Misiones.  Sociedad Argentina de enfermería.  Retrieved from: http://blogsdelagente.com/sae/ 

Ministerio de Salud (n.d).  Registro Unico de Profesionales de Salud.  Retrieved October 30, 2013 from: http://rups.msal.gov.ar/turnos/

Ministerio de Salud (2008).  Consejo de Salud 8 y 9 de Mayo, 2008, Recursos humanos: Residencias Enfermería [PowerPoint presentation].  Retrieved from: http://www.msal.gov.ar/images/stories/cofesa/2008/acta-02-08/anexo-4-acta-02-08.pdf

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

World Health Organization [WHO] (2013b). Disaggregated data: Nursing and midwifery personnel by country.  Retrieved from: http://apps.who.int/gho/data/node.main.HWF1?lang=en

Advanced Practice Nursing in Costa Rica

Snapshot

APN Role Exists in Country Today:
No

Contact:
Colegío de Enfermeras de Costa Rica

Role

There is no current Advanced Practice Nursing (APN) role in Costa Rica today (post by Julie Slivinsky, All Nurses.com, 2011, January 8).  Reportedly from the last World Health Organization (WHO, 2013a) reported in 2000, there were approximately 1.32 physicians per 1000 people, significantly lower than the majority of developed nations.  Meanwhile, there are 0.69 nurses per every physician, creating a healthcare workforce with significantly more physicians than nurses (WHO, 2013b).  This factor is likely a significant inhibiting factor for such APN role development.

Meanwhile, there is reportedly a history of a midwifery role, that has been in existence since 1899 (Colegio de Enfermeras de Costa Rica, 2011).  In 2000, there were reportedly 22 midwives in the country (WHO, 2013b).

Specialties

Not applicable at this time.

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References:
Colegio de Enfermeras de Costa Rica (2011).  Historia de la enfermería en Costa Rica.  Retrieved from: http://www.enfermeras.co.cr/HistoriaEnfermeriaCostaRica.html

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

World Health Organization [WHO] (2013b). Disaggregated data: Nursing and midwifery personnel by country.  Retrieved from: http://apps.who.int/gho/data/node.main.HWF1?lang=en

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

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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