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      Advanced Practice Nursing: “Training” Pillar in Supporting the Proposal in Brazil Translated title: Enfermería de Práctica Avanzada: Pilar “Formación” en Apoyo a la Propuesta en Brasil Translated title: Enfermagem de Prática Avançada: Pilar “Formação” na Sustentação da Proposta no Brasil

      research-article
      I , II , III , IV , V
      Revista Brasileira de Enfermagem
      Associação Brasileira de Enfermagem
      Advanced Practice Nursing, Public Policy, Health Postgraduate Programs, Nursing Education, Education, Nursing, Graduate, Enfermería de Práctica Avanzada, Políticas Públicas, Programas de Posgrado en Salud, Educación en Enfermería, Educación de Postgrado en Enfermería, Prática Avançada de Enfermagem, Políticas Públicas, Programas de Pós-Graduação em Saúde, Educação em Enfermagem, Educação de Pós-Graduação em Enfermagem.

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          ABSTRACT

          Objectives:

          to present the pillars that support what has been called Advanced Practice Nursing and discuss the necessary training for its implementation.

          Methods:

          elements contained in assessment documents for graduate programs proposals, reports of presentations by international professors in countries and selected scientific publications were gathered to compose the argument.

          Results:

          practice/competency (adds broad and in-depth knowledge about health processes and scientific evidence, clinical reasoning and clinical skills for therapeutic indications); 3) professional regulation (corresponding legislation and monitoring); and 4) funding (broad training and professional practice policy).

          Final Considerations:

          the agenda for implementing Advanced Practice Nursing in Brazil involves joining efforts to identify stakeholders for a work to legitimize their importance in the country’s health and education overview.

          RESUMO

          Objetivos:

          apresentar os pilares que sustentam o que vem sendo nominado como Enfermagem de Prática Avançada e problematizar sobre a formação necessária para sua implementação.

          Métodos:

          reuniram-se elementos constantes em documentos de avaliação de propostas dos programas de pós-graduação, relatórios de apresentações de docentes internacionais em países e publicações científicas selecionadas para compor a argumentação.

          Resultados:

          prática/competência (agrega conhecimento amplo e aprofundado sobre os processos de saúde e evidências científicas, raciocínio clínico e capacidades clínicas para indicações terapêuticas); 3) regulação profissional (legislação correspondente e acompanhamento); e 4) financiamento (política ampla de formação e de prática profissional).

          Considerações Finais:

          a agenda para a implementação da Enfermagem de Prática Avançada no Brasil passa por conjugar esforços na identificação de stakeholders para um trabalho de legitimação sobre sua importância no panorama da saúde e educação do país.

          RESUMEN

          Objetivos:

          presentar los pilares que sustentan lo que se ha denominado Enfermería de Práctica Avanzada y discutir la formación necesaria para su implementación.

          Métodos:

          se reunieron elementos contenidos en documentos de evaluación de propuestas de programas de posgrado, informes de presentaciones de profesores internacionales en países y publicaciones científicas seleccionadas para componer el argumento.

          Resultados:

          práctica/competencia (agrega conocimiento amplio y profundo sobre procesos de salud y evidencia científica, razonamiento clínico y habilidades clínicas para indicaciones terapéuticas); 3) regulación profesional (legislación correspondiente y seguimiento); y 4) financiación (política amplia de formación y ejercicio profesional).

          Consideraciones Finales:

          la agenda para la implementación de la Enfermería de Práctica Avanzada en Brasil implica aunar esfuerzos para identificar actores para un trabajo de legitimación de su importancia en el panorama de la salud y la educación del país.

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          Most cited references52

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          Clinical nurse specialists and nurse practitioners: title confusion and lack of role clarity.

          Title confusion and lack of role clarity pose barriers to the integration of advanced practice nursing roles (i.e., clinical nurse specialist [CNS] and nurse practitioner [NP]). Lack of awareness and understanding about NP and CNS roles among the healthcare team and the public contributes to ambiguous role expectations, confusion about NP and CNS scopes of practice and turf protection. This paper draws on the results of a scoping review of the literature and qualitative key informant interviews conducted for a decision support synthesis commissioned by the Canadian Health Services Research Foundation and the Office of Nursing Policy in Health Canada. The goal of this synthesis was to develop a better understanding of advanced practice nursing roles and the factors that influence their effective development and integration in the Canadian healthcare system. Specific recommendations from interview participants and the literature to enhance title and role clarity included the use of consistent titles for NP and CNS roles; the creation of a vision statement to articulate the role of CNSs and NPs across settings; the use of a systematic planning process to guide role development and implementation; the development of a communication strategy to educate healthcare professionals, the public and employers about the roles; attention to inter-professional team dynamics when introducing these new roles; and addressing inter-professionalism in all health professional education program curricula.
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            Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

            ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries.
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              Sistema de Saúde e Trabalho: desafios para a Enfermagem no Brasil

              Resumo O artigo debate a importância da Enfermagem para o Sistema Único de Saúde, considerando a mesma estar presente em todas as estruturas organizacionais de saúde, nas 27 unidades da Federação e em todos os municípios do país, essencial, portanto, para a prestação de uma assistência de qualidade. Apesar disso, a profissão enfrenta muitos desafios, quer no campo da formação e do mercado de trabalho, que necessitam ser enfrentados, visando a valorização desses profissionais que apesar de todas as dificuldades a que estão submetidos, são comprometidos com a saúde da população brasileira.
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                Author and article information

                Contributors
                Role: conception or design of the study/researchRole: analysis and/or interpretation of dataRole: final review with critical and intellectual participation in the manuscript
                Role: conception or design of the study/researchRole: analysis and/or interpretation of dataRole: final review with critical and intellectual participation in the manuscript
                Role: conception or design of the study/researchRole: analysis and/or interpretation of dataRole: final review with critical and intellectual participation in the manuscript
                Role: conception or design of the study/researchRole: analysis and/or interpretation of dataRole: final review with critical and intellectual participation in the manuscript
                Role: conception or design of the study/researchRole: analysis and/or interpretation of dataRole: final review with critical and intellectual participation in the manuscript
                Journal
                Rev Bras Enferm
                Rev Bras Enferm
                reben
                Revista Brasileira de Enfermagem
                Associação Brasileira de Enfermagem
                0034-7167
                1984-0446
                06 October 2023
                2023
                : 76
                : 5
                : e20230118
                Affiliations
                [I ]Universidade Paulista Júlio de Mesquita. Botucatu, São Paulo, Brazil
                [II ]Universidade Federal do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
                [III ]Universidade de São Paulo. São Paulo, São Paulo, Brazil
                [IV ]Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
                [V ]Universidade Federal de Pelotas. Pelotas, Rio Grande do Sul, Brazil
                Author notes
                Corresponding author: Cristina Maria de Lima Garcia Parada, E-mail: cristina.parada@ 123456unesp.br

                EDITOR IN CHIEF: Antonio José de Almeida Filho

                ASSOCIATE EDITOR: Álvaro Sousa

                Author information
                http://orcid.org/0000-0002-9597-3635
                http://orcid.org/0000-0002-1692-0253
                http://orcid.org/0000-0001-6515-4404
                http://orcid.org/0000-0002-9912-4446
                http://orcid.org/0000-0001-9726-3162
                Article
                00800
                10.1590/0034-7167-2023-0118
                10561421
                37820131
                c6223c4c-d5af-45ad-8209-150deca2ddcd

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 January 2023
                : 13 April 2023
                Categories
                Reflection

                advanced practice nursing,public policy,health postgraduate programs,nursing education,education,nursing,graduate,enfermería de práctica avanzada,políticas públicas,programas de posgrado en salud,educación en enfermería,educación de postgrado en enfermería,prática avançada de enfermagem,programas de pós-graduação em saúde,educação em enfermagem,educação de pós-graduação em enfermagem.

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