Summary
Advanced Practice Nursing and Advanced Midwifery Practice in Flanders: nurses and midwives at the crossroads of expert practice, research, innovation, and leadership
Régine Goemaes
AIM: To examine (1) concept “advanced midwifery practice”, (2) factors influencing the implementation of AMPs in Flanders, and (3) practice profile, competency level, and time use of APNs/AMPs in Flanders.
METHOD: concept analysis, interviews, cross-sectional study.
FINDINGS: APNs and AMPs (n=63) in (non) university hospitals executed tasks in all advanced practice domains: (a) clinical expertise, expert guidance and coaching, (b) nurse/midwife consultation and consultancy, (c) multidisciplinary cooperation and coordination of care, (d) clinical and professional leadership, (e) change management and innovation, (f) research, and (g) ethical decision-making. However, role execution in the domains of leadership, innovation, research, and ethical decision-making was suboptimal. Additionally, several factors influencing the implementation of AMPs on a governmental, healthcare organizational, and workforce level were uncovered.
DISCUSSION: Measures for optimizing and making maximal utilization of APNs and AMPs competencies are necessary for inservice training and preservice education, policy and regulations, legislation, financing, management, and augmentation of intra and interprofessional support. Newly implemented specific APN/AMP master programs and a new legal framework for APNs are important steps forward. However, legislation for AMPs is lacking.
CONCLUSION: Implementation of APNs and AMPs is emerging in Flanders. Although task execution is performed in all advanced practice domains, optimization is advised using several measures to remove barriers and promote facilitating factors.
Keywords: advanced practice nursing, advanced midwifery practice, role implementation, professional competence, leadership, task performance and analysis
