Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 15;19(1):19.
doi: 10.1186/s12960-021-00555-6.

Nurses in advanced roles as a strategy for equitable access to healthcare in the WHO Western Pacific region: a mixed methods study

Sue Kim  1 , Tae Wha Lee  1 , Gwang Suk Kim  1 , Eunhee Cho  1 , Yeonsoo Jang  1 , Mona Choi  2 , Seoyoung Baek  3 , David Lindsay  4 , Sally Chan  5 , Regina L T Lee  6 , Aimin Guo  7 , Frances Kam Yuet Wong  8 , Doris Yu  9 , Sek Ying Chair  10 , Yoko Shimpuku  11 , Sonoe Mashino  12 , Gigi Lim  13 , Sheila Bonito  14 , Michele Rumsey  15 , Amanda Neill  15 , Indrajit Hazarika  16
Affiliations

Nurses in advanced roles as a strategy for equitable access to healthcare in the WHO Western Pacific region: a mixed methods study

Sue Kim et al. Hum Resour Health. .

Abstract

Background: The Western Pacific region constitutes one-quarter of the world's population and has diverse health needs. While dialogue on and promotion of advanced practice nurses are ongoing, this study investigated the current responsibilities of nurses in advanced roles, future healthcare needs, and the implications of these components for nurses' professional development within the Western Pacific region.

Methods: This study employed three phases, a descriptive survey on the current status of nurses in advanced roles in the Western Pacific region, followed by a Delphi survey, and exploratory interviews. A total of 55 national experts with clinical, academic, and/or government-related backgrounds from 18 countries participated from December 2017 - December 2018. The descriptive survey via email to identify the status of nurses in advanced roles and a working definition was developed. This formed the basis for the Delphi survey, which identified key barriers and challenges for enhancing the development of nurses in advanced roles within the country (round 1) and for the region (rounds 2 and 3). Lastly, semi-structured individual interviews were conducted to identify strategies for establishing nurses in advanced roles to improve equitable access to healthcare.

Results: Thirty-seven roles and characteristics were identified and categorized for nurses performing advanced roles. Emergency care, critical care, elderly health, child health, and rural/remote communities were identified as fields with particular need for nurses in advanced roles in the Western Pacific region. Providing effective services, influencing government leadership, and advocating for health system sustainability were deemed necessary to improve equitable healthcare access. We found that nurses in advanced roles are not limited to clinical tasks within the hospital but are poised for active participation in primary healthcare, education/teaching, professional leadership, quality management, and research.

Conclusions: Demand for nurses in advanced roles is high in the Western Pacific region and 15 items were identified across five core strategic areas to enhance development of nurses in advanced roles. Governmental-level recommendations include establishing legislative protection, improving systems for remuneration, strengthening supportive channels, and conducting national needs assessments.

Keywords: Advanced practice nursing; Health equity; Health services accessibility; Nurse²s role; Professional role.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Interview guide used for Phase 3
Fig. 2
Fig. 2
Strategies to enhance the development of NAR identified from phases 2 and 3
Fig. 3
Fig. 3
Governmental-level recommendations for the promotion of NAR
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization Western Pacific Region. About WHO in the Western Pacific. 2020. https://www.who.int/westernpacific/about. Accessed 15 June 2020.
    1. World Health Organization Western Pacific Region. Universal Health Coverage: moving towards better health action framework for the Western Pacific region. 2016. https://iris.wpro.who.int/bitstream/handle/10665.1/13371/9789290617563_e.... Accessed 15 June 2020.
    1. United Nations. Transforming our world: the 2030 agenda for Sustainable Development. 2015. https://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E/. Accessed 15 June 2020.
    1. International Council of Nurses. Nurse Practitioner / Advanced Practice Nursing Network. Definitions and characteristics of the role. https://international.aanp.org/Practice/APNRoles. Accessed 20 July 2020.
    1. Keeling AW. Historical perspectives on an expanded role for nursing. Online J Issues Nurs. 2015 doi: 10.3912/OJIN.Vol20No02Man02. - DOI - PubMed

Publication types

LinkOut - more resources