A country's efforts toward creating an advanced practice nurse in public health

Abstract

Aim: The study goal was to inform the creation of a blueprint for an advanced practice nurse (APN) in public health. Background: No internationally accepted standard for an APN in public health exists. Activities of public health nurses (PHN) traditionally have centered on health promotion and disease prevention, but many have added other population-based activities such as chronic and acute disease treatment. Introduction: An APN in public health is needed to address the global challenges threatening the physical, social, and mental health of populations worldwide. Methods: This qualitative study was comprised of six focus groups, each containing a different group of stakeholders (n = 40). Study results followed the requirements of the consolidated criteria for reporting qualitative research (COREQ). Findings: Two major themes emerged: the APN role in public health and core expectations. From the APN role theme, four subthemes emerged on APN domains of public health practice and functions. From the core expectations theme, nine subthemes emerged on the APN's qualifications and behaviors. Discussion: Agreement among stakeholders was found in the nine core expectations; however, among the four different visions of an APN in public health, two fit a population-based model rather than the traditional PHN model. Conclusions: A single APN role in public health is insufficient to address the breadth and complexity of today's global challenges as detailed by the sustainable development goals. Due to the interaction between health and the biopsychosocial environments, we need APNs with different areas of expertise. Implication for nursing policy: Nurses working at universities, in public health services, and as healthcare policymakers are needed to create a multistage strategy that gradually introduces several different types of APNs in public health.