By Chimamaka A. Nwachukwu
One of the most significant shifts in nursing has been the emergence and institutionalization of Advanced Practice Nursing (APN) roles, including nurse practitioners (NPs), clinical nurse specialists (CNSs), and nurse anesthetists. Delamaire and Lafortune (2020), in their review of 12 developed countries, found that advanced practice nurses have become essential to addressing physician shortages, improving access to primary care, and filling critical gaps in specialty care.
The policy environment around advanced nursing practice varies widely across countries. While the U.S., Canada, and parts of Europe have made significant strides, many nurses globally still face legal and institutional barriers that prevent them from practicing to the full extent of their training and expertise (Fawaz, Hamdan-Mansour and Tassi, 2021).
Challenges and Opportunities in Enabling Full Scope of Practice
Despite global progress, nurses still encounter persistent challenges in practicing at an advanced level. Regulatory limitations, interprofessional resistance, lack of role clarity, and insufficient educational infrastructure continue to hinder progress. According to Jangland, Yngman Uhlin and Arakelian (2021), institutional support is critical for enabling advanced practice roles in hospitals. Their research highlighted the importance of clear role definitions, organizational readiness, and interdisciplinary collaboration in sustaining advanced nursing roles.
Equally important is leadership development. Without strategic leadership at the administrative and policy levels, nursing contributions risk being underutilized or overlooked in systemic reforms.
Nursing Practice and Health Equity
As emphasized in the National Academy of Medicine’s report The Future of Nursing 2020–2030, nurses are uniquely positioned to address health equity due to their consistent proximity to patients and communities (Institute of Medicine, 2021). The report advocates for expanding nursing education, leadership, and policy involvement to address social determinants of health and reduce disparities in access and outcomes.
Advanced nursing practice supports a more culturally competent, person-centered, and preventive approach to care—one that aligns with modern public health objectives.
Read also: Innovative Surgical Nursing Strategies By Jane Ekwerike
Innovation in Nurse-Led Models of Care
Nurse-led care models are proving highly effective in diverse healthcare settings. Chang, Shyu and Tsay (2020) found that nurse-led interventions in integrated healthcare systems led to improved chronic disease outcomes, reduced hospital readmissions, and higher patient satisfaction. These models not only expand access but also reinforce nursing autonomy and interprofessional trust.
Moreover, nursing informatics and digital care delivery (such as telehealth) are increasingly being adopted to enhance the scope and efficiency of nursing services, particularly in rural and remote settings.
The Link Between Nursing Practice and Healthcare Quality
A growing body of evidence demonstrates that empowering nurses correlates with improved healthcare quality. Hajizadeh, Zamanzadeh and Kakemam (2021) stress that skilled nursing interventions directly influence patient satisfaction, clinical outcomes, and system efficiency. When nurses operate within supportive environments—where their voices are valued and their contributions recognized—healthcare systems become safer, more responsive, and more effective.
Conclusion
Advancing nursing practice is not just a matter of professional development; it is a strategic priority for modern healthcare systems. To meet the demands of a dynamic global health environment, healthcare leaders must foster systems where nurses are supported to practice at the top of their licenses, assume leadership roles, and drive quality care innovation.
Through better education, clearer policies, supportive regulation, and interprofessional collaboration, nursing can evolve into its full potential—as a pillar of 21st-century healthcare delivery.
Ms. Chiamaka Afonne Nwachukwu is a distinguished health and social care expert and a licensed nurse-midwife with a deep commitment to improving maternal and community health outcomes. With extensive clinical experience and leadership in patient-centered care, she has worked across diverse healthcare settings, integrating evidence-based practice with compassionate service. Her expertise spans reproductive health, chronic disease management, and integrated social care systems. Known for her advocacy in women’s health and healthcare equity, Chiamaka combines professional excellence with a strategic vision for transformative care delivery, making her a respected voice in both frontline nursing and health system development.
References
Delamaire, M.-L., & Lafortune, G. (2020). Nurses in advanced roles: A description and evaluation of experiences in 12 developed countries. OECD Health Working Papers, No. 54. OECD Publishing.
Fawaz, M., Hamdan-Mansour, A., & Tassi, A. (2021). Challenges facing advanced practice nurses in the Middle East: A systematic review. BMC Nursing, 20(1), 1–9.
Jangland, E., Yngman Uhlin, P., & Arakelian, E. (2021). Enabling the implementation of advanced practice nurse roles in hospital settings: A qualitative study of nurses’ and managers’ views. BMC Nursing, 20(1), 197.
Institute of Medicine. (2021). The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity. National Academies Press.
Chang, Y. P., Shyu, Y. I. L., & Tsay, S. F. (2020). Nurse-led care models in integrated healthcare systems: A systematic review. International Journal of Nursing Studies, 112, 103707.
Hajizadeh, A., Zamanzadeh, V., & Kakemam, E. (2021). The impact of nursing practice environment on patient satisfaction and quality of care: A systematic review. Journal of Nursing Management, 29(3), 423–433.