Feature
NURSING MANAGEMENTApril 2009 | Volume 16 | Number 118
Plans for the future include:
Working in partnership with the local education
provider, the University of the West of Scotland,
to ensure that educational opportunities are
provided to current and future post holders.
Completion of a scoping exercise to identify
which roles operate at advanced-practice level and
which would do so after development.
Provision of professional guidance on advanced
practice and related role developments to enable
nurses and their managers to provide better services.
Responding to, participating in and influencing
other national developments related to advanced
practice, for example regulation issues or issues
arising from developments in other parts of
the UK such as Towards a Framework for Post-
Registration Nursing Careers (Dh 2008).
Conclusion
This article describes the experiences of
advanced practice to date in one NhS board in
Scotland and highlights some of the challenges
inherent in defining and supporting advanced
practice in nursing. Although it is not research-
based, it draws on the experiences of nurses,
patients and service managers.
Marie Cerinus is director
of nurse, midwife and
allied health professional
practice development
and Paul Wilson is
executive director of
nurses, midwives and
allied health professionals,
both at NHS Lanarkshire
Implications for practice
Advanced nursing practice can help improve
patient safety and experiences, and can underpin
service modernisation.
Further reading
For more information on the development of
advanced nursing practice in Scotland, visit
the Scottish Government sites www.scotland.
gov.uk/publications/2006/08/31120554/0 and
www.aanpe.org/LinkClick.aspx?fileticket=giFsLijsCR
w%3D&tabid=1051&mid=2508&language=en-US
Association of Advanced Nursing
Practice Educators (2006) Advanced
Nursing Practice. www.aanpe.org/
advancednursingpractice/tabid/721/default.
aspx (Last accessed: March 5 2009.)
Department of Health (2006) Modernising Nursing
Careers: Setting the direction. www.dh.gov.uk/
en/Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/Dh_4138756
Department of Health (2008) Towards
a Framework for Post-Registration Nursing
Careers: Consultation response report.
www.dh.gov.uk/en/Consultations/
responsestoconsultations/Dh_086465
(Last accessed: March 5 2009.)
NHS Education for Scotland (2007) Pilot Succession
Planning Development Pathway for Advanced
Practice. www.nes.scot.nhs.uk/nursing/
roledevelopment/advanced_practice/documents/
Post_Consultation_Succession_Planning_Pathway.
pdf (Last accessed: March 5 2009.)
NHSScotland (2008) Advanced Nursing Practice
Toolkit. www.advancedpractice.scot.nhs.uk
(Last accessed: March 5 2009.)
Nursing and Midwifery Council (2005)
Implementation of a Framework for the
Standard of Post Registration Nursing:
Decision. www.aanpe.org/LinkClick.
aspx?fileticket=giFsLijsCRw%3D&tab
id=1051&mid=2508&language=en-US
(Last accessed: March 5 2009.)
RCN (2008) Advanced Nurse Practitioners:
An RCN guide to the advanced practitioner role,
competencies and programme accreditation.
RCN, London.
Scottish Executive Health Department
(2001) Consultant Nurse/Midwife Guidelines.
www.sehd.scot.nhs.uk/mels/hDL2001_52.htm
(Last accessed: March 5 2009.)
Scottish Government (2008) Supporting
the Development of Advanced Nursing
Practice: A toolkit approach. www.aanpe.org/
LinkClick.aspx?fileticket=giFsLijsCRw%3D
&tabid=1051&mid=2508&language=en-US
(Last accessed: March 5 2009.)
Skills for Health (2006) Career Framework
for Health. Skills for health, Bristol.
References
Box 1 The scope of practice of advanced
nurse practitioners
Advanced nurse practitioners can:
Take comprehensive histories.
Carry out holistic examinations.
Use their expert knowledge, skills and clinical
judgement to identify potential diagnoses.
Refer patients for appropriate investigations.
Make final diagnoses.
Decide on and initiate best-practice treatments,
including the prescribing of medicines.
Refer patients to appropriate specialists.
Plan and provide expert care to meet patients'
health and social care needs, involving other
members of care teams when appropriate.
Ensure continuity of care including the provision
of follow-up visits as necessary.
Evaluate with patients the effectiveness of
treatments and care, and makes changes
when required.
Work independently although be part of teams.
Provide leadership and consultancy functions.
Make, and be accountable for, professionally
autonomous decisions.
Screen patients for disease risk factors and early
signs of illness.
Provide counselling and health education.
Admit or discharge patients from caseloads or
refer them to other healthcare professionals.

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