“Advance Practice Nurse (APN) is an umbrella term given to a Registered Nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for extended practice”. This definition of APN was adapted from International council of Nurses’ in 2005 by Singapore nursing Board (Kannusamy, 2007). The American Association of colleges of Nursing defines advance practice nursing as licensed registered nurses prepared at the graduate level in nursing as a nurse practitioner, clinical nurse specialist, certified nurse midwife or certified registered nurse anaesthetist to provide direct patient care. (Ruel & Motyka, 2009). As u can see, there are actually many different definitions for Advance Practice nursing depending on the countries and their settings.
The education of Advance practice nurses (APNs) started in the USA in the 1960s and the role of APN has already been implemented in approximately 24 countries, excluding the USA. (Nieminen, Mannevaara & Fagerstrom, 2011). However, in Singapore APN was introduced rather lately compared to the overseas context. Singapore started on the development of Advance Practice Nursing (APN) roles in the year 2001, and progressed consecutively with the introduction by the Ministry of Health (MOH) as one of the clinical nursing career (Schober, 2010).
APN was launched in Singapore due to rising chronic disease conditions, aging populations, higher levels of patient acuity and shortened hospital stays (Kannusamy, 2006). Another article extracted from overseas to compare with Singapore article, stated that APN’s was launched because they are needed in tertiary care, the follow-up-care of patients with chronic disease and in secondary prevention primarily in the care of older people (Nieminen et al., 2011). The reason for establishing APN, in both local and overseas context is for nearly the same reasons, is to improve the effectiveness of the health care system.
APN in Singapore has 3 different roles, firstly Clinical roles, where they have to assess, diagnose, prescribe diagnostic test and treatment plan within establish guidelines, to do follow up care and educations to the patients, followed by Professional roles, where they have to educate other health care worker by teaching and mentoring them, as well as, need to do research and also need to implement Evidence Based Practices, lastly Administrative Roles, which is to develop nursing specific policies and procedures and clinical leadership (MeiLing, 2009). Role of an APN in overseas consists of evaluating, diagnosing, and taking care of normal health problems patients, APN must also be able to perform and initiate diagnostic actions, prescribe medication (limited at the movement of most country) and treatments, as well as lead and coordinate health promotion, additionally, APN must be able to refer a patient to other care institutions and also must be able to register and admit patients from other...