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

 Sue Kim  ;  Tae Wha Lee  ;  Gwang Suk Kim  ;  Eunhee Cho  ;  Yeonsoo Jang  ;  Mona Choi  ;  Seoyoung Baek  ;  David Lindsay  ;  Sally Chan  ;  Regina L T Lee  ;  Aimin Guo  ;  Frances Kam Yuet Wong  ;  Doris Yu  ;  Sek Ying Chair  ;  Yoko Shimpuku  ;  Sonoe Mashino  ;  Gigi Lim  ;  Sheila Bonito  ;  Michele Rumsey  ;  Amanda Neill  ;  Indrajit Hazarika 
 HUMAN RESOURCES FOR HEALTH, Vol.19(1) : 19, 2021-02 
Journal Title
Issue Date
Advanced practice nursing ; Health equity ; Health services accessibility ; Nurse²s role ; Professional role
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.
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3. College of Nursing (간호대학) > Dept. of Nursing (간호학과) > 1. Journal Papers
Yonsei Authors
Kim, Gwang Suk(김광숙) ORCID logo https://orcid.org/0000-0001-9823-6107
Kim, Sue(김수) ORCID logo https://orcid.org/0000-0003-3785-2445
Lee, Tae Wha(이태화) ORCID logo https://orcid.org/0000-0003-2568-3074
Jang, Yeon Soo(장연수) ORCID logo https://orcid.org/0000-0002-1898-025X
Cho, Eunhee(조은희) ORCID logo https://orcid.org/0000-0002-7871-6848
Choi, Mona(최모나) ORCID logo https://orcid.org/0000-0003-4694-0359
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