Under the impact of changes in global demography, epidemiology and technology, nursing has transitioned into an era of increased specialisation. Advanced Nursing Practice (ANP) has emerged worldwide in response to the changing needs and patient expectations of nursing care. The development of ANP will be explored in different perspectives in this issue.
Developed in the United States in the 1970s, ANP has evolved throughout the decades. The basic concepts and issues of ANP were reviewed by Schwirian in her paper "Advanced Nursing Practice: Questions, Issues and Answers". The manners in which the nurses of the United States addressed the questions and issues in the United States were described. Practical advice was recommended to the readers.
ANP being a more recent development in Australia, Lopez had a different experience to share with the readers on this subject. The education and accreditation requirements, roles of the nurse practitioners and legislative changes of the Nurse Practice Act were explored in her article "Advanced nursing practice: Development in Australia".
Similar movements also occurred in the United Kingdom. In 1999, a new strategy "Making a Difference" was launched and it proposed a new career framework for nurses. Thompson, in his paper "Advanced nursing practice: Development in the United Kingdom", reported the conflicts encountered when the role of consultant nurse was being discussed.
In Hong Kong, the restructuring of the nursing system and the introduction of the position of nurse specialist in 1993 by the Hospital Authority marked the development of ANP. Wong in her article "Development of advanced nursing practice in Hong Kong: A celebration of ten years' work" outlined the development of ANP from 1990 to early 2000 and gave us an insight in its future.
To strengthen ANP in Hong Kong, Chan in his article "The utilization and reasons of choice for Chinese or western medicine among rheumatoid arthritis patients in Hong Kong" attempted to advance the clinical care of local patients with rheumatoid arthritis. Through the study of the utilization of Chinese medicine among these patients, the author suggested how advanced practice nurses could offer help in supporting those who choose to have alternative therapies.
Evolution and transformation of nursing practice occur under the impact of global factors. However, further advancement of nursing practice requires innovative practitioners, clinical leadership and plenty of hard work at all levels. If we uphold the strong belief that the nursing profession is accountable for the health of the people, we are confident to say we are ready for the challenge.
Issue Editors