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Open Access 01-12-2021 | Care | Research

Situational analysis and reflections on the introduction of advanced practice nurses in Brazilian primary healthcare

Authors: Carinne Magnago, Celia Regina Pierantoni

Published in: Human Resources for Health | Issue 1/2021

Abstract

Background

The shortage of doctors and their unequal distribution serve as challenges to advancing primary healthcare (PHC) and achieving effective universal healthcare coverage in Brazil. In an effort to use nurses’ potential more efficiently, the country is investigating the introduction of the advanced practice nurse (APN) into PHC. This paper presents a situational analysis of the practices of Brazilian nurses based on the following components: regulation, practice, and education.

Methods

This is a national multi-method study with triangulated data from a documentary study, a scoping review, and an exploratory study. The regulation component involved the analysis of official normative documents on the regulation of nursing education and nurses’ scope of practice. The practice component aimed to identify the practices performed by nurses in Brazilian PHC based on primary studies. The education component intended to identify the practices taught in nursing training based on a survey and interviews with directors of undergraduate nursing programs.

Results

Federal legislation in Brazil authorizes nursing graduates to perform a set of advanced practices as part of the PHC nurse's daily routine. They can request and interpret complementary tests and prescribe medication. However, in the local context, municipalities define the scope of this assistance based on technical norms or nursing protocols. Furthermore, this study indicates that undergraduate nursing programs do not fully prepare students to adequately execute these tasks.

Conclusions

In the context of Brazilian PHC, advanced practices have already been implemented and respond to main healthcare demands. Therefore, it is unnecessary to introduce the APN as a new professional category. Upon detecting deficiencies in the training process, the current education model should undergo reforms that seek to incorporate the skills compatible with the regulated advanced practices and in-service training for practicing nurses. Regarding the introduction of APN along international lines, this article presents recommendations that may support the operationalization of a Brazilian APN model.

Available only for authorised users

This is the professional nursing council in Brazil—an organization created by federal law for the purpose of regulating, standardizing, and supervising the profession it represents.

Tendency of each profession to act in isolation. It is the result of the culture of separate training, with an emphasis on the development of specific skills, which ends up building very rigid professional identities and which, historically, has been configured as a barrier to communication between professionals of different categories.

In Brazil, there are two types of postgraduate; lato sensu, which encompasses specialization and residency programs in one area of study, mostly addressed to professional practice, and stricto sensu, which means a Master or Doctorate, encompassing broader and profound activities of scientific research.

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Title: Situational analysis and reflections on the introduction of advanced practice nurses in Brazilian primary healthcare
Authors: Carinne Magnago
Celia Regina Pierantoni
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Care
Published in: Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI: https://doi.org/10.1186/s12960-021-00632-w

At a glance: The STEP trials

Springer Medicine

Situational analysis and reflections on the introduction of advanced practice nurses in Brazilian primary healthcare

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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