The Columbia University School of Nursing (CUSN, New York, USA) has recently signed a research and educational exchange with the University of Navarra School of Nursing. For that reason Jennifer E. Dohrn, Assistant Professor of Nursing at CUSN, visited Pamplona with some students that are currently carrying out a period of practical training at the Spanish institution and at the University of Navarra Clinic.

Professor Dohrn is also the Director of the Office of Global Initiatives and WHO Collaborating Center for Advanced Practice Nursing. For that reason, we took the opportunity to ask her about Advanced Practice Nursing, a trend of a new specialized nurse that is established in the USA and extends throughout Europe.

First of all, what is an Advanced Practice Nursing?
Advanced practice nursing (APN) is defined by the International Council of Nurses as a "registered nurse who has acquired the expert knowledge base, complex decision-making skills, and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which she/he is credentialed to practice. A master's degree is recommended for entry this level." 

What does the work for an APN entail?
APN integrates research, education, practice and management, a high degree of professional autonomy and independent practice.  It is a central way of meeting a health system's needs by providing a higher level of nursing care that can lead in meeting critical gaps for primary care and universal health coverage, with nursing as frontline providers for families and communities and as an entry point to the health care system. 

How do you think this new role benefits a Health Center? 
Have a cadre of Advanced Practice Nurses open the door to expanding primary care to greater numbers of people improves access to care.  It also helps build strong teams since APNs can play a larger role. 

How well established is it in the USA?
It is highly developed within the USA.  Nurse practitioners practice at all levels of care – primary health care centers and hospitals.  And now we have a doctorate for Advanced Practice Nursing, called the Doctorate of Nursing Practice, which allows APNs to have continuous care for patients, including admitting rights at hospitals.  The door is wide-open for nursing and improved population health outcomes.

At the University of Navarra School of Nursing there is a Master's Degree in Advance Practice and Management in Nursing, what do you expect of the recent collaboration agreement of your university and the Spanish institution?
This collaboration is very important to us at CUSN: it begins a time of student exchange and learning about different health systems.  It also begins an exploration at the faculty level for sharing of program possibilities and advanced degrees.