Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice
Article first published online: 27 NOV 2012
© 2012 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 69, Issue 9, pages 1931–1942, September 2013
How to Cite
2013) Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice. Journal of Advanced Nursing 69(9), 1931–1942. doi: 10.1111/jan.12054, , & (
- Issue published online: 14 AUG 2013
- Article first published online: 27 NOV 2012
- Manuscript Accepted: 20 OCT 2012
- Queensland Nursing Council, Australia. Grant Number: RAN 0726
- advanced practice nursing;
- health services research;
- models of advanced practice;
- nurse practitioner;
- nursing roles
To test a model that delineates advanced practice nursing from the practice profile of other nursing roles and titles.
There is extensive literature on advanced practice reporting the importance of this level of nursing to contemporary health service and patient outcomes. Literature also reports confusion and ambiguity associated with advanced practice nursing. Several countries have regulation and delineation for the nurse practitioner, but there is less clarity in definition and service focus of other advanced practice nursing roles.
A statewide survey.
Using the modified Strong Model of Advanced Practice Role Delineation tool, a survey was conducted in 2009 with a random sample of registered nurses/midwives from government facilities in Queensland, Australia. Analysis of variance compared total and subscale scores across groups according to grade. Linear, stepwise multiple regression analysis examined factors influencing advanced practice nursing activities across all domains.
There were important differences according to grade in mean scores for total activities in all domains of advanced practice nursing. Nurses working in advanced practice roles (excluding nurse practitioners) performed more activities across most advanced practice domains. Regression analysis indicated that working in clinical advanced practice nursing roles with higher levels of education were strong predictors of advanced practice activities overall.
Essential and appropriate use of advanced practice nurses requires clarity in defining roles and practice levels. This research delineated nursing work according to grade and level of practice, further validating the tool for the Queensland context and providing operational information for assigning innovative nursing service.