Abstract
BackgroundThe 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.MethodsThis 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.ResultsFederal 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.ConclusionsIn 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.
Highlights
The shortage of doctors and their unequal distribution serve as challenges to advancing primary healthcare (PHC) and achieving effective universal healthcare coverage in Brazil
Brazil is a country with continental dimensions that is subdivided into five geographic macroregions (North, Northeast, Midwest, Southeast, and South) with different demographic and socioeconomic conditions and wide internal inequalities [1]
We performed a scoping review [16] of primary studies conducted on nurses practicing in PHC in Brazil to identify the practices effectively performed by these professionals
Summary
The shortage of doctors and their unequal distribution serve as challenges to advancing primary healthcare (PHC) and achieving effective universal healthcare coverage in Brazil. System (SUS), that is oriented toward primary healthcare (PHC), suffers from a shortage, high turnover, and unequal distribution of physicians [2, 3], especially in the rural and remote areas of the Northern and Northeastern macroregions. There is a growing number of nurses in the labor market (40,000/year), with greater availability to work in the public healthcare sector, whose services could be more efficiently utilized [6, 7]. New profiles such as the advanced practice nurse (APN) may be instrumental in advancing Brazilian PHC and achieving universal healthcare coverage [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
