Title page
Contents
Acknowledgements 4
Abstract 5
Résumé 6
In Brief 9
1. Introduction 11
2. Recent developments in advanced nursing roles in primary care in OECD countries 13
2.1. Main reasons for introducing or expanding the roles of nurses 14
2.2. Scope of advanced nursing roles in primary care 14
2.3. Evolution in number of advanced practice nurses in selected countries 17
3. Impact of the pandemic on the scope of practice of advanced practice nurses 19
3.1. Administering COVID-19 vaccinations 19
3.2. Providing teleconsultations and other forms of telehealth 20
4. Recent developments in selected countries 24
4.1. Australia 24
4.2. Canada 27
4.3. France 31
4.4. Italy 33
4.5. United States 36
Annex A. Recent evaluations of impact of nurses in advanced roles 39
Annex B. Titles of nurses in advanced roles in primary care in OECD countries 41
References 43
OECD Health Working Papers 46
Recent related OECD publications 47
Table 1. Main reasons for introducing or expanding roles of nurses in primary care in OECD countries 15
Table 2. Total number of NPs and share of all RNs in selected OECD countries, 2015 and 2022 18
Table 3. Ability of nurses working in primary care to administer COVID-19 vaccinations 20
Table 4. Ability of nurses working in primary care to provide teleconsultations 21
Table 5. Selected telehealth initiatives led by or involving advanced practice nurses during the COVID-19 pandemic 23
Table 6. Examples of recent initiatives to increase the training, recruitment, scope of practice and funding of NPs in Canada 30
Figure 1. Scope of advanced roles of nurses in primary care in OECD countries (by independence of practice and expansion of scope in last 3 years) 16
Figure 2. Rising number of registered nurse practitioners (NPs) in Australia, 2016-2022 25
Figure 3. Rising number of licensed nurse practitioners (NPs) in Canada, 2013-2022 28
Figure 4. NPs working in community health, hospital, and nursing homes in Canada, 2013-2022 28
Figure 5. Graduates in nursing specialties and advanced practice nursing in France, 2001-2021 31
Figure 6. Barriers to employment identified by APN graduates in France, 2021 32
Figure 7. Rising number of Nurse Practitioners (NPs) employed in the United States, 2012-2020 36
Figure 8. Variation in NP practice authority across the United States 37
Boxes
Box 1/Box 2. Background on Family and Community Nurses 34