2. 1 Making a difference – nurses’ role in advanced practice David R Thompson PhD RN FRCN FESC Professor of Nursing and Director The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong SAR People’s Republic of China

3. 2 Happy 20 th Anniversary

4. 3 Advanced nursing practice s ignificant developments in AP proliferation of roles and titles lack of conceptualization inadequate definition and regulation lack of clarity about scope, authority, autonomy (Thompson & Watson 2003 Int J Nurs Pract 9, 129-30)

5. 4 Two major issues definitions of AP and competencies required contribution of AP to patient outcomes (Twinn et al. 2005 Health Soc Care Community 13, 11-20)

6. 5 Scope of practice advanced clinical skills research teaching consultancy leadership

7. 6 Nurses undertake comprehensive assessments make diagnostic decisions develop and evaluate individualized care plans prescribe treatments

8. 7 Influence of AP on outcomes difficult to ascertain but, improved general health outcomes and seem to be cost-effective

9. 8 Examples pain anxiety knowledge satisfaction adherence self-care

10. 9 Issues different models used across specialties lack of consistency in academic / clinical preparation different job description, pay and conditions great expectations

11. 10 Debate knowledge, skills, role preparation, educational requirements influence of medicine, accusations of elitism, professional self interest precise national critera and standards national system for accreditation and regulation

12. 11 Does AP make a difference?  A hesitant Yes!  Likely to be growing demand