{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:49:53Z","timestamp":1791805793881,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Nursing Review"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore the relationship between professional regulatory systems and advanced practice nursing development in Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Advanced practice nursing has expanded rapidly, yet regulatory frameworks have often struggled to keep pace with the extended scope of practice demanded by contemporary service delivery. Misalignment leaves new roles inadequately supported, with consequences for both patient safety and the broader transformative potential of the profession.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For this cross\u2010sectional descriptive study, key informants were recruited by purposive sampling across the World Health Organization's Europe Office member countries, including regulators, educators and nursing association representatives. A purpose\u2010built questionnaire was analysed using descriptive statistics and pattern comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of European countries have advanced practice nursing roles, yet scope of practice and accompanying regulatory mechanisms varied considerably. Independent prescribing authority was the least commonly reported characteristic, having been established in only four countries. An observed descriptive pattern indicated that role maturity was related to government\u2010led or statutory regulation designed specifically to address extended clinical skills. Interest\u2010holders were largely in favour of regulatory intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Regulatory modernisation is a key step for health systems seeking to expand advanced practice nursing. Legal scopes of practice must be realigned with clinical realities.\u00a0In this sample, reported independent prescribing authority co \u2010occurred with government led or legally mandated regulatory arrangements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing<\/jats:title>\n                    <jats:p>Nursing organisations should advocate for mandatory frameworks encompassing title protection, standardised educational requirements and competency standards for high\u2010risk clinical skills, such as independent diagnosis and prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Health Policy<\/jats:title>\n                    <jats:p>Governments should establish statutory advanced practice frameworks, with nursing leadership within government playing a key role.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/inr.70250","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:31:56Z","timestamp":1791804716000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced Practice Nursing Development Within Diverse Regulatory Landscapes: A Descriptive Survey of European Countries"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8400-4969","authenticated-orcid":false,"given":"Caroline","family":"Bohlender","sequence":"first","affiliation":[{"name":"School of Healthcare and Nursing Sciences Northumbria University, Newcastle\u2010upon\u2010Tyne  \u00a0 UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3635-4102","authenticated-orcid":false,"given":"Karen","family":"Bj\u00f8ro","sequence":"additional","affiliation":[{"name":"The European Forum of National Nursing and Midwifery Associations  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4056-3230","authenticated-orcid":false,"given":"Paul","family":"Gill","sequence":"additional","affiliation":[{"name":"Nursing and Head of School of Healthcare and Nursing Sciences Northumbria University, Newcastle\u2010upon\u2010Tyne  \u00a0 UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4150-6513","authenticated-orcid":false,"given":"John","family":"Unsworth","sequence":"additional","affiliation":[{"name":"Community Nursing and Workforce Policy Centre for Health and Social Equity Northumbria University, Newcastle\u2010upon\u2010Tyne  \u00a0 UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep13040113"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2155\u20108256(15)30153\u20108"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2155\u20108256(17)30154\u20100"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15607"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/6678458"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15775"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnr.2025.10.002"},{"key":"e_1_2_14_9_1","doi-asserted-by":"crossref","DOI":"10.4324\/9781003139799","volume-title":"National Health Services of Western Europe: Challenges, Reforms and Future Perspectives","author":"Giarelli G.","year":"2023"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/inr.12193"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnsa.2021.100034"},{"key":"e_1_2_14_12_1","volume-title":"Guidelines on Advanced Practice Nursing","author":"International Council of Nurses","year":"2020"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2155\u20108256(23)00064\u20109"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.12968\/ijap.2024.2.2.100"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2015.09.002"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ienj.2012.03.004"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1109\/ACCESS.2023.3292119"},{"key":"e_1_2_14_18_1","volume-title":"Global Regulatory Atlas","author":"National Council of State Boards of Nursing","year":"2023"},{"key":"e_1_2_14_19_1","volume-title":"Independent Report on the Regulation of Advanced Practice in Nursing and Midwifery","author":"Palmer W.","year":"2023"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.20147"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547\u20105069.2009.01322.x"},{"key":"e_1_2_14_22_1","unstructured":"Stewart D. M.Schober L.Nissen et\u00a0al.2021.Guidelines on Prescriptive Authority for Nurses. ICN.https:\/\/www.icn.ch\/system\/files\/2021\u201009\/ICN_Nurse_prescribing_guidelines_EN_WEB.pdf."},{"key":"e_1_2_14_23_1","unstructured":"United Nations Statistics Division.2023.Standard Country or Area Codes for Statistical Use.https:\/\/unstats.un.org\/unsd\/methodology\/m49\/."},{"key":"e_1_2_14_24_1","unstructured":"United Nations.2019.Political Declaration of the High\u2010Level Meeting on Universal Health Coverage. (A\/RES\/74\/2).https:\/\/www.un.org\/pga\/wp\u2010content\/uploads\/sites\/53\/2019\/07\/FINAL\u2010draft\u2010UHC\u2010Political\u2010Declaration.pdf."},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/inr.12800"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.3233\/wor\u20102012\u20100037\u20104560"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.3698"},{"key":"e_1_2_14_29_1","volume-title":"State of the World's Nursing Report: Investing in Education, Jobs and Leadership","author":"World Health Organization","year":"2020"},{"key":"e_1_2_14_30_1","first-page":"2021","volume-title":"Global Strategic Directions for Nursing and Midwifery","author":"World Health Organization","year":"2021"},{"key":"e_1_2_14_31_1","volume-title":"State of the World's Nursing 2025: Investing in Education, Jobs, Leadership and Service Delivery","author":"World Health Organization","year":"2025"}],"container-title":["International Nursing Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/inr.70250","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/inr.70250","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/inr.70250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:32:00Z","timestamp":1791804720000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/inr.70250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["10.1111\/inr.70250"],"URL":"https:\/\/doi.org\/10.1111\/inr.70250","archive":["Portico"],"relation":{},"ISSN":["0020-8132","1466-7657"],"issn-type":[{"value":"0020-8132","type":"print"},{"value":"1466-7657","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70250"}}