History, challenges and opportunities of advanced practice nursing in primary care within the currirent health system

Abstract

Introduction: Advanced practice nursing (APN) represents a substantial change in the healthcare field, emerging as an innovative alternative to meet the growing demands of the healthcare system. Faced with challenges such as an aging population, the proliferation of chronic diseases, a shortage of specialists, and inequalities in access to healthcare services, APN is consolidating as an effective strategy to address the multifactorial complexities of the contemporary healthcare system. Objective: To examine the characteristics of advanced practice nursing (APN) to optimize quality in primary care, based on its historical evolution, the obstacles it faces, and the opportunities it offers in the contemporary healthcare system. Development: APN is experiencing significant global growth and adaptation to different sociocultural contexts. Despite facing significant barriers such as a lack of clear regulations, interprofessional opposition, training limitations, and economic restrictions, it presents significant potential in primary care to address the shortage of healthcare personnel. The literature demonstrates that advanced practice nurses achieve comparable or superior clinical outcomes, increase patient satisfaction, and reduce inequalities in care. Among the educational challenges are the lack of curricular uniformity and the lack of specialized teachers. Conclusion: The APN constitutes a transformative strategy with proven potential to improve the quality, accessibility, and efficiency of primary care. Its future consolidation depends on the creation of solid regulatory frameworks, investment in professional training, and collaboration across disciplines, positioning it as a key component for more effective and equitable health systems.