Advanced Practice Nursing: analysis of United States context to underlie the implementation process of this practice in Brazil
Advanced Practice Nursing; Midwives; Human Health Resources; Brazil.
This research aims to analyze the Advanced Practice Nursing, focusing on the role of Certified Nurse-Midwives and Nurse Practitioners, in the United States context, in order to underlie its implementation in Brazil. This is a qualitative study. The research strategy used is the case study. This case study can be classified as an unique and holistic case. The questions that guided this research were: How is the Advanced Practice Nursing developed in a real context in the United States of America (USA)? How can the understanding of the context levels of Advanced Practice Nursing in the USA contribute to its implementation in Brazil ?. The assumptions were the following: (a) Advanced Practice Nursing allows Nurses to act in a differentiated scope of practice, which includes advanced clinical evaluation, diagnosis and treatment skills, so that these professionals are allowed to meet the health needs of a large part of the population in an autonomous and recognized way. (b) Understanding the contextual levels of Advanced Practice Nursing in the United States of America allows the identification of which aspects of the Brazilian reality need to be modified or encouraged to support a proposal of implementation of this practice in Brazil. (c) Advanced practice nursing can turn into a valid reality in Brazilian context and contribute to improve the health outcomes especially in the maternal and child health. The unit of analysis ("the case" itself) was the practice of Certified Nurse-Midwives and Nurse Practitioners in New York, United States of America. The logic that links data to propositions is based on the relevant literature. The data were collected through a literature review, which has been developed during the research; non-participant observation in a large hospital in New York (USA); and interview with six Certified Nurse-Midwives / Nurse Practitioners. As a criterion for the interpretation of the findings, the method of analysis of responsive interviews proposed by Rubin & Rubin (2005) will be used, which is described over two phases: preparation of the transcripts, with identification of concepts, themes and events, with subsequent codification that data; and the construction of the narrative that culminates in building up a theory. The data will be examined under the theoretical lens of Hinds et al. (1992), which deals with the analysis of the context at all its levels: the immediate, specific, general context, and the metacontext.