Advanced Practice Nursing in the context of Primary Health Care: a strategy for transforming the Brazilian health scenario.
Advanced Practice Nursing. Nursing. Primary Health Care; Universal Health Coverage.
In view of the growing global dimension on the strengthening of Primary Health Care through the expansion and training of human resources, especially nursing, it is essential to present the role of Advanced Practice Nursing and its potential for transformation in Primary Health Care in Brazil. The objective of this study is to understand Advanced Practice Nursing, focusing on the role of Family Nurse Practitioners, in order to assist its implementation in Brazil. This is a multi-method study with three steps, with a conceptual focus on the PEPPA framework, described below: Literature review on the impact of the management of Advanced Practice Nurses on NCDs in Primary Health Care; Case study with Family Nurse Practitioners in the USA; Theoretical-Philosophical Essay in the light of Max Horkheimer's Critical Theory. In step 1, it was possible to verify the positive impact that advanced nursing practice has on the four most frequent categories of Noncommunicable Diseases, namely: Diabetes, Cardiovascular Diseases, Chronic Respiratory Diseases and Cancer. In step 2, from the analysis of the interviews carried out with the Family Nurse Practitioner in the USA, three partitions emerged based on the content of the participants' statements: 1) Being an advanced practice nurse; 2) Educational routes and possibilities of action and 3) Being political: a path for transformation, where it was possible to describe competences and skills considered to be outstanding points in relation to other professional categories, points of improvement in their educational background and the importance of political representation and being active in performing the role. In the last stage of the research, the emergence of a change in the scenario of primary health care in Brazil was highlighted, placing nurses as a primary tool in the struggle for social transformation and the search for autonomy as citizens and professionals in the light of Critical Theory and its concepts. The complexity of the nurse's work dialogues with the concepts of Critical Theory and stimulates the critical behavior towards praxis in knowledge / action, strengthening their function. At the present time, there is a tendency to expand the practice of nurses through the implementation of Advanced Nursing Practice as one of the possible solutions for the reduction of social inequalities caused by the lack of equal access to health. Through this study, it is expected to subsidize the implementation of Advanced Nursing Practice in the context of Primary Health Care, along the lines of the PEPPA framework, by understanding what Advanced Nursing Practice is in the scope of family health, reflecting on the path traveled here and the next steps we need to take, always in the constant search for recognition, autonomy and transformation.