The international nurse practitioner

The November issue is dedicated to international NPs! A not-so-quiet nursing revolution is taking hold across the globe as nurse practitioners (NPs) are increasingly recognized for their pivotal role in addressing global health challenges. Countries worldwide are integrating NPs and other advanced practice nurses (APN) to fully leverage their expertise to improve health care access, outcomes, and cost. As Editor-in-Chief, I am highly aware of the invaluable contributions that international submissions bring to our journal. These articles showcase how countries adapt their health care models, develop curricula, structure organizations, and secure support from the International Council of Nurses in their quest to increase access to equitable and high-quality health care by NPs. This issue features a variety of initiatives aimed at tackling global health challenges, such as a project in the United States focused on enhancing hypertension management among Filipino Americans and an analysis of a pediatric malnutrition telehealth program in rural Guatemala. In addition, it explores the evolving role of NPs in Japan, Australia, and New Zealand. Dr. Heather McGrath provides us with an update on the NP movement in Jamaica. Finally, we have included insights from Liz Messner, the vice president of membership at AANP, who discusses the remarkable growth of international membership within the organization. Happy Nurse Practitioner Month! American Association of Nurse Practitioners Welcomes International Members Liz Messner, CAE, IOM Vice President of Membership, American Association of Nurse Practitioners The American Association of Nurse Practitioners (AANP) has been committed to advancing the role of the NP globally. Some globalization efforts have included the establishment of an International Committee 10 years ago, creation of the International Advance Practice Nurse Ambassador Program in 2018 and the opening of the AANP International Specialty Interest Group in 2019. In addition, AANP has welcomed attendees from across the globe to its conferences and will continue to expand access to education through on-demand courses in the AANP CE Center. AANP also participates in the NP/APN network, which is an official affiliate group of the International Council of Nurses (ICN). The AANP board of directors sought to create a more visible and accessible pathway to AANP membership for international constituents. The key driver of this effort was to raise the level of patient care around the world. Making the vast educational resources provided by AANP more widely available is essential to further building skills and enhancing knowledge on a global scale. AANP wants to see APN around the world contribute in even bigger ways to better the health of their patients and communities. Work began in 2021 to define international membership categories, eligibility requirements, benefits, and dues rates. A stated goal from the outset was to establish a fee structure that would diminish financial barriers as much as possible. In outlining eligibility criteria, AANP staff looked to the ICN for definitions of APN globally. According to the ICN “Guidelines on Advanced Practice Nursing 2020,” an APN is a generalist or specialized nurse who has acquired, through additional graduate education (minimum of a master's degree), the expert knowledge base, complex decision-making skills, and clinical competencies for advanced nursing practice, the characteristics of which are shaped by the context in which they are credentialed to practice. The two most commonly identified APN roles are clinical nurse specialist (CNS) and NP. For CNS practitioners, AANP membership is available at the Associate Member category. AANP recognized that, especially for international memberships, the CNS role needed to be eligible for membership. These terms and definitions were incorporated into AANP international membership criteria. To establish international membership dues rates, AANP staff proposed using the World Bank as a guide for affordability. The World Bank produces the World Development Indicators database, which includes all 189 World Bank member countries (plus 28 other economies with populations of more than 30,000) that are classified so data users can aggregate, group, and compare statistical data—including purchasing parity. The term country, used interchangeably with economy, does not imply political independence but refers to any territory for which authorities report separate social or economic statistics. The World Bank uses high income, upper middle income, lower middle income, and low income as groupings for countries. AANP adapted these country groups into three groups for simplicity and flexibility. AANP accepts international dues payments online and in US dollars. As member benefits were assessed for international memberships, AANP decided benefits would be delivered electronically to speed delivery and keep costs low. Member benefits remain in English, although some benefits such as insurance and loan refinancing may only be available to US residents. Further, advocacy initiatives are not of benefit to international members. Information about any benefits that are not available to international members is made apparent before joining. Without question, one of the most important member benefits for any AANP member is the AANP CE Center—which features hundreds of continuing education activities, including dozens of activities available free of charge and at substantial discounts for AANP members. International members will be able to use AANP's suite of clinical resources, including point-of-care tools, practice briefs, and the Journal of the American Association of Nurse Practitioners (JAANP) Resource Center. In addition, international members gain access to both JAANP and the Journal for Nurse Practitioners and have the ability to connect with NPs and APNs across the world through the AANP Communities, the International APN Ambassador Program, and much more. AANP proudly represents the interests of more than 385,000 NPs in the United States, and, with the opening of international memberships, AANP is excited to invite NPs and other APNs outside of the United States to join AANP in advancing practice, education, advocacy, research, and leadership in their countries. “We are excited to open international memberships to NPs and APNs working all over the world,” said AANP President Stephen A. Ferrara, DNP. “The worldwide nursing community is united by our passion to serve our patients in their communities and beyond. The diverse experiences and the scholarship of international members will further AANP's core purpose to meet patients where they are and promote high-quality health care to all.”