Evolution of Advanced Practice Nursing:
1751 Pennsylvania Hospital opens in Philadelphia 1820 Florence
Nightingale born 1860 Notes on Nursing published in the United States
1861 Dorothea Dix appointed Superintendent of Female Nurses of the Union
Army 1861 Catholic Sisters deliver chloroform anesthesia during American
Civil War 1873 Bellevue Hospital Training School and Connecticut
Training School founded 1879 Mary Eliza Mahoney, first black graduate
nurse, completes training program 1880-1900 Rapid proliferation of hospital
nursing schools, from 15 schools to more than 400 1881 Clara Barton and
others establish American Red Cross 1893 Nightingale pledge first recited in
Detroit 1893 American Society of Superintendents of Training Schools for
Nurses (precursor to National League for Nursing [NLN]) founded at
Chicago World's Fair 1900 American Journal of Nursing first published
1901 Nurse Corps becomes permanent (became Army Nurse Corps in 1908)
1903 North Carolina passes first nurse registration law in United States 1908
National Association of Colored Graduate Nurses established 1910 Florence
Nightingale dies 1910 Flexner Report criticizes quality of medical education
1912 National Organization of Public Health Nursing founded 1915
Lakeside Hospital School of Anesthesia opens in Cleveland, Ohio 1917
Frank v. South (Kentucky) upholds nursing anesthesia 1918-1919 Influenza
epidemic and World War I 1922 Sigma Theta Tau formalized 1923
Goldmark Report criticizes quality of nursing education 1923 Yale School
of Nursing becomes first autonomous school of nursing in the United States
1925 Kentucky Committee for Mothers and Babies, precursor to Frontier
Nursing Service, founded 1931 American Association of Nurse Anesthetists
, (AANA) founded 1938 Chalmers Frances v. Nelson; practice of nurse
anesthesia made legal 1943-1948 U.S. Cadet Nurse Corps supports nursing
education to prepare nurses for military 1945 AANA develops and
implements Certified Registered Nurse Anesthetists (CRNA) certification
examination 1946 Hill Burton Act enacted, providing funds to construct
hospitals 1947 Army-Navy Nurse Act secures commission status for
military nurses 1950 NLN assumes responsibility for administering first
national state board examination 1955 American College of Nurse-
Midwives incorporated 1964 Nurse Training Act passed 1965 Medicare
legislation enacted 1965 Pediatric Nurse Practitioner (PNP) certification
program opens in Colorado 1975 American Nurses Association (ANA)
holds ceremony to honor first certified nurses 1979 Nursing Doctorate (ND),
first clinical doctorate program, established at Case Western Reserve
University 1984 All states recognize nurse-midwifery 1985 American
Academy of Nurse Practitioners (AANP) founded 1995 National
Association of Clinical Nurse Specialists formed 2004 American
Association of Colleges of Nursing recommends that all advanced practice
nurses earn Doctorate in Nursing Practice (DNP)
Components of APN:
Primary criteria – graduate education, certification, practice focused on
patient/family
Roles of APN - NP, CNS, CNMW, CRNA
Central competency – direct clinical practice
Other competencies - guidance/coaching, consultation, evidence-based
practice, leadership, collaboration, ethical decision making
Hamric’s Integrative Model of APN: