Book excerpt: Addressing all major advanced practice nursing competencies, roles, and issues, Advanced Practice Nursing: An Integrative Approach, 5th Edition provides a clear, comprehensive, and current introduction to APN today. It applies APN core competencies to the major APN roles - including the burgeoning Nurse Practitioner role - and covers topics ranging from the evolution of APN to evidence-based practice, leadership, ethical decision-making, and health policy. This edition includes a new chapter on the international development of APN, new and enhanced illustrations, and a colorful new reader-friendly format for improved readability. From internationally known APN experts Ann Hamric, Charlene Hanson, Mary Fran Tracy, and Eileen O'Grady, along with a host of internationally recognized APN contributors, Advanced Practice Nursing introduces you to APN and helps you identify an APN role, develop key competencies for that role, and succeed as an APN. Coverage of APN core competencies defines and describes all competencies, including direct clinical practice, guidance and coaching, consultation, evidence-based practice (EBP), leadership, collaboration, and ethical decision-making. Operationalizes and applies APN core competencies to the major APN specialties including the Clinical Nurse Specialist, the Primary Care Nurse Practitioner, the Acute Care Nurse Practitioner, the Certified Nurse-Midwife, and the Certified Registered Nurse Anesthetist. Content on managing APN environments addresses such factors as business planning and reimbursement; marketing, negotiating, and contracting; regulatory, legal, and credentialing requirements; health policy issues; and nursing outcomes and performance improvement research. Unique Exemplar boxes provide real-life scenarios, showing APN competencies in action. In-depth discussions of educational strategies show how nurses develop competencies as they progress into advanced practice. Discussions of APN role development clearly explain the career trajectory that you can anticipate as you transition to advanced practice. EXPANDED international focus includes a NEW International Development of Advanced Practice Nursing chapter that addresses common issues such as the public image and status of APN, dealing with physician resistance, discrepancies in titling, and educational standardization. ENHANCED reader-friendly format includes more headings, tables, and illustrations in lieu of long stretches of unbroken text. REVISED Evidence-Based Practice chapter emphasizes the key competency of evidence-based practice (EBP) and includes a comprehensive history and explanation of the steps of the EBP process. UPDATED Health Policy chapter covers key U.S. initiatives affecting APN including the Patient Protection and Affordable Care Act, the Institute of Medicine's Future of Nursing report, the Consensus Model of APRN Regulation, and how APNs can engage in the political process. ENHANCED Exemplar boxes (case studies), including Day in the Life vignettes of each APN specialty, emphasize innovative practices and coverage of advanced practice roles. Increased interprofessional content emphasizes the subjects of ethics, collaboration, and consultation. Enhanced integration of Doctor of Nursing Practice (DNP) considerations and literature makes this text ideal for DNP programs.