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New Features Expanded international focus, with a NEW! chapter addressing the international development of APN: According to the Editors, "There has been a rapid evolution of interest in and enactment of advanced practice around the globe." The Editors note that, "Particular countries such as the UK, Canada, and Australia have supported advanced practice nurses for some time. Other countries such as China and Switzerland are newly developing education and practices for advanced practice nurses." A new chapter (Chapter 6), therefore summarizes the current state of development of APN internationally This new chapter includes the "contextual" issues of educational systems, political systems, and health care systems and financing. Common issues addressed in the international evolution of APN include the public image and status of nursing, dealing with physician resistance, discrepancies in titling, and educational standardization. This new chapter identifies what various countries can learn from one another as APN roles continue to evolve and develop and spotlights APN in Singapore and the Netherlands in two new exemplars. To further expand the book's international focus, international APN literature is incorporated throughout the book as appropriate. Updated chapter on Health Policy and Politics: The new edition features expanded coverage of key U.S. initiatives affecting APN, including healthcare reform (the Patient Protection and Affordable Care Act), the IOM "Future of Nursing" report, and the increasing attention being given to the Consensus Model of APRN Regulation. The chapter also features expanded information on the U.S. federal budget and how APNs can engage in the political process. Enhanced integration of DNP considerations and literature: While the current edition of Hamric includes integrated coverage DNP programs, which were emerging at the time of writing, the importance of DNP programs has grown significantly since publication. The 5th edition therefore features expanded and more seamless integration of DNP considerations and literature. Shift in focus from research to evidence-based practice (EBP): The Research chapter has been substantially revised, refocused, and retitled to shift its emphasis from research to EBP. This chapter emphasizes the key competency of EBP as enacted and led by the APN. Rather than three different competencies, one competency with three core phases is described: I. Use of evidence in the advanced practice nurse's own practice; II. Use of evidence in changing practice in the advanced practice nurse's practice setting; and III. Use of evidence in evaluating practice. The chapter also includes a comprehensive history and explanation of the steps of the EBP process. Increased use of Exemplar boxes: The number of Exemplar boxes has been increased to ensure that this feature is used more evenly throughout the book. Selected new Exemplar boxes emphasize innovative practices in APN. Each chapter in Part III, "The Operational Definitions of Advanced Practice Nursing," consistently includes Exemplars that focus on a day in the life a nurse working in that chapter's specialty. This feature is now a consistent thread throughout the chapters in this part of the book. New two-color design and art program: The 5th edition has transitioned from a one-color design and art program to two-color, and virtually all illustrations have been colorized in order to make the best possible use of two-color printing Increased use of headings, tables, and figures: To help break up long stretches of "gray" text, the 5th edition features increased use of headings, conversion of some text content into tables/boxes, and judiciously increased use of illustrations. Chapter Outlines: Chapter Contents outlines, consisting of #1 and #2 heads, have beenadded at the start of each chapter as advance organizers, in lieu of a Detailed Table of Contents in the front matter. Increased "interprofessional" content: Interprofessional content has been added throughout as relevant to particular chapter content-particularly in the subjects of ethics, collaboration, and consultation. Integrated discussion of supportive administrative climates: Discussion of administrative climates that support practice for various APN roles has been integrated into each APN role chapter as appropriate, rather than in a separate chapter as in the previous edition. Key Features Retained Defines and describes APN core competencies: Hamric et al Advanced Practice Nursing: An Integrative Approach both defines and describes all of the competencies that constitute APN, including direct clinical practice, coaching and guidance, consultation, evidence-based practice (EBP), leadership, collaboration, and ethical decision-making. Operationalizes and applies APN core competencies to APN specialties: Hamric then operationalizes and applies these 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. Reviews the critical elements of managing APN environments: The book concludes with a review of the critical elements of managing APN environments, addressing 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. Includes unique Exemplar boxes: Unique Exemplar boxes throughout the book provide vignettes of actual situations common to APN, to help bring important issues to life. Integrates educational strategies: All of the competencies chapters in Part II include in-depth discussions of educational strategies that allow faculty and students to see how the competencies are developed as the nurse progresses into advanced practice. Discussions of role development are thorough, current, and research-based: The book's discussions of APN role development clearly explain the career trajectory that nurses transitioning to advanced practice can anticipate. Includes Evolve Resources: Streamlined Evolve Resource include PowerPoint Slides, an Instructor's Manual, and an Image Collection (NP ancillary package pending Editorial approval).