Implementation strategy for advanced practice nursing in Gabon: A multicenter mixed-method study

AimTo describe the expectations, acceptability, and challenges identified by nurses and key healthcare stakeholders regarding the implementation of advanced practice nursing in Gabon. Background: Advanced practice nursing presents an opportunity to address the epidemiological transition and the shortage of healthcare professionals in Africa. In anticipation of establishing a master's degree program in advanced practice nursing and its subsequent implementation, it is important to understand Gabon's specific needs and characteristics. Design: This study used a multicenter cross-sectional mixed-method design. Methods: From April to May 2022, a total of 187 healthcare professionals were included from two hospitals and two universities in Gabon. Data were collected through questionnaires and complemented by focus group discussions, guided by the existing literature, the PEPPA framework, and Hamric's model. Results: The implementation of advanced practice nursing was generally well accepted. Factors influencing acceptability included being female, awareness of advanced practice nursing, and supporting the role of advanced practice nurses in diagnosing chronic diseases. Barriers to implementation included the absence of a legal framework for the profession and a lack of recognition of nursing skills by both nurses and doctors. Facilitators included the establishment of a master's degree program, formalization of a legal framework, raising awareness, providing training to medical doctors and other healthcare professionals about advanced practice nursing, and the development of nursing leadership. Implications for nursing: Advanced practice nursing can play a crucial role in addressing healthcare resource shortages and the dual burden of chronic and infectious diseases in Gabon, as well as in other African countries. Implications for nursing policy: To successfully implement advanced practice nursing in Gabon and French-speaking Africa, it is essential to regulate the nursing and advanced nursing professions by creating a legal framework and establishing nursing councils. An effective implementation strategy for advanced practice nurses should be based on the specific needs of the country. Guidelines: COREQ, STROBE