International Competencies of Advanced Practice Nurses in Critical Care: An Integrative Review.

AIM This review explores the roles, competencies, and scope of practice of APNs in critical care based on international literature. It also derives implications for the development of advanced nursing roles in Austria. DESIGN Integrative review. DATA SOURCES The research team conducted a systematic search of PubMed, CINAHL, and Web of Science to identify relevant peer-reviewed publications from 2007 to 2023. REVIEW METHODS A systematic search of electronic databases was undertaken, following Whittemore and Knafl's five-step methodology. The included publications met the defined inclusion criteria and were appraised for quality using the Joanna Briggs Institute critical appraisal checklists. Relevant data were extracted and thematically analysed. RESULTS The analysis of 14 international studies revealed recurring themes related to APN core competencies and scope of practice in critical care. These were structured according to Hamric's model. However, Austria faces several challenges, including limited legal frameworks, missing educational structures, and a lack of role clarity. These factors hinder the implementation of APN roles. CONCLUSIONS Internationally, APNs demonstrate advanced clinical skills, provide leadership in team-based care, and integrate evidence-based practice. These attributes enhance patient outcomes and system efficiency. In Austria, restrictive regulations, limited education, and unclear roles hinder these competencies. Reform is needed to align with international standards, and further research should explore their implementation in Austria. IMPLICATIONS A gap exists between internationally demonstrated APN competencies and the current state of advanced nursing practice in Austria. This highlights the need for clearer role definitions, regulatory frameworks, and educational strategies. Addressing this gap would strengthen APN roles and improve healthcare quality. This study highlights the need to bridge this disparity. REPORTING METHOD This review follows the PRISMA 2020 guidelines for systematic reviews Page et al. (2021). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.