Implementation strategy for advanced practice nursing in primary health care in Chile

Francisca Aguirre-Boza*, María Consuelo Cerón Mackay, Joyce Pulcini, Denise Bryant-Lukosius

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objectives: (i) Outline the steps and progress made by Chile to implement the advanced practice nursing role using the PEPPA framework as a guide, (ii) demonstrate the effectiveness of the PEPPA framework to identify barriers and guide the implementation process, and (iii) discuss the next steps for role implementation. Methods: The framework includes nine steps in a flexible and iterative process. Results: This paper provides an in-depth analysis of activities employed for each step of the PEPPA Framework and their contribution to advanced practice nursing role development in Chile. In particular, stakeholder engagement activities were essential for informing key health care decision and policy-makers about the advanced practice nursing role, obtaining their buy-in and support for the role, and establishing consensus on role priorities. Strategies used to overcome some challenges in implementing framework steps are also discussed along with next steps to evaluate and monitor the implementation and establishment of the advanced practice nursing role in the long term. Conclusion: The PEPPA Framework provides important guidance for countries where advanced practice nursing roles are just being introduced by identifying and addressing barriers to the effective role design and successful implementation.

Original languageEnglish
Pages (from-to)120-128
Number of pages9
JournalACTA Paulista de Enfermagem
Issue number2
StatePublished - Mar 2019

Bibliographical note

Publisher Copyright:
© 2019 Departamento de Enfermagem/Universidade Federal de Sao Paulo. All rights reserved.


  • Advanced practice nursing
  • Chile
  • Health policy
  • Nurse's role
  • Primary health care


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