RESUMEN
As Advanced Practice Nurse actively shaping nursing practice - A reflection Abstract. Background: The development of Advanced Practice Nurses (APN-roles) in Germany in the acute inpatient setting is heavily dependent on context factors. Establishing APN-roles in patient care represents a significant organisational development process. In the year 2010 the Florence-Nightingale-Hospital in Düsseldorf began the implementation of APN-roles. Aim: To reflect our experiences in the development of APN-roles and furthermore the identification of influencing factors. Understanding facilitators and barriers intends to support future APN-role developments and interventions. Methods: Four Advanced Practice Nurses carried out a partially structured review, with the help of the Consolidated Framework for Implementation Research (CFIR). For this purpose, the cyclical process of critical self-reflection according to Titchen (2009) was used. Results: The influencing factors were summarised in categories. The categories presented are: support from management, recognising the need for change, professional expertise, presence on site, self-efficacy and personal characteristics and role clarity. Discussion: The implementation of APN-roles requires time and perseverance, both from the organization as well as from the respective Advanced Practice Nurse. To achieve role clarity is, in this process, substantial. Boundaries and Transfer: This review presents context-related results. However, the identified influencing factors could provide a helpful framework for future implementation processes and developments of APN-roles.