Clinical autonomy for nurse practitioners
Author Identifier (ORCID)
Abstract
Nurse practitioners (NPs) have emerged globally as advanced practice nurses educated at the graduate level and prepared to assess, diagnose, prescribe, and manage care across primary and specialty settings in partnership with individuals, families, and communities. Clinical autonomy refers to the professional capacity to make informed, accountable decisions within one’s scope of practice, enabled and bounded by legislative and regulatory requirements, organizational governance, and effective interprofessional collaboration, and is central to realizing the role’s potential to deliver timely, safe, high-quality, person-centered care. This chapter traces the evolution of the NP role across World Health Organization (WHO) regions; examines workforce distribution and demand; profiles representative education and training models; synthesizes evidence on the impact of optimal autonomy on health outcomes, access, and cost; reviews regulatory architectures and authority levels; and summarizes perspectives of patients and interprofessional colleagues. We compare jurisdictions where regulation, organizational policy, and collaborative practice environments enable NPs to exercise clinical autonomy within scope (including prescribing authority) with jurisdictions where restrictive scope-of-practice requirements constrain timely care, with attention to implications for safe access, person-centered outcomes, and shared decision making. Countries that align rigorous graduate education with enabling regulation and supportive practice environments are best positioned to leverage NPs for universal health coverage.
Keywords
nurse practitioners, clinical autonomy, advanced practice nursing, scope of practice, healthcare access, primary care
Document Type
Book Chapter
Date of Publication
7-9-2026
Publication Title
A Global View on Clinical Autonomy for Advanced Practice Nurses
Publisher
Springer
School
School of Nursing and Midwifery
RAS ID
100019
Copyright
subscription content
Recommended Citation
McKay, N., & Kapu, A. (2026). Clinical autonomy for nurse practitioners. In A. Kapu, J. Rowles, J. Manning, & M. Schorn (Eds.), A global view on clinical autonomy for advanced practice nurses (pp. 1-16). Springer. https://doi.org/10.1007/978-3-032-21458-4_1