Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing.

Disasters present unique challenges for teams providing medical assistance to those populations impacted by the event. This scoping review focused on the characteristics of medical teams in disaster and how these characteristics are developed. The scoping review methods of Arksey and O'Malley were followed. An inductive thematic analysis of selected articles was used to identify recurrent themes. A total of 6,521 articles were reviewed from eight databases, yielding 33 articles. Four recurrent theme groups were identified: (1) adaptability, flexibility, and improvisation; (2) creativity and innovation; (3) experience and training; and (4) leadership and command structure. The study highlighted key characteristics identified by responders for effective team functioning and interdependence between the characteristics. It also identified the paucity of literature on the subject. Results from the study can help to guide future research and training development for medical teams in disaster. Oldenburger D , Baumann A , Banfield L . Characteristics of medical teams in disaster. Prehosp Disaster Med. 2017;32(2):195-200.

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Introduction:The COVID-19 pandemic had a devastating impact on long-term care in Canada, exacerbating an existing crisis of staff shortages, inadequate infrastructure and funding, into a disaster. In response, the province of Ontario enacted emergency legislation and requested federal government support, resulting in the deployment of personnel from the Canadian Armed Forces and acute care hospitals into long-term care homes across the province. This exploratory study aims to develop a rich description of the long-term care context during the pandemic, deployed personnel's perspectives on providing care in the context, and identification of lessons learned while working during the pandemic.Method:Descriptive exploratory design with demographic questionnaire and semi-structured interviews will be used to understand the background and perspective of deployed personnel and managers on working in long-term care during the pandemic. Thematic analysis will be used to analyze the transcripts, organize codes, and identify and describe major themes. Findings will also be compared with disaster literature to understand how the perspectives of deployed personnel compare with existing disaster research.Results:21 interviews were initially conducted. Analysis of these interviews identified key challenges experienced by those deployed, including human resources, leadership and accountability, and policies and regulations. Perspectives and strategies for overcoming these challenges were also shared.Conclusion:The scale, duration, and context of the redeployment of personnel into long-term is unprecedented and has seen little research. This exploratory study shares the experiences of personnel who deployed into long-term care and helps identify lessons learned from overcoming challenges in the disaster context. These findings will be able to inform future disaster research and how to better prepare responders in the future.