Project R-16798

APN-LEAD: Advancing Advanced Practice Nursing Leadership in Low- and Middle-Income Countries — A Contextual Framework Development with Evidence from Ethiopia (Research)

Background: Advanced practice nurses' leadership is pivotal to strengthening health systems in low- and middle-income countries (LMICs). However, the development of APN leadership is often impeded. Understanding the determinants influencing APN leadership development in LMICs contexts is crucial for developing strategies that will empower nurses and elevate the standard of care. Aim: To examine how APN leadership is conceptualized, developed, and influenced in LMICs, with an empirical focus on Ethiopia, and to produce a contextually grounded APN Leadership Framework to guide role development, policy integration, curriculum innovation, and capacity building. Methods: A mixed-methods design will be employed. Phase 1: a scoping review to map literature on APN leadership in LMICs, identifying concepts, competencies, and contextual determinants. Phase 2: a multiphase qualitative descriptive study, including document analysis and stakeholder perceptions. Phase 3: in-depth interviews and focus groups with APNs to explore insights and lived experiences of APN leadership. Phase 4: a modified Delphi technique with an expert panel will be used to synthesize evidence and reach consensus, producing a validated, context-sensitive APN Leadership Framework. Expected outcomes: Consolidated LMIC evidence and comprehensive Ethiopian empirical findings on APN leadership, and a validated framework with actionable recommendations adaptable to similar LMICs settings.

18 June 2026 - 31 July 2030