Internationally the concept of specialized expert or advanced nursing is not new and can be identified as early as the 19th century in the United States Civil War. (Hamric et al., 2005; Jacobs 2007). Advanced nursing practice, however, became definitively established in the USA in the 1970’s through advances in educational preparation and clinical practice roles for both the CNS and NP (Harmic et al.). The present-day CNS role is also established in Australia, Taiwan, China, Japan, New Zealand and the United Kingdom (Chen, 2009; Hamric et al.).
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