The identification of clinical and professional leadership activities of advanced practitioners: Findings from the Specialist Clinical and Advanced Practitioner Evaluation study in Ireland

Aim: To report a case study that identifies how leadership is enacted by advanced practitioners in nursing and midwifery and differentiates between clinical and professional leadership in advanced practice. Background: A national evaluation of advanced practitioners in nursing and midwifery was commissioned to inform policy makers' decision-making about future developments in Ireland. Leadership is a key aspect of the advanced practitioner role. However, leadership in the advanced practice context is under researched and lacks empirical evidence on how advanced practitioners enact their clinical and professional leadership function in practice. Design: A multiple case study methodology was used to identify the leadership activities of advanced practitioners. Methods: Purposive sampling of advanced practitioners in nursing and midwifery across various specialities and health regions in Ireland was employed. Data sources included non-participant observation of advanced practitioners, interviews with key stakeholders, and documentary evidence including audits, policies, and guidelines. Collectively these data were used to identify the leadership activities of advanced practitioners in practice. The study was conducted between December 2008-December 2010. Results: Seven key activities that indicated clinical leadership and three key activities for professional leadership at advanced practice level were identified. Conclusions: The leadership activities identified provide greater clarity in distinguishing between professional and clinical leadership and in specifying the nature and scope of leadership activities.