What is already known about this topic
• There is growing demand internationally for advanced
practice nursing roles.
• Many barriers to the successful introduction of new
advanced practice nursing roles could be avoided by
improved planning and systematic efforts to address
implementation issues unique to advanced practice
nursing.
What this paper adds
• The PEPPA framework, or a participatory, evidencebased,
patient-focused process, for guiding the development,
implementation, and evaluation of advanced
practice nursing (APN) roles.
• Engaging stakeholders in the role development process
gives opportunities to establish the need and identify
shared goals for a clearly-defined advanced practice
nursing role.
• The goal-directed and outcome-based process provides
the foundation for prospective evaluation and thus
continued improvement of advanced practice nursing
roles and delivery of health care services.