Perspectives of Executive Nurse Leaders on Advanced Practice Nursing in Saudi Arabia: Challenges to be Overcome and Opportunities to be Seized

Aim. To explore the perception of executive nurse leaders regarding the implementation of advanced practice nursing in Saudi Arabia. Design. An exploratory, descriptive, and qualitative design was used. Methods. Purposive sampling was used to recruit chief nurse officers and executive nurse directors from government, private, and military health systems in tertiary, secondary, and primary settings. Data were collected from July to November 2022 using virtual semistructured interviews, which were recorded and transcribed. Thematic analysis was conducted manually. Results. Eleven participants were included in the study. The following themes were identified: unique characteristics of advanced practice nursing, impacts of advanced practice nursing in nursing profession, challenges to utilize the advanced practice nursing roles, opportunities to foster the proper implementation of advanced practice nursing, and recommendations to move forward with fitting advanced practice nursing in Saudi health system. Participants characterized advanced practice nursing as specialized, advanced, and autonomous and reported that it increases access to care, provides efficient and cost-effective care, and expands nursing career pathways. The lack of job description, fragmentation of implementation efforts, lack of training programs, and resistance from physicians, nurses, and patients hinder its implementation. The Saudi Vision 2030, gaps in health care, the growing population, and the familiarity of the healthcare system with advanced practice nursing were viewed as opportunities. The following subthemes emerged under recommendations: establish, train, and implement. Conclusion. Executive nurse leaders perceived advanced practice nursing as a promising initiative to improve healthcare delivery and the nursing profession. Several opportunities make "now" the right time to implement it.