Consensus-based indicators of advanced practice nursing outcomes: Results of a Delphi study in France.

BACKGROUND

Despite one of the world's most advanced health systems, advanced practice nursing (APN) roles in France are less than a decade old. Globally, APNs strengthen access, quality, and efficiency of care, but sustaining these roles requires demonstrating outcomes meaningful to patients, providers, and policymakers.

PURPOSE: To describe consensus among French stakeholders on patient- and system-level indicators for evaluating APN contributions.

METHODS

A two-round Delphi process, followed by a nominal group discussion, was conducted. Participants included APNs, nurse managers, physicians, and academics. Candidate indicators, classified using Hamric's framework, were rated on nine-point Likert scales; indicators with ≥75% agreement were validated.

FINDINGS: Forty indicators were retained across seven domains, reflecting outcomes such as patient access, continuity, quality of care, collaboration, and leadership.

DISCUSSION: Consensus indicators show how APN practice is viewed in France-focused on expertise, coordination, and integration. This aligns with global APN competencies but contrasts with physician-substitution models elsewhere.

CONCLUSION

These validated indicators provide a foundational framework for evaluating APN contributions in France. They offer a strategic tool to support integration, and to inform policy.