Developing an Evaluation Framework Based on Entrustable Professional Activities for Advanced Practice Nurses in China

AIM: To address conceptual ambiguity, unclear scope, and regulatory gaps hindering advanced practice nurse role implementation in China, this study developed an evaluation framework based on entrustable professional activities to facilitate the introduction, implementation, and development of the advanced practice nurses while guiding policy formulation, educational design, and credentialing. BACKGROUND: Globally, advanced practice nurses are recognized for delivering high-quality, safe, and cost-effective care. Many countries have formalized this role, often marked by prescriptive authority. However, China lacks a clearly defined advanced practice nurse role and national evaluation standards, creating barriers to effective role integration. METHODS: A scoping review identified international evaluation frameworks and their core components. A two-round Delphi study with 27 experts established relevant entrustable professional activities, and structured consensus meetings refined the framework. RESULTS: Delphi consensus was achieved on an entrustable professional activity framework consisting of 20 indicators across five domains: assisting in clinical assessment, diagnosis, and treatment; engaging in advanced nursing practice; communicating, consulting, coordinating, and collaborating; managing teaching and promoting research innovation; and preventing and managing chronic diseases. After two rounds of expert panel consultations, the final evaluation framework was established. DISCUSSION: This framework clarifies advanced practice nurse roles and offers a coherent structure linking education, competencies, and clinical practice to promote practice-ready development. CONCLUSION: This participatory framework provides an organized approach to evaluating advanced practice nurses' competencies and role readiness, supporting safe and effective advanced practice. IMPLICATIONS FOR NURSING: The framework supports competency-based education, workplace assessment, and continuing professional development for advanced practice nurses. IMPLICATIONS FOR NURSING POLICY: This evaluation framework offers a foundation for role legislation, credentialing, and evidence-informed policy development in China.