Global trends and issues in APN practice: engage in the change.

The advanced practice nursing (APN) movement represents a global vision with similar issues facing APNs across dissimilar countries, disparate political structures, and diverse cultures. As APNs work toward independent practice, they face external challenges from medicine and internal barriers within the domain of nursing. This paper presents reflections on the major practice issues raised at the 7th International Nurse Practitioner/Advanced Practice Nursing Network Conference, a subgroup of the International Council on Nursing (ICN), in London in August, 2012. Major issues addressed at the conference included independent practice, barriers to practice, educational standards, and the APN role in research and evidence-based practice. APNs are best placed to provide and direct an advanced level of quality healthcare. APNs must develop consensus models and present as a more unified force in the quest for independent practice.