CNS Role and Practice in Japan

Abstract

The aim of this chapter is to describe the Certified Nurse Specialist (CNS) role and practice in Japan from the history of the role’s development to current challenges and opportunities. The CNS was the first post-RN role in Japan, a developed country with a high proportion of elderly people and a high healthy life expectancy. Included in the chapter is a brief history of modern Japanese nursing since 1874 noting the first CNS practice in hospitals began in the early 1990s. In Japan, laws governing health professional scope of practice are national. National law stipulates the qualifications for licensure of Japanese health care professionals. In the chapter, definition of CNS role and practice is described. A case exemplar described the practice of an expert Japanese CNS. The U.S. CNS was the model for the Japanese CNS. Initially the role focused on inpatient hospital care with both direct and indirect care activities. In Japan, practice competencies for CNSs are jointly endorsed among three organizations: the Japanese Nurses Association (JNA), the Japanese Association of Nursing Programs in University (JANPU) and professional nursing specialty organizations. JNA certifies individual CNSs. The JANPU accredits CNS educational programs.

Discussion of research on CNS outcomes includes recommendations for additional research. Psychiatric CNS outcomes research has demonstrated the effectiveness of psychiatric liaison CNSs, influencing health policy. Current issues in advanced practice nursing development are reviewed in relation to challenges and opportunities for the future.

This chapter has been written before the 2020 APN ICN guidelines were published and reflects the views of the authors.