ADVANCED NURSING PRACTICE AS A RESPONSE TO THE CHALLENGES OF PRIMARY CARE IN BRAZIL

Abstract

Introduction: Primary Health Care (PHC) faces challenges related to expanding access, care resolvability, and workforce shortages, especially in more vulnerable contexts. In this scenario, Advanced Nursing Practice (ANP) has been discussed as a potential strategy to improve the organization of care and strengthen the Unified Health System. Objective: To analyze the scientific evidence on Advanced Nursing Practice as a response to the challenges of Primary Health Care in Brazil. Method: This is an integrative literature review conducted in the SciELO, Virtual Health Library, and PubMed databases, considering articles published between 2020 and 2025. Descriptors in Portuguese and English related to advanced nursing practice and primary health care were used. The selection followed systematized steps, summarized by an adapted PRISMA flowchart. Data were extracted using a standardized instrument and analyzed through thematic analysis. Results: Eleven studies were included, demonstrating the presence of practices consistent with ANP in the daily routine of PHC. The evidence indicated contributions of ANP to expanding access, increasing care resolvability, and strengthening care coordination. Key elements for its effectiveness included the development of advanced competencies, supported professional autonomy, and the need for implementation, regulation, and governance strategies. Conclusion: Advanced Nursing Practice is a viable response to the challenges of Primary Health Care in Brazil when understood as a structuring strategy, requiring equitable institutionalization, qualified training, and appropriate governance to enhance its impact on health care delivery.