Intraprofessional cultural competence in nursing regulation: A critical content analysis of standards and codes in the United Kingdom, New Zealand and Australia.

There is a global shortage of nurses, leading many countries to recruit internationally qualified nurses (IQNs) to fill the gap. However, IQNs encounter challenges in integrating into their new professional environment, particularly in their interactions with locally qualified nurses (LQNs). Intraprofessional cultural competence (IPCC), defined as 'a set of congruent behaviours and attitudes that enable professionals to work respectfully and effectively in cross-cultural situations', may be a strategy to address these challenges. Content analysis was used to examine nursing regulatory documents (Standards for Practice [Standards] and Codes of Conduct [Codes]) from the United Kingdom, New Zealand and Australia. Data were extracted and organised based on four key themes relevant to IPCC. The analysis revealed a focus on 'Mutual collaboration and professional relationships' in six regulatory documents, with explicit commitments to preventing racism and discrimination in the Australian and NZ Codes. However, issues such as racism, discrimination, bullying and harassment faced by IQNs are not comprehensively addressed, as the documents mainly prioritize culturally appropriate patient interactions over relationships between colleagues. Using regulatory documents to address IPCC may influence positive change such as improving communication, and preventing racism, bullying, discrimination and harassment within nursing.

The Global Leadership Mentoring Community: An evaluation of its impact on nursing leadership.

AIM: To evaluate a year-long mentorship program, pairing nurses from different regions across the world to support their global leadership capability, and identifying additional consequences of their participation. BACKGROUND: Investment in developing nurse leaders continues as a strategic global imperative. Building on the first cohort's recommendations, this second program illustrates continued progress. PROGRAM EVALUATION: Using the logic model of program evaluation, this non-empirical paper uses data collected from anonymized questionnaires and participants' stories to help improve the program, illustrating innovative practices to develop the confidence and competence of emerging and established nurse leaders globally. DISCUSSION: The value of mentorship was recognized, and there were gains for both mentors and mentees in the development of leadership confidence and competence. Through engagement and collaboration with the whole community, participants were encouraged to understand their own and others' cultures avoiding assumptions and stereotypes. CONCLUSION: This evaluation illustrates that in addition to helping improve future programs, mentorship has enabled the growth of individuals' skill sets and the confidence to reach out to peers across the world to understand the meaning of global health and to make a meaningful contribution to the challenges they face. IMPLICATIONS FOR NURSING PRACTICE: Nurse managers should be encouraged to develop and formalize a mentoring culture to benefit the leadership competence and well-being of their workforce. IMPLICATIONS FOR NURSING POLICY: Every nurse has a responsibility to invest in nursing leadership for themselves and others. Mentorship can assist nurse leaders to build workforce capability to lead and contribute to the policy agenda locally, nationally, and internationally. Starting early and at the individual level, global mentorship programs can develop leadership expertise to help nurses find their voice and strengthen their confidence and competence to lead and therefore build the strategic leaders of the future.

Advanced practice nursing initiatives in Africa, moving towards the nurse practitioner role: Experiences from the field.

AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa. BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue. SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects. DISCUSSION: Four African countries have formally adopted the advanced practice nurse practitioner role, with significant interest from countries throughout Africa, and ever-increasing requests for assistance regarding initiation, development and integration of advanced practice roles. Initiatives to advance the roles have been supported by the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network and Global Academy of Research and Enterprise. Next steps and projects for future role development are discussed. CONCLUSIONS: There is a progression towards the adoption of the advanced practice nurse practitioner role in Africa, and further mechanisms are suggested to allow full uptake and utilization. IMPLICATIONS FOR NURSING PRACTICE: Prioritization and investment in initiatives implementing nurse practitioner/advanced practice nurse roles in Africa allows nurses to pursue further education, advanced role and leadership opportunities consistent with Nursing Now goals. IMPLICATIONS FOR HEALTH POLICY: Implementation of nurse practitioner/advanced practice nurse roles increases the primary care workforce, consistent with recommendations and priorities in the World Health Organization Global Strategic Directions for Nursing and Midwifery 2021-2025 helping countries ensure that nurses optimally contribute to achieving universal health coverage and other population health goals.

A global examination of clinical ladder programs - A synthesis of commonalities and opportunities for standardization.

BACKGROUND: Clinical ladder programs (CLPs) have been part of the nursing profession for nearly 4 decades. However, the structure and implementation of CLPs vary widely throughout healthcare systems. CLPs are a valuable factor in nurse retention and employee satisfaction initiatives, but globally replicating and measuring their impact is difficult due to lack of standardization. AIM: To identify opportunities for global standardization of CLPs through a systematic review of published evidence and facility-sourced CLPs applications and program documents. METHOD: This study used a systematic literature search and scan of existing programs from facilities within the United States (US), Lebanon, and Ghana obtained through professional ties and organizational membership. RESULTS: Seventy-nine articles were screened with 30 studies identified for inclusion, plus 20 CLPs from the US and international facilities. Identified commonalities were the lack of consistency in the number of clinical levels across the CLPs, eligibility requirements and application process, reward and recognition, lack of emphasis on technology and informatics, and missed opportunities to use CLPs to drive a culture of safety. The administrative burden of the programs and the time required by the nurse to complete the CLP application were rarely referenced. LINKING EVIDENCE TO ACTION: The lack of consistency between facilities and across the healthcare sectors limits the measurable impact CLPs have on the nursing profession. Recommendations for practice include developing a standardized professional development framework. A standardized framework will encourage adoption of a retention tool that will provide the profession with a measurable method to demonstrate the value it brings to patient care. Providing guidance to health care facilities in low- and middle-income countries on the implementation of a professional development framework will assist in closing the global gap of professional development opportunities for nurses.

Dialogues on nursing curriculum and pedagogy: a critical planning activity for global educational collaboration.

PURPOSE: We describe the experience of a collaborative, dialogical process on nursing pedagogy to identify the best process for creating a mutually beneficial international nursing education exchange. APPROACH: Faculty from two universities in Sucre, Bolivia and in Seattle, Washington, US engaged in planned virtual dialogues to share their nursing curricula, course content, teaching methodologies, and contextual challenges and strengths. RESULTS: From the dialogues, a thematic analysis using a modified conventional content analysis approach was completed, and four themes emerged: 1) similarities in course content, pedagogy, and curricular challenges; 2) differences in teaching competencies; 3) teaching methodologies responsive to national trends; and 4) benefits from and alternatives to the use of educational technology. Early dialogues among participants allowed them to discern areas of need and interest for future planning. IMPLICATIONS FOR INTERNATIONAL AUDIENCE: Intentional academic dialogues should be the first step to enter in an exchange program to enable participants from different hemispheres to contribute equally as partners in the formation of nurses able to respond the current global health concerns.

Experiences of nurse educators facilitating and teaching in an international setting.

BACKGROUND: Multiple studies focus on the experiences of visiting students from high resource regions that participated in clinical placements in lower resource countries but less focus on the experiences of the educators accompanying students. AIM: The purpose of this study was to explore the experiences of educators during an international clinical placement of nursing students in a country in West Africa. METHODS: We implemented a focussed ethnographic design. We purposively sampled educators who accompanied students on an international clinical placement. Data collection from 2018 to 2019 consisted of in-depth individual interviews. We utilized Roper and Shapira's (2000, 10.4135/9781483328294.) data analysis process, which includes coding keywords, identifying patterns and theorizing. FINDINGS: Three themes emerged from the data: rewards in accompanying students, challenges experienced and the need for mentoring and continuous support. Educators found it rewarding to see growth in students, how students developed as global citizens, how students developed critical thinking and problem-solving skills and create lifelong friendships. CONCLUSION: Educators who accompany nursing students to international clinical placement experience valuable learning and challenging issues. Educators must navigate, support and advance student learning when on an international placement. It is crucial to have adequate institutional support from both the home and host country.

Advancement of global health: Recommendations from the Global Advisory Panel on the Future of Nursing & Midwifery (GAPFON®).

AIMS: To discuss nurses' contributions to global health through their participation in GAPFON®. DESIGN: Discussion paper that reviews literature related to global health, global nursing and midwifery based on the contributions of the GAPFON® report. DATA SOURCES: A literature search of electronic databases was conducted for published articles during 2014-2018 in English focusing on the main themes of the GAPFON® report. Manual searches of relevant journals and internet sites were also undertaken. RESULTS: Recommendations and strategies were discussed that could have an impact on the advancement of the nursing profession's contribution to global health based on the GAPFON® report outcomes. IMPLICATIONS FOR NURSING: GAPFON® provides a framework to synergize and converge our activities to address professional issues around the globe, through implementation of the suggested strategies identified in the GAPFON® report. GAPFON® has engaged with nursing and midwifery leaders around the globe to determine both the most pressing health issues and professional issues in regions and the report is a synthesis of all the data, reflecting regional and global challenges. This article explores ways of how the report can be used as a basis for engagement with decision makers in global health. CONCLUSION: Advances in the professional areas embedded in the GAPFON® Model are expected to lead to capacity building, evidence-based practice and ultimately improved quality of global health care. The strategies for implementation identified by regional stakeholders can have an impact on the global health agenda by focusing on nurses and midwives as the drivers of this change.

A model operationalizing sustainability in global nursing.

BACKGROUND: The concept of sustainability has received growing attention since the adoption of the United Nations' (UN) Sustainable Development agenda. Yet, in the context of sweeping changes regarding the status and profile of global nursing, sustainability has not been fully conceptualized. PURPOSE: To explore the concept of sustainability in global nursing in order to develop an operational definition and model. METHODS: Concept analysis using Rodger's Evolutionary method to explicate the term "sustainability" in a global nursing context. FINDINGS: Key features of sustainability were described. Existing models of global nursing focus on partnerships and lack a clear conceptualization and integration of sustainability. An operational definition and model of sustainability in global nursing were developed. DISCUSSION: Evolutionary review and analysis led to clarity in operationalizing sustainability in global nursing. The definition and model compliment existing models and provide a road map for global nursing to contribute toward the UN Sustainable Development agenda.

Global nursing leadership: alive and kicking in the midst of the COVID-19 pandemic.

As the COVID-19 pandemic continues its journey around the world, it has triggered a global nursing response, with nurses everywhere working to save the lives of their extremely sick patients. In parallel with the frontline response, the International Council of Nurses, the World Health Authority and the International Confederation of Midwives have used their biennial Triad meetings to set out what needs to be done from a global perspective to protect nurses and the people they serve. At a time of crisis, it is imperative that the world's nursing leaders, through ICN's National Nursing Associations, step up to give support and guidance at this historically unsettling time.

[Social Impacts of International Nursing Education].

The objective of international nursing education in Taiwan is to prepare nursing elites to improve the quality of global healthcare. Nurses are on the frontlines in terms of helping the public through increasingly frequent climate-change disasters, helping care for the rising populations of older adults and patients with chronic diseases, and dealing with the emergence of new infectious diseases. Advancing the knowledge and capabilities of global nursing elites is imperative. The main purpose of nursing education is to educate future nursing leaders. This paper describes the internationalization of nursing education in the Department of Nursing at National Cheng Kung University as well as the process of establishing the Asia-Pacific Nursing Education Alliance to highlight the international characteristics of nursing education, the related global social influence, and the pursuit of sustainable development goals.

Global citizens, healthy communities: Integrating the sustainable development goals into the nursing curriculum.

BACKGROUND: Integrating the Sustainable Development Goals (SDGs) into the nursing curriculum is an ethical response and facilitator developing students into global citizens. Nurse educators can promote global citizenship through the concept of "glocal" experiences in local communities as students work in partnership with communities to address social determinants of health and begin to achieve SDG targets. PURPOSE: This paper explores the process of integrating the SDGs into the nursing curriculum emphasizing the strategic vision of international agencies and national nursing organizations. DISCUSSION: Distinct pedagogical and clinical approaches for implementing SDG content into the curriculum are provided including an exploration of global health competencies and their relationship to the SDGs. Finally, an academic-community partnership is described as a clinical exemplar to strengthen the health of communities and begin realizing the SDGs at a local level.

A Global Approach to Promoting Evidence-Based Practice Knowledge: Validating the Translated Version of the Evidence-Based Practice Knowledge Assessment in Nursing Into Spanish.

BACKGROUND: Government and professional organizations have issued a call for evidence-based practice (EBP), prompting the development of competencies and expectations for knowledge, skills, and attitudes. However, EBP is still inconsistently implemented. To advance the science of nursing globally, educators and leaders need to use consistent, rigorous evaluation methods to assess the EBP knowledge of students and clinicians. AIMS: This study sought to translate the Evidence-based Practice Knowledge Assessment in Nursing (EKAN) instrument into Spanish, evaluate the psychometric performance of the newly translated instrument, and establish a baseline measure of EBP knowledge of baccalaureate nursing (BSN) students for future program improvement. METHODS: This study utilized a cross-sectional, descriptive, correlational design. A total of 139 BSN students were recruited from a single study site in the Dominican Republic. Subjects completed the 20-item EKAN-Spanish, which was translated and back-translated to promote semantic accuracy. RESULTS AND FINDINGS: Infit and outfit statistics for the sample centered around 1.0 (weighted mean square = 0.978; unweighted mean square = 0.988), indicating strong evidence of validity. The individual items on the EKAN-Spanish showed item reliability of 0.94. The mean EBP knowledge score was 6.52 (SD = 2.03) with scores ranging from 2 to 12 points (20 points maximum). Differential item functioning (DIF) analysis supported translational accuracy. DISCUSSION: This study provides validation support for an objective assessment of EBP knowledge in the Spanish language and will be useful for future studies of EBP in over 21 Spanish-speaking countries. LINKING EVIDENCE TO ACTION: While EBP is a global nursing concept, there has been no instrument to objectively measure EBP knowledge across levels of education in academe and practice in Spanish-speaking countries until just recently. The availability of a validated instrument will promote global consistency in assessing EBP knowledge. Further, this will promote a collaborative approach in teaching EBP to nursing students and practicing nurses.

'Global health' and 'global nursing': proposed definitions from The Global Advisory Panel on the Future of Nursing.

AIMS: To propose definitions of global health and global nursing that reflect the new paradigm that integrates domestic and international health. BACKGROUND: Increased globalization has led to expanded awareness of the importance of global health and global nursing among students and faculty in the health professions and among policymakers and practitioners. DESIGN: Discussion paper that includes a discussion and review of the literature related to global health and global nursing. DATA SOURCES: A task force searched for and reviewed articles published in English, Spanish or Portuguese between 2005-2015, developed summaries, listed key elements, identified prevalent themes and developed consensus definitions. IMPLICATIONS FOR NURSING: The definitions will be used by the Global Advisory Panel on the Future of Nursing to guide promoting a voice and vision for nursing that will contribute to the advancement of the profession's contribution to global health. CONCLUSIONS: Definitions of global health and global nursing were developed based on main themes and concepts identified in the literature review to guide contributions of nursing to global health.

Perspectives of nursing faculty in Africa on global health nursing competencies.

BACKGROUND: It is important to define global health competencies for health professionals. To date, we know little about perspectives of nurses in Africa where environments are particularly challenging. PURPOSE: The purpose was to describe perceptions of nursing faculty in Africa about global health competencies and compare those to faculty from the Americas. METHODS: A 32-item online survey with a convenience sample of nursing faculty. RESULTS: Data from 63 nurses in 21 African countries and 618 in the Americas were analyzed. Competencies related to Social and Environmental Determinants of Health were awarded relatively higher scores. Competencies related to globalization of health and health care were ranked relatively lower. This was similar across regions. DISCUSSION: Nursing education should address the social implications for health. CONCLUSION: Participants in all three regions considered Social and Environmental Determinants of Health as a priority. These data help set educational priorities in a setting where educational and training resources are limited.

Perspectives on global nursing leadership: international experiences from the field.

AIM: Nursing leaders from six countries engaged in a year-long discussion on global leadership development. The purpose of these dialogues was to strengthen individual and collective capacity as nursing leaders in a global society. Field experiences in practice and education were shared. Perspectives on global leadership can strengthen nurses' contributions to practice, workplace and policy issues worldwide. BACKGROUND: Transformational leadership empowers nurses' increasing confidence. Mentoring is needed to stimulate leadership development but this is lacking in many settings where nurses practice, teach and influence policy. Organizations with global mission provide opportunity for nurses' professional growth in leadership through international dialogues. PROCEDURES: Dialogues among participants were held monthly by conference calls or videoconferences. Example stories from each participant illustrated nursing leadership in action. From these exemplars, concepts were chosen to create a framework. Emerging perspectives and leadership themes represented all contexts of practice, education, research and policy. The cultural context of each country was reflected in the examples. RESULTS: Themes emerged that crossed global regions and countries. Themes were creativity, change, collaboration, community, context and courage. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Relationships initially formed in professional organizations can be extended to intentionally facilitate global nursing leadership development. Exemplars from the dialogues demonstrated nursing leadership in health policy development within each cultural context. Recommendations are given for infrastructure development in organizations to enhance future collaborations.

How Can a Global Experience Enkindle a Passion for Oncology Nursing?

I have had a broad global life experience. I was born in China and at the age of 11 years, my family decided that going to live with relatives in the United States was the best thing for me. I had to learn a new culture and l.

Leadership qualities faculty desire in academic leaders: An international Delphi study.

BACKGROUND: The global nursing workforce is confounded by shortages of nurses, faculty, and academic nursing leaders. Nursing academic leaders influence faculty recruitment and retention influencing the enrollment pipeline to fill nurse workforce capacity. OBJECTIVE: To identify leadership qualities nursing faculty prefer in nursing academic leaders globally. DESIGN: A multi-country exploratory design employed a three-round Delphi process including Demographic Data and open-ended questions. SETTING: An online Qualtrics survey was emailed to schools of nursing selected from seven global regions: United States (North America), Mexico (Latin America/ Caribbean), South Africa (Africa), Saudi Arabia (Middle East), Korea (Asia), Sweden (Europe), and Australia (Oceania). PARTICIPANTS: A convenience sample of faculty members employed in schools of nursing in the seven countries. METHOD: A 43-item Qualtrics survey developed from literature review of leadership qualities of nursing academic leaders was distributed to nursing faculty who participated in three Delphi rounds using descriptive statistics to analyze each round. Open-ended questions were analyzed using qualitative descriptive analysis. RESULTS: In Round 1, 54 faculty rated the 43 leadership qualities using a Likert Scale, identified the top 10, and added additional qualities not in the list. In Round 2, 26 of the original participants rated the resulting 29 leadership qualities. In Round 3, 16 of the original participants ranked their top 8 leadership qualities: mutual trust and respect; clear communication; creating a cohesive culture; assuring diversity, equity, and inclusivity; integrity; developing effective team structure; effective decision-making; and leading by example. In Round 3 participants rated nurses' preparedness for academic leadership. Open-ended questions identified 1) Strategies to prepare nurses for academic leadership roles and 2) Essential characteristics for effective academic leaders. CONCLUSION: Developing key leadership skills can increase the leadership capacity of nursing academic leaders, enhancing work environments, faculty recruitment and retention, helping mitigate a global challenge.

Impact of COIL: Learning From Student Nurses in Norway Who Collaborated With U.S. Students.

AIM: The aim of this study was to describe the experience of Norwegian nursing students with internationalization through participation in a Collaborative Online International Learning (COIL) course. BACKGROUND: Educators in Norway and the United States collaborated to incorporate internationalization and population health concepts into virtual courses during the pandemic. Literature gaps exist in post-implementation assessment data that ascertain internationalization through the COIL experience. DESIGN: This was a qualitative study with a descriptive design. Data were collected from focus group interviews and analyzed conventional content-analysis approaches. METHODS: Fifteen Norwegian undergraduate nursing students who participated in the COIL opportunity completed focus group interviews. FINDINGS: The themes identified included, "virtual conversation builds collaborations and enhances learning," and "this opened my eyes." CONCLUSIONS: Norwegian students acknowledged they had learned transferable lessons from their global partners that could be applied to patient care of the marginalized population in Norway.

Strategies for academic nursing to advance global and planetary health: A call to action.

Nurses play a crucial role in addressing human health influenced by global forces such as pandemics, and political conflicts that displace millions; in leading efforts to promote planetary health; and in achieving the United Nations (UN) Sustainable Development Agenda. Academic nursing programs have a significant role in actualizing nursing's impact on global health (GH) and planetary health (PH). This paper describes how nursing programs can actualize their GH and PH nursing perspectives to benefit students and society, thereby increasing nursing's effectiveness and improving health outcomes in local and global settings. Numerous strategies to actualize GH and PH perspectives were derived from current literature and an assessment of eleven nursing program websites. Nursing programs may adopt program-wide strategies such as reflecting GH and PH in their mission statement; through education, in courses; and through faculty or student scholarship, policy endeavors, and/or partnerships. Now is the time to take such action, recommitting to GH and PH nursing and deepening nursing's impact. Academic nursing programs' leadership role in society, and their role in preparing nurses to lead, educate, discover, and advocate is essential for the health of populations and the planet long into the future.

The global nursing faculty shortage: status and solutions for change.

BACKGROUND: In addition to a global shortage of nurses, there is also a shortage of academically qualified faculty available to teach in schools of nursing. METHODS: A systematic review examined proposed solutions to the global shortage of nursing faculty. Metasynthesis was used to compare and critically appraise strategies offered for solving or ameliorating the global nursing faculty shortage by premier nursing organizations. FINDINGS: 181 recommendations in 62 publications were categorized into eight major themed solutions, including centralizing data management, international collaboration in nursing research, and increased funding for full-time faculty positions in nursing programs. DISCUSSION: The nursing faculty shortage is due to a confluence of factors, including the global migration of nurses, a seeming persistent devaluation of faculty by academic programs, disincentives, and an overall reduction in full-time equivalent faculty positions. CONCLUSIONS: Results point to a needed change in direction and approach to solving the nursing faculty shortage. By designing new education models that fit global healthcare needs and pooling teaching resources, designing and using the same databases across organizations to track and project faculty needs, and collaborating between schools and businesses to create mutually beneficial agreements for services, nursing faculty capacity can be enhanced, and nursing's capacity to meet global healthcare needs can be expanded. CLINICAL RELEVANCE: The results of this systematic review can be used as a rubric for the design and development of strategies to end the nursing faculty shortage and expand global nursing capacity.