Search

Aim: To explore the health beliefs of clinical and academic nurses from Japan, Australia and China regarding wearing paper masks to protect themselves and others, and to identify differences in participants' health beliefs regarding masks. Background: The correct use of face masks and consensus among health professionals across the globe is essential for containing pandemics, and nurses need to act according to policy to protect themselves, educate the public and preserve resources for frontline health workers. Paper masks are worn by health professionals and the general public to avoid the transmission of respiratory infections, such as COVID‐19, but there appear to be differences in health beliefs of nurses within and between countries regarding these. Methods: This qualitative descriptive study used content analysis with a framework approach. Findings: There were major differences in nurse participants' beliefs between and within countries, including how nurses use paper masks and their understanding of their efficacy. In addition, there were cultural differences in the way that nurses use masks in their daily lives and nursing practice contexts. Conclusion: Nurses from different working environments, countries and areas of practice hold a variety of health beliefs about mask wearing at the personal and professional level. Implications for nursing policy and health policy: The COVID‐19 pandemic has sparked much discussion about the critical importance of masks for the safety of health professionals, and there has been considerable discussion and disagreement about health policies regarding mask use by the general public. Improper use of masks may have a role in creating mask shortages or transmitting infections. An evidence‐based global policy on mask use for respiratory illnesses for health professionals, including nurses, and the general public needs to be adopted and supported by a wide‐reaching education campaign. [ABSTRACT FROM AUTHOR]

Aim: This paper discusses four main strategies for addressing nursing shortages that have been persistent, widespread and growing. Fallout from the COVID‐19 pandemic might offer valuable impetus to address this tenacious challenge. Background: Nursing shortages are common, widespread and have been persistent for most of a century. Many of the reasons behind these shortages are well known and are themselves enduring, as are the types of strategies put forward for addressing them. These strategies can generally be classified into four main categories: enhancing retention, improving recruitment, encouraging return to practice and drawing on international human resources. The COVID‐19 pandemic is the latest major threat to ensuring a sufficiently sized and skilled nursing workforce. Many nurses have succumbed to burnout as well the plethora of factors that predated the pandemic and have a negative impact on nurse wellbeing, turnover and intention to leave. Sources of evidence: This discussion paper draws on international sources of evidence. Discussion/conclusion: This paper highlights how many of the factors behind and strategies for addressing nursing shortages at the local, national and global levels are widely studied and known. A sustained combination of strategies that focus both within and beyond health and nursing, including on the broader social context, is necessary. While COVID‐19 has been extremely damaging, it might present an opportunity to make sustainable, effective reforms to address nursing shortages. Implications for policy: Knowledge users must recognise that a combination of approaches across the gamut of policies that influence nursing workforces is necessary to address nursing shortages. Attention must also focus on factors beyond nursing and healthcare if shortages are to be remedied. [ABSTRACT FROM AUTHOR]

Aim Background Sources of evidence Discussion Conclusion Implications for nursing practice Implications for nursing and health policy To provide insight into the process of developing health and nursing policy and how that process can be influenced by both researchers and nursing leaders.Nurses care for people across the life course from birth to death, in our communities, hospitals, care homes and schools. They have unique insight into how people live their lives and how this affects their health. Despite being well placed to influence health policy, nurses often fail to capitalise on this. At the same time, academics often struggle to identify the policy implications of their research resulting in further missed opportunities to use policy influence.Classical policy theory, which is predominantly drawn from economics and public administration together with a range of contemporary nursing and health policy studies, is used in this paper to discuss the policy process and opportunities to influence.Researchers need to focus on realistic policy suggestions that aim to raise awareness, highlight policy problems or set the agenda. In turn, nursing leaders, from National Nursing Associations, need to harness evidence to support their efforts to influence policy. In terms of influence, a range of approaches exist, and each lends itself to different parts of the policy cycle.The role nurses can play in health policy is not well developed in many countries. Nursing researchers and leaders are well placed to influence policy but must do so in a clear and pragmatic way recognising that policymakers make decisions despite being faced with conflicting evidence, competing demands and economic imperatives.Recognising that nurses can offer much in terms of policy development, the paper argues that a pragmatic approach based on different forms of influence at different stages is likely to be most successful.The evidence reviewed in this paper suggests that nursing academics and leaders need to identify realistic policy interventions when examining their own empirical work or identifying ways to individually or collectively influence policymakers. [ABSTRACT FROM AUTHOR]

Aim Background Sources of evidence Discussion Conclusion Implications for nursing practice Implications for nursing policy This paper explains how we created the Global Intellectual Disability Nurse Research Collaboratory (GIDNRC), a transformative network. The GIDNRC aims to make improvements in the understanding, research, policy, clinical care, and support provided to people with an intellectual disability.In 2022, the World Health Organization (WHO) called upon healthcare leaders internationally to take actions to promote more equal healthcare for disabled persons. This paper promotes the GIDNRC as a way for professionals to work together to make more equal healthcare throughout the world for people with intellectual disabilities.We created this paper by reviewing peer‐reviewed literature and research, international policies, and nursing networking initiatives.This paper explores current policy, research, and practice issues that formed the basis of beginning the GIDNRC, including how the COVID‐19 pandemic changed care.Nurses are over 50% of the world's health workforce. Therefore, they have the potential to make a large impact in making care for people with intellectual disability much more equal than currently exists throughout the world. However, barriers exist. Forming the GIDNRC, as well as using the World Wide Web, offers an opportunity to address barriers to this goal.Nurses can address the needs of people with intellectual disability in their daily nursing practice. The GIDNRC aims to strengthen these clinical skills, understand how care may vary throughout the world, and share knowledge, good practices, and new ways to approach care for people with an intellectual disability worldwide.International nursing policy should actively focus on the needs of people with intellectual disabilities and the role nurses play in addressing these health needs. The GIDNRC may provide an important way to achieve developments in this policy. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aim: To provide a framework for the production of policy briefs, and offer a practical example of how evidence can be turned into a succinct document to inform policy and bring about change targeted at delivering universal health coverage. Introduction: Policymakers are too busy, or do not have the necessary expertise, to read and comprehend complex scientific papers. As a result, policy briefs that capture and present the essential points are needed if evidence‐informed policy is to be developed and implemented. Method: A two‐page example of how evidence from meta‐analytical and systematic reviews can be presented to identify options and recommendations to address a major global disease burden. Results: The example uses a simple, seven‐section template for developing a policy brief. The essential characteristics of each section are provided. The briefing, targeted at the global level, provides information on the major challenges associated with the treatment of individuals with diabetes. Discussion and Conclusions: This paper demonstrates how to use existing research evidence to address the pursuit of UHC relevant to a wide range of geographies, settings or disadvantaged groups. Implications for Policy: Gaps in universal health coverage and major disease burdens such as diabetes can be pursued through entities such as country‐based Nursing Now groups. In addition, ongoing opportunities exist through the International Council of Nurses annual International Nurses Day and WHO's regular regional meetings to inform and influence policy discussions at national and subnational levels. By focusing on a small number of global topics each year, measurable changes in addressing the burden of disease can be achieved while simultaneously keeping the nursing profession's contribution centre stage. [ABSTRACT FROM AUTHOR]

Aim Background Method Result Discussion Conclusion and implications for nursing and/or health policy This research examines the effects of artificial intelligence (AI)‐based decision support systems (DSS) on the operational processes of nurses in critical care units (CCU) located in Amman, Jordan.The deployment of AI technology within the healthcare sector presents substantial opportunities for transforming patient care, with a particular emphasis on the field of nursing.This paper examines how AI‐based DSS affect CCU nursing workflows in Amman, Jordan, using a cross‐sectional analysis. A study group of 112 registered nurses was enlisted throughout a research period spanning one month. Data were gathered using surveys that specifically examined several facets of nursing workflows, the employment of AI, encountered problems, and the sufficiency of training.The findings indicate a varied demographic composition among the participants, with notable instances of AI technology adoption being reported. Nurses have the perception that there are favorable effects on time management, patient monitoring, and clinical decision‐making. However, they continue to face persistent hurdles, including insufficient training, concerns regarding data privacy, and technical difficulties.The study highlights the significance of thorough training programs and supportive mechanisms to improve nurses' involvement with AI technologies and maximize their use in critical care environments. Although there are differing degrees of contentment with existing AI systems, there is a general agreement on the necessity of ongoing enhancement and fine‐tuning to optimize their efficacy in enhancing patient care results.This research provides essential knowledge about the intricacies of incorporating AI into nursing practice, highlighting the significance of tackling obstacles to guarantee the ethical and efficient use of AI technology in healthcare. [ABSTRACT FROM AUTHOR]

The development of advanced practice nursing has evolved globally over the past decades and has become an important component in the contemporary healthcare system. The term 'advanced practice nurse' is used to refer to nurses practising at a higher level than traditional nurses and is defined as a registered nurse who has acquired the expert knowledge base, complex decision‐making skills and clinical competencies for expanded practice. In 2003, Singapore embarked on the development of advanced practice nurses as an initiative to improve the nursing professional image, retain excellent clinical nurses and fill the gaps in the provision of healthcare services for the ageing population. This paper documents Singapore's journey of advanced practice nursing development and shares our unique learning experience in the aspects of education, certification, registration and scope of practice. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to propose Park's sweet spot theory‐driven implementation strategy, which makes optimal safe staffing policy really work in nursing practice. Background: For the last 40 years, mainstream nursing workforce research has emphasized that having more registered nurses leads to better patient outcomes, and yet staffing policies have failed to implement this crucial concept. Meanwhile, global nursing shortages have become rampant, a problem that only dilutes the skill‐mix ratios in the nursing workforce. Low fertility and an aging population worldwide are then accelerating these shortages. These dire circumstances may be persisting because of unclear, unsubstantiated cost‐efficiency in the nursing workforce. For this reason, there remains a dearth of well‐researched evidence for a clear threshold on optimal safe staffing levels that could maximize quality of care relative to cost given limited healthcare financial budgets and which could also be fitted into each care setting. Along with that, an implementation strategy for optimal safe staffing levels is nonexistent. Sources of evidence: An implementation strategy has been developed through interdisciplinary consilience‐based theory synthesis of both prospective theory and regulatory focus theory combined with Park's optimized nursing staffing (sweet spot) estimation theory. Discussion/conclusions: A theory‐driven novel implementation strategy is proposed, which functions as a nudge strategy that uses the synchronous balance of quality of care, nurse staffing, and cost. It illustrates (1) how to create shared value among patients, nurses, and stakeholders through robust evidence‐based, informed shared decision‐making rationales on the optimal safe nurse staffing levels and (2) how to induce stakeholders to overcome resistance to innovation and improve their nursing workforce through value chain in management science. Implications for nursing workforce policy: This novel implementation strategy may be a viable solution to mitigate the nursing shortage by leading stakeholders (1) to compete with each other (on the basis of nursing sufficiency) and (2) to competitively demonstrate the patient‐centered value (patient‐perceived care quality relative to cost) of their institutions. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to reflect upon the experiences of a senior nurse in a patient‐facing role, who led a tea providing direct care to those with coronavirus disease 2019 (covid‐19). This would establish what those experiences meant to nurses during the initial outbreak to enable their coping mechanisms to face subsequent waves in the United Kingdom. Background: The worst infectious disease outbreak of a generation rapidly made its impact known to the medical profession and its support infrastructure across the globe. It imparted unprecedented challenges, not only for managing the care of the most critically ill but for minimising its spread and protecting the workforce. Sources of evidence: Reflections of working on the covid‐19 frontline during the initial stages of the pandemic, the challenges faced, and lessons learned enabled the development of a strategy to better support nurses in the ongoing pandemic. Discussion: Visible, invested and consistent leadership was key in forming a strong foundation to support clear communication, peer support and increasing confidence. Consequently, strong bonds were forged to enable the team to face further challenges as they felt 'in it together'. Summary and implications for nursing and health policy: The experiences described in this paper are those of a senior nurse leader within a particular care context. However, the lessons learned are likely to resonate with many nurses who are facing the same challenges in very similar care contexts and who are urged to reflect upon their own experiences. Furthermore, the associated lessons may help support others and inform their strategy for coping throughout potential future admission surges of this pandemic. [ABSTRACT FROM AUTHOR]

Global inequality exists in the availability of a nursing workforce, supported evidentially by the ratio, in low‐income countries, of only 9.1 nurses per 10 000 people versus 107.7 nurses per 10 000 people in high‐income countries. Mongolia is no exception with 42.14 nurses per 10 000 people and a nursing shortage severe enough to endanger patient safety and well‐being. This paper details both a policy analysis and contextually well‐designed recommendations to strengthen Mongolia's nursing science and practice systems. Obstacles that significantly affect the successful development of nursing and midwifery professions in Mongolia include (1) a lack of strategic planning and regulation; (2) low status of nurses and midwives; (3) absence of professional representation for nurses and midwives; and (4) a dearth of strategic programs for postgraduate training of nurses and midwives. The suggested recommendations include the appointment of a chief nursing office within the government and a cohort of nurse leaders to work to establish a nursing and midwifery board as an independent, professional regulatory body in Mongolia to develop and implement standards to ensure best practice, higher standards of nurse education, and regulate the profession. [ABSTRACT FROM AUTHOR]

Aim: This paper examines aspects of pandemic policy responses to the COVID‐19 and SARS‐CoV‐2 variants and presents an integrated view of the consequences of response tactics at national and health service levels for older adults. Background: Nurses are positioned at the intersection of health service and policy implementation; therefore, their influence on clinical protocols and health policy directions post pandemic is crucial to preventing further premature deaths in the 65+ years age group and others. Sources of evidence: Perspectives presented here are based on a critical evaluation of the many published reports, comments, research and insights concerning the pandemic. That evidence, combined with my experience in various fields of study and professional service, enables me to envisage what some decisions and policies may mean for older people, nurses and societies worldwide. Discussion: Established information on world population patterns and the location and health of national groups has been made less reliable by population shifts caused by years of geo‐political conflicts and now the impact of the pandemic. Added to this already chaotic context, the pandemic has further disrupted societies, health services and economies. Ageist responses by these systems have further disadvantaged older people and generated trust deficits that need to be resolved. Conclusion: When the pandemic recedes, policy and management decisions taken by governments and hospital administrators will be a telling indicator of whether the established systematic ageism exposed during the pandemic will continue to compromise the health and longevity of older adults. Implications for nursing, health and social policy: The ascendency of nursing influence within the health and social policy environment must be further strengthened to enable nurses to champion equity and fairness in the pandemic recovery effort. [ABSTRACT FROM AUTHOR]

Background: In 2016, the Act on Decisions on Life‐Sustaining Treatment for Patients in Hospice and Palliative Care was implemented in Korea, providing a broad framework for end‐of‐life decision‐making for the first time and making advance directives legally recognized documents. This Act can correct long‐standing under‐recognition of patients as valid decision makers for their own treatment choices. However, limited recognition of patient self‐determination, rigid legal forms for documenting patient wishes, and the roles of family under the Act may pose challenges both to patients and nurses. Aim: This paper critiques whether this newly introduced system of advance directives can truly guarantee protection of the patient's interests and respect for patient autonomy in real life​, and discusses ethical and legal issues regarding the Act. Source of evidence: We reviewed the current system of advance directives by raising three questions: (1) Do advance directives reflect a competent person's voluntary and informed choice?, (2) Are advance directives applicable in diverse clinical situations?, and (3) Does the Korean advance directive system ensure that such directives are honored in reality? Conclusion: Although the Act is an important first step in respecting patient autonomy in end‐of‐life decision‐making, it remains inadequate as it fails to provide thorough guidance in terms of the quality of writing process, applicability, and the guaranteed effects of advance directives. Implications for nursing and health policy: As nurses are best situated for addressing these limitations due to their roles and competencies in clinical practice, expanding the roles of nurses in every stage of advance directive practice could help achieve the original purpose of advance directives. This calls for a policy that promotes an expanded role of nurses to improve the quality of advance directive practice. [ABSTRACT FROM AUTHOR]

In this paper, we strongly advocate for universal palliative care access during the COVID‐19 pandemic. The delivery of universal palliative care services has been called for by leading global health organizations and experts. Nurses are critical to realizing this goal. COVID‐19 diagnoses and fatalities continue to rise, underscoring the importance of palliative care, particularly in the context of scant resources. To inform the writing of this paper, we undertook a review of the COVID‐19 and palliative care literature and drew on our experiences. It is very clear that investment in nurses is needed to ensure appropriate palliative care services now and into the future. Avoiding futile interventions and alleviating suffering is an ethical imperative for nurses regardless of the setting. Multi‐level practices and policies to foster the delivery of safe, high‐quality palliative care for all are urgently needed. [ABSTRACT FROM AUTHOR]

Aim: This paper describes an innovative approach to tackling the shortage of qualified nurse educators, which is a major constraining factor or 'bottle‐neck' to improve the global supply of nurses, especially in low‐ and middle‐income countries. Background: The World Health Organization commissioned experts to develop Nurse Educator Core Competencies that describe expectations for this cadre of workers. In their deliberations, the WHO experts cited the challenges affecting the adoption of these competencies, particularly the lack of resources available for implementation. To address this specific challenge, a USA‐based non‐government organiization, Nurses International, has developed Open Education Resources (NI‐OER) to support nurse educators with freely accessible curriculum materials and remote mentoring support. Methods: This paper applies item analysis to consider how the NI‐OER could assist higher education institutes and individual faculty members in meeting each of the WHO Nurse Educator Core Competencies. Findings: The NI‐OER is a good fit with six of the Nurse Educator Core Competencies and a partial fit with the other two. Discussion: Congruence with the WHO Nurse Educator Core Competencies is an important validity check for the NI‐OER. The ultimate goal of the NI‐OER is to promote sustainable development through intermediate goals related to supporting faculty as they prepare nurses for current and future service needs. Technological solutions like the NI‐OER cannot solve all aspects of a complex problem like the global nursing shortage but are an important tool. Implications for Nursing and Health policy: This resource has significant implications for nursing and health policy because it tackles several constraints to the global goal of increasing production and capacity of nurses. Combined with the organization's remote mentoring and communities of practice, the NI‐OER appears to have the potential to support novice nurse educators with accessible, adaptable resources. [ABSTRACT FROM AUTHOR]

Aim: This paper examines the possibility of including families, particularly mothers, within the health workforce using the human resource for health planning model to improve newborn outcomes. Background: In many low‐ and middle‐income countries, there is a critical shortage of healthcare providers which impacts care for the neonatal population. A maternal and newborn health need that is prevalent in such countries is the care available between pregnancy and the postnatal period, where significant maternal and newborn deaths occur. Sources of evidence: Using the population health need of the neonatal population in Tanzania, this paper explores the opportunity to include mothers as an additional human resource for health within the Needs‐Based Health Human Resources and Health Systems Planning model. Discussion: In relation to educating and engaging family caregivers, the possible extension of the health workforce to include mothers as a response to meeting the healthcare needs of the neonatal population has yet to be explored. Through mothers and healthcare providers working together to address the population health need of essential newborn care, it offers a way forward for planning the resources needed in a health system. If utilized, mothers offer the opportunity to supplement the demand for human resources for health in the provision of newborn care, without replacing healthcare providers. Conclusion: Mothers as potential members of the health workforce furthers the health system as a whole whereby population health needs are addressed and newborn mortality declines. Implications for health policy: To solve the critical gap based on the supply of and demand for providers including doctors, nurses and midwives, a broader look at innovative solutions is essential. Implications for nursing practice: Mothers offer the opportunity to supplement the available human resources for health in the provision of newborn care, thus helping to close existing gaps. [ABSTRACT FROM AUTHOR]

Aim: To review published literature descriptions of advanced practice nurses' roles in low‐ and lower middle‐income countries. Background: Advanced practice nurse roles have the potential to address insufficient healthcare resources in low‐ and lower middle‐income countries. Introduction: This integrative review highlights advanced practice nurses' roles in the delivery of healthcare services in low‐ and lower middle‐income countries. Methods: Three electronic databases PubMed, CINAHL complete and ProQuest Health & Medicine were searched. No limits by year or language were set. The names for low‐ and lower middle‐income countries and combinations 'related to advanced practice nurses' titles were used to identify papers. In addition, a review of publication type was performed. Themes found within the publications were assessed against the advanced practice nurses' International Council of Nurses' characteristics. An integrative review facilitated an appraisal of the papers identified. Results: The initial search identified 5778 publications in 16 languages. This number was reduced to 23, from 18 low‐ and lower middle‐income once exclusion criteria were applied. Six publications were from 1977 to 1999, and six between 2000 and 2010, with the remaining 11 from 2011 to 2018. Zambia had the most publications. Notably, 63 countries were not represented. Of those meeting inclusion criteria, the majority addressed education with a lesser extent focusing on practice and regulation of advanced practice nurse's roles. The majority were published during the last decade. Discussion: This review of the published literature identified advanced practice nurses' roles and function within some healthcare systems. However, not all components were reported. Examination of the grey literature could provide additional information about the actual and potential benefits of advanced practice nurses' in low‐ and lower middle‐income countries. Conclusion: The published literature that referred to advanced practice nurses' identified their contribution to positive impacts on health care over the last 40 years. However, with only 11 publications identified in the last 7 years, further review is required to understand the advanced practice nurses' roles in these countries. Implications for nursing and/or health policy: Further development of advanced practice nurses' in low‐ and lower middle‐income countries is supported by the lack of published literature. [ABSTRACT FROM AUTHOR]

Aim: This paper explores the potential for incorporating big data in nursing regulators' decision‐making and policy development. Big data, commonly described as the extensive volume of information that individuals and agencies generate daily, is a concept familiar to the business community but is only beginning to be explored by the public sector. Background: Using insights gained from a recent research project, the College and Association of Registered Nurses of Alberta, in Canada is creating an organizational culture of data‐driven decision‐making throughout its regulatory and professional functions. The goal is to enable the organization to respond quickly and profoundly to nursing issues in a rapidly changing healthcare environment. Sources of evidence: The evidence includes a review of the Learning from Experience: Improving the Process of Internationally Educated Nurses' Applications for Registration (LFE) research project (2011–2016), combined with a literature review on data‐driven decision‐making within nursing and healthcare settings, and the incorporation of big data in the private and public sectors, primarily in North America. Discussion: This paper discusses experience and, more broadly, how data can enhance the rigour and integrity of nursing and health policy. Conclusion: Nursing regulatory bodies have access to extensive data, and the opportunity to use these data to inform decision‐making and policy development by investing in how it is captured, analysed and incorporated into decision‐making processes. Implications for Nursing and Health Policy: Understanding and using big data is a critical part of developing relevant, sound and credible policy. Rigorous collection and analysis of big data supports the integrity of the evidence used by nurse regulators in developing nursing and health policy. [ABSTRACT FROM AUTHOR]

Background: In 2020, the SARS‐CoV‐2 pandemic forced the redesign of the International Council of Nurses' (ICN) Global Nursing Leadership Institute (GNLI) that heretofore had included an intensive, week‐long residential experience in Geneva, Switzerland. Aim: This paper describes the development, implementation, challenges and preliminary outcomes of an approach that regionalized GNLI and delivered it online, while preserving some cross‐regional connections among participants. Results: A virtual approach to a global policy leadership programme cannot replace the richness of an intensive, concentrated residential one, but the redesign of GNLI has given ICN, its member national nursing associations and individual nurse leaders previously unexplored opportunities for networking and collaboration aligned with the six WHO regions, and for cross‐region networking and discussions of global issues. Conclusion and implications for nursing and/or health policy: The SARS‐CoV‐2 pandemic has highlighted the need for nursing leadership in policy and practice. A virtual approach to leadership development can increase the reach of programmes that seek to build nursing's capacity to advance health‐promoting policies in workplaces, organizations and nations. [ABSTRACT FROM AUTHOR]

Background: In the 121st anniversary year of the birth of Florence Nightingale, and during the COVID‐19 pandemic, it is both interesting and salient to be reminded of the foundational work of this famous woman who began modern nursing. Her work in nursing care and nursing, health and public policy has been a continuing strong foundation to practices in societies around the world. Methods: In this short communication about historical research, various aspects of Florence's life and work are described, as well as the locations, memorials and museum significant to our remembrance of her. Results: A particular focus of this paper is the description of a larger but little‐known medicine chest located at the College of Nursing, University of Saskatchewan, in Saskatoon, SK, Canada, and attributed as belonging to Florence. Conclusion: Best known to this point in time is a smaller medicine chest at the Florence Nightingale Museum in London. [ABSTRACT FROM AUTHOR]

Nurses are the largest group of healthcare workers in the world, and during the COVID‐19 pandemic, nurses have been recognized worldwide as frontline warriors working hard to stem suffering, infection rates and deaths. Korean nurses experienced the effects of the pandemic earlier than in most other countries, and the work of our nurses has been recognized as a successful model in responding COVID‐19. In this paper, we share the experiences of Korean nurses, including their experiences of workload, acute shortages of staff and equipment and work overload, and suggest ongoing tasks that need to be addressed to combat the pandemic's second wave and other possible waves. Specifically, the nursing issues relating to COVID‐19 are critically reviewed and recommendations for each issue are suggested in terms of nursing staffing, practice and policy, as well as health policy. [ABSTRACT FROM AUTHOR]

Aim: This paper describes the situation regarding COVID‐19 emergency in France as of early May 2020, the main policies to fight this virus, and the roles and responsibilities of nurses regarding their work at this time, as well as the challenges facing the profession. Background: Europe continues to be affected by the COVID‐19 pandemic. At the time of writing France was the fourth country with the highest number of detected cases and cumulative deaths. Sources of evidence: Websites of the World Health Organization, French Government, French Agency of Public Health, French National Council of Nurses and ClinicalTrials.gov database, as well as the experiences of the authors. Discussion: The history of the development of the pandemic in France helps explain the establishment of the state of health emergency and containment of the population. Many decisions made had undesirable repercussions, particularly in terms of intra‐family violence, mental health disorders and the renunciation of care. Hospitals and primary care services, with significant investment by nurses, played a key role in the care of persons with and without COVID‐19. Conclusion: France has suffered a very high toll in terms of COVID‐19 morbidity and mortality, and effects on its people, health systems and health professionals, including nurses. Implications for nursing practice: Nurses are recognized for their social usefulness in France. However, it is important to consider the collateral effects of this crisis on nurses and nursing and to integrate the health emergency nursing skills established during the pandemic into the standard field of nursing competence. Implications for nursing policy: The nursing profession has expectations of a reflection on and revision of nursing skills as well as of its valorization in the French healthcare system, notably carried out by the French National Council Order of Nurses. [ABSTRACT FROM AUTHOR]

Aim To conduct a bibliographic analysis of the indexed literature relating to scope of practice in nursing so as to identify underlying patterns in journal publication, volume of scholarly work over time, countries of origin, central contributors, academic affiliation and the major dimension of the studies conducted. Methods A systematic search of the Scopus database provided data that was then extracted and utilized to undertake a bibliometric analysis of published work relating to scope of practice. In addition to identification of aggregated metrics relating to the most frequently occurring journals and most cited authors, a co-word analysis was conducted. Results A total of 2730 articles with the term Scope of Practice in the Title, Abstract or Keywords were identified. Co-word analysis revealed five major themes - Changing Regulatory Environment; Health Care Drivers; Competence & Role Implementation; Policy Context; and Role Evolution & Role Differentiation. Conclusions and policy implications From a policy perspective, we conclude that bibliographic analysis of the indexed literature is a useful technique that can augment our understanding of key regulatory issues such as scope of practice. However, the overemphasis on advanced practice in the scope of practice literature coupled with the increased interest in task shifting to support-personnel as governments pursue the goal of universal health coverage may leave nursing inadequately prepared to inform any evidence-based policy change. [ABSTRACT FROM AUTHOR]

Aim: This study explores how scholarship relating to meta‐analytical studies and systematic and integrative reviews can inform nursing's contribution to universal health coverage. Introduction: As nursing globally embraces the 200th anniversary of the birth of Florence Nightingale, the Nursing Now social movement has called for the profession to improve universal health coverage through increasing nursing's policy voice. Methods: In determining how the Nursing Now social movement could pursue the aim of this study, researchers undertook a comparative bibliometric analysis of scholarship relating to the systematic curation of evidence. This study uses a mixed‐method analysis of the bibliometric data available through extracting and synthesizing information from one of the commercially produced indexing and citation databases. Results: Generally, medicine has contributed far more synthesized contributions than nursing, except in the case of integrative reviews. Co‐occurrence analysis of nursing literature through examination of key terms yielded a complex visualization of 11 specific clusters of scholarship (Care of the Older Person, Nurse Education, Emergency and Critical Care, Occupational Health and Safety, Rural Services, Anxiety and Depression, Measurement, Newborn and Post‐natal Health, Cardiovascular Disease, Preventative Health and Cancer Care). Discussion and conclusions: Bibliometric analysis of curated evidence demonstrates that there is ample nursing‐relevant material to inform evidence‐based policy change directed towards the attainment of universal health coverage and several of the Sustainable Development Goals. Implications for policy: Nursing literature is available to support policy change directed towards the pursuit of universal health coverage and sustainable development goals. Leveraging existing networks of research collaboration to increase research capacity through communities of scholarship or by twinning experienced and neophyte contributors is possible. Further work is needed to equip nurses with the competencies to navigate the policy environment and develop and deliver impactful policy messaging. [ABSTRACT FROM AUTHOR]

Background: The human resources for health crisis has generated much debate as to the radical changes necessary to mitigate the risks to universal health coverage. Nurses can make a significant impact on global health, if only they feel empowered to take their seat at the political table. Aim: The aim of this paper was to outline nurse‐led initiatives to enhance organizational culture and clinical processes at the Combined Military Hospital in Rawalpindi, Pakistan. These have been designed and implemented by the United Kingdom (UK) Defence Medical Services to empower the nursing workforce in Pakistan. Outcome: An educational model has been developed that will build capacity, within a workforce constrained by numbers, by bridging the gap between nursing theory and practice. It is geared to actively engage Pakistani nurses in quality improvement to ensure care is based on best evidence that will enhance patient outcomes. Conclusion and implications for nursing & health policy: The wider impact of the model has already been evidenced by nurses, country‐wide, who are gaining the necessary skills and confidence to realize their true potential in influencing the patient care pathway and future policy. This is crucial to the recruitment and retention of nurses who might otherwise seek alternative career paths if they lack a sense of value within the profession. Their renewed sense of value will enable them to find their voice and ability to contribute to the sustainable development goals adopted by the United Nations General Assembly in 2015. [ABSTRACT FROM AUTHOR]

Aim: Using the case of Israel, we examine the confluence of current philosophies of health care along with the historical trends of health promotion/disease prevention services to consider strategies for increasing inclusiveness and for updating and improving their service delivery. Background: Health services in Israel are at a crossroads. Plans to integrate the historic, nurse‐operated, nationwide programme, providing health promotion/disease prevention services to pregnant women and young children for all residents (Tipat Halav) into the National Health Service System's existing Sickness Funds are under discussion. Sources of evidence: Using a discourse approach, this paper examines the current and historical context of health promotion/disease prevention services. Our history shows an increasingly treatment‐based perspective and dwindling support for inclusive services. In the current health system, Tipat Halav nurses solely provide inclusive health promotion/disease prevention services to pregnant women and young children. Informed by the World Health Organization, a reorientation to health promotion/disease prevention is essential in an ageing society where chronic rather than infectious diseases are the reigning health problems. Conclusion: Israel needs to reorganize the health system using a public health approach that both incorporates existing structures and establishes new ones, such as creating a network to elicit community input, and instituting nurse‐operated clinics designed to provide health promotion/disease prevention services for all ages and all residents. Implications for health and nursing policy: The newly created health system framework demands activism among all health professionals to legislate for an inclusive, holistic orientation. Master's level clinical programmes in community health nursing are vital to ensure the provision of optimal health promotion/disease prevention services. [ABSTRACT FROM AUTHOR]

Aim: This article considers the systems leadership doctor of nursing practice degree as an option to increase nursing leadership roles and heighten presence at policy tables globally, particularly in low‐ and middle‐income countries. Recent global reports emphasize core competencies needed for nursing leadership, particularly systems leadership and health policy, to successfully move the global health agenda forward. Using the Yale University School of Nursing programme as an exemplar, this paper is focused on the elements directly linked to leadership competencies and relevance of a systems leadership doctor of nursing practice programme globally. Background/Introduction: The dramatic growth and wide variability of doctor of nursing practice programmes offered in all 50 US States have generated questions and debate. According to the American Association of Colleges of Nursing as of May 2018, there are 121 schools that reported having a leadership focus in postmaster's doctor of nursing practice degree offering. Yet there has not been the same enthusiasm for development and implementation for a practice doctorate in nursing across the globe. Sources of evidence: A narrative literature review was conducted aimed at addressing the relevance of a practice doctorate globally. This analysis of the literature included a search of peer‐reviewed and grey literature. Nursing school websites were visited, and opinions of nurse leaders and students were sought. In addition, global reports that supported nursing leadership and their role in policy development were reviewed. Discussion/Conclusion: Globally, nurses have a critical role in leading health systems. Developing a cadre of nurse leaders educated at the doctoral level who can communicate with policymakers and develop strategies to meet health systems' goals is necessary. Implications for nursing, health and education policy: In recent global health reports and campaigns, strengthening nursing leadership and presence at policymaking tables are recurring themes. Offering a systems leadership doctor of nursing practice degree is one viable option to increase doctorally prepared nurse leaders for nursing policy and practice engagement. This calls for work with country and regional governments, regulatory bodies and nursing associations to empower nursing to contribute fully. [ABSTRACT FROM AUTHOR]

Preparing the world to manage future pandemics must take priority. It is clear that we were not prepared for the COVID‐19 pandemic which continues to cause great suffering around the world. Nurses and other health professionals everywhere must be involved in health policy planning and implementation of public health measures to combat this and future pandemics. Such preparation needs community policy involvement at grassroots levels and needs to be collaboratively instigated at international levels. The death so far of over 2000 nurses is unacceptable in this pandemic, and we need to better protect and sustain the workforce. The International Council of Nurses has been instrumental in data gathering of nurses' experiences during COVID‐19. Key points from analysis of this data have been included in Second Progress Report of the World Health Organization's Independent Panel for Pandemic Preparedness and Response. This paper summarises the key messages from this report, as well as the nursing shortage. The International Council of Nurses resounds the call for massive investment in nursing education, leadership and jobs, as well as protection for our nurses on the frontlines of the pandemic. [ABSTRACT FROM AUTHOR]

Aim: The article addresses selected determinants of the nursing shortage in Poland and other countries in the face of employee ageing. Background: Global demographic changes have led to a systematic increase in the elderly population and a decreasing number of births, which have impacted health policy and healthcare systems in various countries. Both processes necessitate transitions in global health care. Nursing care, which has faced a human resources crisis, is a strategic area within this context. Sources of evidence: This study is based on national listings and strategic documents for nursing policy in Poland, including Increasing average age of nurses and midwives prepared by the Polish Main Council of Nurses and Midwives, the incorporation of big data, international reports and a literature review on nursing and healthcare challenges. Discussion/Conclusions: This paper argues that the causes of the nursing shortage are multifaceted with no single global or local measure of its nature. An overview of the problem indicates ineffective planning and use of available nursing resources, poor recruitment or an undersupply of a new staff, and global demographic conditions. The overview highlights the fact that nursing shortages have reached a critical point for healthcare services on both the local and global levels. Conclusions for nursing and health policy: The general recommendations for nursing policy include the need to prepare and implement national social security agendas into services provided by nurses. Such a programme would include general issues: improving working and employment conditions, implementing mechanisms regulating salary and providing the possibility of lifelong learning with the incorporation of mobile and technological innovations as a sustainable solution. [ABSTRACT FROM AUTHOR]

Aim: This paper will review progress towards the identified targets within the Australian government policy document commonly known as 'Closing the Gap' and examine the role of nurses in supporting its implementation. Background: Australia is not alone in seeking to address the health inequity between Indigenous and non‐Indigenous people. Globally such health inequities are similar and require interventions supported by governments in conjunction with health and education systems to affect desired change. For this reason, it is timely to undertake a review of progress on the impact of the Closing the Gap initiative. Sources of evidence: The Australian national partnership agreement and subsequent annual performance reports issued between 2010 and 2017. Discussion: Targets set within the Australian government national partnership agreement have had a range of success. Those targets not on track require significant long‐term investment to ensure their success. Nurses as a large professional group are powerful advocates to speak up and support policy change that affects disempowered social groups. Conclusion: Long‐term social change takes time, yet without the commitment of Australian Governments through effective policy and economic support, the inequity in the health of Indigenous people will continue both now and in the future. Implications for health and social policy: Nurses, as the largest health professional group, are uniquely placed to support and implement social change at all levels of health care (primary, secondary and tertiary) and to lobby government to amend policy alongside those who are disempowered. Implications for nursing practice: Health promotion and education programmes that are led by nurses can make an impact to health disparities within groups who are most at risk. [ABSTRACT FROM AUTHOR]

Aim To explore the debate on the development of the nurse practitioner profession in the Netherlands. Background In the Netherlands, the positives and negatives of nurse practitioners working in the medical domain have been debated since the role was introduced in 1997. The outcome of the debate is crucial for nurse practitioners' professional development and society's justification of their tasks. Method Review of 14 policy documents, 35 opinion papers from nurses, 363 opinion articles from physicians and 24 Dutch research papers concerning nurse practitioners from 1995 to 2012. Results Two discourses were revealed: one related to efficiency and one to the development of the profession. In both, the nurse practitioner role was presented as a solution for healthcare and workforce problems, while arguments differed. The efficiency discourse seemed most influential. Opinions of nurse practitioners were underrepresented; taking up new responsibilities was driven by the wish to improve patient care. While most physicians were willing to delegate tasks to nurse practitioners, they wished to retain final responsibility for medical care. Limitations All available publications were extensively studied, which could not include unpublished policy documents from the government or influential parties. This may have led to some selectivity. Conclusion The case of the Netherlands shows that nurses in developing their advanced role are facing barriers, similar to those in other countries. The dominance of efficiency arguments combined with protection of medical autonomy undermines the development towards nursing care that really benefits patients. Implications for nursing and health policy Nurse practitioners should strive to obtain positions in which they are allowed to make their own decisions and wise use of healthcare resources for the good of patients and society. Nurse practitioners should aim to become members of influential healthcare Boards in their countries, in which they can raise their voices and be involved in policy making. [ABSTRACT FROM AUTHOR]

Aim: The aim of this article is to describe our experience in operating a capacity‐building programme, the Korea International Cooperation Project, for global nursing leaders from developing countries, held during the International Council of Nurses (ICN) Conference in 2015 in Seoul, Korea. Background: Globalization points to the importance of global leadership among nursing leaders. In accordance with the theme of ‘Global Citizen, Global Nursing’ at the ICN conference in 2015, a capacity‐building programme for nursing leaders of developing countries was implemented. Introduction: The global nursing leadership programme shared experiences during the preparation and operation of the conference. To prepare the programme, this paper describes selecting participants, working with invitation lists from 30 countries, and recruiting and training volunteers. The operation of the programme, orientation, organizing tailored programmes for participant groups, addressing unexpected issues and evaluating the programme are described. Implications for nursing policy: ICN could implement capacity‐building programmes for nursing leaders of developing countries during its ICN conference for the nursing society. A programme tailored for each continent with similar sociocultural backgrounds and health issues would provide chances for collaboration and networking. A policy to compile global nursing indicators should be developed. This would allow nursing leaders to learn about the strengths and weaknesses of global nursing and provide evidence for collaboration. Conclusion: The programme was successful in introducing and broadening global perspectives of participants on health and education as well as building a network among leaders and next‐generation leaders in participating countries for future cooperation and collaboration. [ABSTRACT FROM AUTHOR]

Introduction: The development of a nursing practice, improvements in nurses’ autonomy, and increased professional and personal responsibility for the medical services provided all require professional documentation with records of health status assessments, decisions undertaken, actions and their outcomes for each patient. The International Classification for Nursing Practice is a tool that meets all of these needs, and although it requires continuous evaluation, it offers professional documentation and communication in the practitioner and researcher community. Aim: The aim of this paper is to present a theoretical critique of an issue related to policy and experience of the current situation in Polish nursing – especially of the efforts to standardize nursing practices through the introduction and development of the Classification in Poland. Discussion: Despite extensive promotion and training by International Council of Nurses members worldwide, there are still many countries where the Classification has not been implemented as a standard tool in healthcare facilities. Recently, a number of initiatives were undertaken in cooperation with the local and state authorities to disseminate the Classification in healthcare facilities. Conclusions: Thanks to intense efforts by the Polish Nurses Association and the International Council of Nurses Accredited Center for ICNP® Research & Development at the Medical University of Łódź, the Classification is known in Poland and has been tested at several centres. Nevertheless, an actual implementation that would allow for national and international interoperability requires strategic governmental decisions and close cooperation with information technology companies operating in the country. Implications for nursing & health policy: Discussing the barriers to the implementation of the Classification can improve understanding of it and its use. At a policy level, decision makers need to understand that use Classification in eHealth services and tools it is necessary to achieve interoperability. [ABSTRACT FROM AUTHOR]

The author discusses the importance of the position statement by the International Council of Nurses (ICN) on evidence-based nurse staffing. She said that rigorous studies are available documenting the link between nurses caring for fewer patients each and better outcomes for hospitalized patients. The RN4CAST study of 12 European countries is considered an effective resource for staffing advocacy. ICN first suggested that decisions on nurse staffing must respond to clients' healthcare needs.

The article focuses on the two papers published by the International Alliance of Patients' Organizations (IAPO) before its sixth Global Patients Congress that will focus on universal health coverage. It mentions that the paper provides an introduction to the topic of universal health coverage, highlights the importance of the issues, and reflects on the work that needs to be done to secure access to healthcare. The second paper provides various examples where improvements have been made.

Aim Use a Delphi Methodology to identify nursing research priorities in Uganda. Background Identifying nursing research priorities, empowering researchers, and encouraging relevant studies can advance attaining global health goals. The Uganda Nurses and Midwives Union identified the need to establish a nursing research agenda. Nurse leaders have a priority of increasing the influence of nurses in practice and policy. This study was conducted as a preliminary step in a long-term strategy to build nurses' capacity in nursing research. Methods A three-round Delphi study was conducted. The 45 study participants were nurses in practice, nurse faculty and members of the Uganda Nurses and Midwives Union. In the initial round, the participants wrote their responses during face-to-face meetings and the follow-up rounds were completed via email. Results Maternal and child morbidity and HIV/AIDS were identified as research priorities. Nurses also identified nursing practice, education and policy as key areas that nursing research could impact. Limitations Demographic characteristics such as length of time in nursing were not collected. Additionally, first round participants completed a pencil-paper survey and the follow-up rounds were done by email. Conclusions Nurse Leaders in Uganda identified areas where research efforts could have the most impact and were most relevant to nursing practice. Implications for nursing and health policy Health policy decisions have historically been made without nursing input. Nursing research can provide evidence to inform policy and, ultimately, improve population health. The focus of nursing research in priority areas can be used to guide nursing contribution in policy discussions. [ABSTRACT FROM AUTHOR]

Aim The aim of this paper was to (1) highlight nursing continuing education as a key initiative for strengthening healthcare delivery in low-resource settings, and (2) provide an example of a nursing continuing education programme in Haiti. Background Haiti and other low-resource settings face extreme challenges including severe shortages of healthcare workers, high rates of nurse out-migration and variations in nurse competency at entry-to-practice. Nursing continuing education has the potential to address these challenges and improve healthcare delivery through enhanced nurse performance and retention; however, it is underutilized in low-resource settings. Methods A case study is presented from the Hôpital Universitaire de Mirebalais in Mirebalais, Haiti of a new nursing continuing education programme called the Beyond Expert Program. Results The case study highlights eight key dimensions of nursing continuing education in low-resource settings: (1) involving local stakeholders in planning process, (2) targeting programme to nurse participant level and area of care, (3) basing course content on local context, (4) including diverse range of nursing topics, (5) using participatory teaching methods, (6) addressing resource constraints in time and scheduling, (7) evaluating and monitoring outcomes, and (8) establishing partnerships. The case study provides guidance for others wishing to develop programmes in similar settings. Conclusion Creating a nursing continuing education programme in a low-resource setting is possible when there is commitment and engagement for nursing continuing education at all levels of the organization. Implications for Nursing and Health Policy Our report suggests a need for policy-makers in resource-limited settings to make greater investments in nursing continuing education as a focus of human resources for health, as it is an important strategy for promoting nurse retention, building the knowledge and skill of the existing nursing workforce, and raising the image of nursing in low-resource settings. [ABSTRACT FROM AUTHOR]

Aim Through an examination of the present situation relating to legalizing euthanasia and/or physician-assisted death in New Zealand, this paper is intended to encourage nurses worldwide to ponder about their own position on the ever present topic of assisted dying and euthanasia. Background In New Zealand, euthanasia remains illegal, but in 2012, the 'End of Life Choice Bill' was put in the ballot for potential selection for consideration by Parliament, later to be withdrawn. However, it is increasingly likely that New Zealand will follow international trends to offer people a choice about how their lives should end, and that such a Bill will be resubmitted in the near future. Undoubtedly, the passage of such legislation would have an impact on the day-to-day practices of nurses who work with dying people. Sources of Evidence This article has been prepared following a comprehensive review of appropriate literature both in New Zealand and overseas. Discussion This article aims to highlight the importance of nursing input into any national debates concerning proposed euthanasia or assisted dying laws. The discussion therefore covers New Zealand's experience of such proposed legislation, that is, the draft Bill itself and the implications for nurses, the history of the assisted dying debate in New Zealand, public and professional opinion, and national and international nursing responses to euthanasia. Conclusion New Zealand nurses will eventually have an opportunity to make their views on proposed euthanasia legislation known, and what such legislation might mean for their practice. Nurses everywhere should seriously consider their own knowledge and viewpoint on this vitally important topic, and be prepared to respond as both individuals and as part of their professional bodies when the time inevitably arrives. The result will be a better informed set of policies, regulations and legislation leading to a more meaningful and dignified experience for dying people and their families. Implications for Nursing and Health Policy Nurses need to be fully informed about, and contribute to, proposed euthanasia or assisted dying legislation. They have extensive expertise in care of the dying, and should therefore be ready to influence law, policy and future nursing practices. [ABSTRACT FROM AUTHOR]

Objective: The objective is to assess the reasoning by families in deciding between a home vs. facility delivery and vaginal vs. caesarean. Study design: The authors selected a convenience sample of 16 villages in Sathkira district in southwest Bangladesh. Evidence was drawn from detailed in‐home post‐delivery interviews with all mothers in these villages who delivered in 2015 or 2016. Methods: Local family health workers and paramedics used a structured questionnaire that enabled gathering of relevant quantitative and qualitative evidence. Mothers' reasons for selection of delivery location and type were categorized, and regression analysis was conducted to assess significance of variables that proxy supply and demand factors. Results: Among 492 completed interviews, 48% were home deliveries, 52% facility deliveries; two‐thirds of facility deliveries in private clinics. Overall, sample caesarean rate is 39%, public hospital rate 53%, private clinic rate 86%. Over half of reasons for home delivery refer to pregnancy without complication or access to trusted birth attendant. Over half of reasons for facility delivery refer to medical complications allegedly precluding home delivery, or requiring home‐to‐facility transfer during labour for reasons not clear to the mother. The decision depends on both 'demand' factors originating with the family (proxied by family income, birth order and education levels) and 'supply' factors originating with obstetric care providers (proxied by number of antenatal visits and variation of caesarean rate by village). In a regression controlling for both demand and supply variables, the above proxy variables are all significant. Implications for nursing and health policy: Bangladesh has inadequate nursing support for vaginal delivery in either home or facility. Hence, physicians frequently recommend that women deliver in a facility (usually a physician's clinic). Physicians are reluctant to hire adequate nurses to attend vaginal deliveries. Hence, families with some discretionary income are increasingly opting for a caesarean over vaginal delivery. Facility deliveries reduce incidence of obstructed labour fistula, but probably contribute to rising incidence of iatrogenic fistula. Reducing caesarean rates requires a large increase in numbers of nurses and midwives, and acceptance by physicians of a broad scope of practice for nurses/midwives in vaginal deliveries. [ABSTRACT FROM AUTHOR]

Background Hospital and home-based cardiac rehabilitation programmes improve the health outcomes of cardiac patients. Both types of programmes include patient education as a core component. However, many patients do not attend cardiac rehabilitation programmes for a variety of reasons. In Singapore, where cardiac rehabilitation is comparatively uncommon, patient education is usually delivered face-to-face by healthcare professionals because educational materials designed specifically for cardiac patients recovering at home are not available. Aim This paper describes the development of a patient education booklet designed to aid recovery at home after a myocardial infarction in Singapore. Methods The conception and development of this evidence-based Heart Recovery Education Booklet was based on patient need and current clinical guidelines pertaining to cardiac rehabilitation and planned in consultation with specialists such as cardiologists, psychiatrists and physiotherapists. Results The booklet is a patient resource to aid recovery at home after an myocardial infarction. It is interactive, based on identified need and aims to guide and assist the patient in performing their usual activities of daily living and adhering to treatment regimens, including exercise. Conclusion This booklet is a resource for patients with myocardial infarction and healthcare professionals and its effectiveness in improving health-related quality of life, psychological status and coronary risk profile is to be tested in a randomized controlled trial. Implications for nursing and health policy Policy makers in health and nursing must find ways of developing and implementing cardiac rehabilitation programmes that aid recovery from myocardial infarction. This education booklet offers one way to do this. [ABSTRACT FROM AUTHOR]

Aim: To clarify factors that support a policy change from pandemic to endemic status and to examine options for non‐medical responses to reduce COVID‐19 transmission. Background: Critical factors to be considered in pandemic response decisions are not limited to medical options or public health orders, although these are important. Sources of evidence: All evidence drawn from publicly available sources is presented through the lens of the authors' nursing, management, education, policy and research experience. Discussion: As COVID‐19 variants cause infections to surge nurses and other health practitioners, who are the de facto implementers of public and health policy, need to consider the evidence supporting a pandemic policy change to endemic status. Non‐medical options for reducing transmission and variant mutations are needed to enable at‐risk populations to avoid infection. Conclusion: Public policy that shifts infection risks onto the general population requires close scrutiny of the evidence base for such decisions and warrants open debate and review. If people are to manage risks arising from policy decisions, they need access to non‐medical virus detection options as well as access to effective medicines and treatment. Implications for nursing practice: Nurses have an extension to their advocacy role when policy changes about infectious disease status are declared. Evaluation of policy in terms of validity, equity and scientific basis is part of nursing's public responsibility. Policies that fail to reflect what is happening at the patient care level need to be questioned and modified where necessary. Only policies deemed 'good' policy by nurses should be implemented without challenge. Access to devices for environmental detection of the virus would enable real‐time estimation of infection risks and inform individual decisions about the real risk of participating in work or other activities. Implications for health and social policy: Policy decisions to transition from pandemic to endemic status must be evidence based. Clear messaging about risks and options assists policy implementation. Terminologies describing stages of infectious disease spread from 'outbreak, epidemic, endemic and pandemic' are not interchangeable, although they will expand and contract across the range in response to interventions such as public health safety measures (PHSM), quarantine, vaccinations, antivirals and fatalities that alter the case count in defined locations for those who avoid or survive an infection. [ABSTRACT FROM AUTHOR]

Aim: To explore interventions and coping strategies used to treat the psychological symptoms associated with compassion fatigue among nurses. Background: The rapid transmission of infectious diseases (e.g., COVID‐19) has put nurses, around the world, at high risk of developing profound psychological health issues due to compassion fatigue. If unrelieved, compassion fatigue can lead to catastrophic psychological symptoms such as depression, stress, anxiety, and insomnia, negatively impacting patient care. This necessitates interventions to prevent or mitigate the psychological symptoms of compassion fatigue. Method: Following Whittemore and Knafl's integrative review method, the literature search comprised three databases: CINAHL, MEDLINE‐OVID, and Scopus. Results: The 11 included studies were categorized into four themes: (1) using relaxation strategies, (2) neutralizing emotional trauma, (3) enhancing nurses' preparedness for confronting disasters, and (4) educating nurses about coping strategies to manage their psychological issues. Conclusion: Researchers studied several coping strategies and interventions. There is a need for policymakers' support and hospital‐level interventions. Early interventions may prevent or relieve psychological issues. Implications: The findings have implications for hospital leaders around the world to initiate interventions that teach nurses strategies to cope with stressful events. Future researchers might consider long‐term supports and multiple interventions that target several leading causes of psychological symptoms among nurses before, during, and after high‐stress situations. Policymakers around the world could use the findings to initiate policies to facilitate nurses' access to needed resources, hence protecting their mental health and increasing the quality of patient care. [ABSTRACT FROM AUTHOR]

Aim: To review how nursing is engaged with genetics/genomics developments in the Philippines' healthcare system. Background: There is an increasing demand for genetics services. However, the number of genetics professionals is lagging with this demand. Nurses play pivotal roles in mainstreaming genetics/genomics across healthcare settings. Sources of evidence: Published and gray literature on genetics/genomics services in the Philippines and roles of nurses and the experiences of the authors. Discussion: Nurses involved in genetics in the Philippines work in specialty genetics clinics and in newborn screening (NBS). Several issues hinder maximizing roles of nurses in genetics, such as the absence of competency standards, inadequate educational preparation, absence of a specialty organization, and increased workload of nurses. Conclusion: The engagement of nursing with genetics/genomics is limited. Increasing awareness on the impact of nursing in genetics/genomics, adopting competency standards, and curricular integration are key if nurses' roles in genetic healthcare are to be realized. Implications for nursing practice: Introducing genetics/genomics systematically in practice environments is crucial. Tools such as the Method for Introducing New Competency Genomics can be used as a guide. Existing population‐based genetics programs such as NBS and rare disease offer a good context to introduce genetics in existing courses in the curriculum. Implications for nursing policy: Nursing leaders need to be aware and recognize the relationship between nursing and genetics/genomics. A local specialty group in genetics and collaboration with international organizations are crucial to advocate the inclusion of genetics/genomics in nursing. Existing genetics/genomics competency standards can be validated in the local context to inform curricular integration. [ABSTRACT FROM AUTHOR]

Aim: This study aimed at evaluating the effects of a modified psychological first aid (PFA) training program on nurses' psychological preparedness for emergencies and disasters. Background: Nurses need to be psychologically prepared in order to mitigate the impact of conflicts and disasters. The PFA training could ensure their psychological preparedness in responding to different emergencies and disasters. Design: A nonequivalent controlled group trial was conducted between July 2019 and August 2019. Methods: Nurses working in the trauma units from five hospitals in Palestine were allocated into two arms: a control arm and an intervention arm incorporating a 9‐hour modified PFA training program. Both groups were assessed at start (pretest) and upon completion of the program (post test) using a number of validated self‐reports. Results: Eighty‐four nurses were allocated to each arm, and 75 in each arm completed baseline data (n = 150). The results of generalized estimating equation estimates revealed that PFA training imposed a significant group‐by‐time effect on psychological preparedness (p = 0.013). The mean scores of psychological preparedness showed greater improvement in the intervention group than in the control group at posttest (37.81 vs. 32.64). Improved group‐by‐time effect was further identified in relation to optimism (p = 0.009), self‐esteem (p = 0.008), and self‐efficacy (p = 0.033). The intervention effect was large (Cohen d = 1.41). Conclusion: PFA training may help to build nurses' capacity in being better prepared to respond to psychological issues during and after emergencies and disasters. Implications for Nursing and Health Policy: Nurses should be adequately equipped with knowledge and skills to deal with different emergencies and disasters. Health policy needs to address psychological preparedness for emergencies and disasters of all healthcare workers. Healthcare policymakers and educators could adopt PFA training on a regular basis to consolidate psychological preparedness of nurses. [ABSTRACT FROM AUTHOR]

In Canada, as elsewhere, it has been agreed that primary health care (PUC) is needed, particularly for the underserved population. But the debate continues over which approach, what measures and who should be involved. To help find the answers, the Canadian Nurses Association presented a working paper already in 1980 to the Canadian Government recommending changes in the health system and proposing various roles that nurses could play in formulating and implementing its national primary health policy and in November this year organized a two-day PHC workshop involving representatives from provincial councils and government as well as nurses. Below, two nurses teaching at the University of Ottawa's School of Nursing give their view on what should and could be done in Canada. [ABSTRACT FROM AUTHOR]

The American Academy of Nursing introduces a panel on alternative care models. The session was the first in a series of explorations by the academy of the influence, real and potential of the nursing profession on health policy for the next decade. In addition to those addressing alternative care models , papers by academy fellows included in a new publication are about payment for the services of nurses and women and power. Also included in the publication is the keynote paper of the session delivered by Anne J. Davis, a fellow of the academy and Professor, School of Nursing, University of California.

Aim: To emphasize that nurses need to be fully protected to carry out their vital role, particularly during pandemics, yet the lack of a standardized and systematic collection of high‐quality disaggregated data on nurses health inhibits our ability to assess this within and across countries. Background: Nurses are the largest workforce group in the health sector, yet only 59 countries worldwide report on nurse COVID‐19 infections and related deaths, and the standardized, systematic collection of disaggregated health data is not yet in place. Sources of evidence: Medline, International Council of Nurses, World Health Organization, Centers of Disease Control and Prevention and the experiences of the authors. Discussion: Inconsistent recording and definitions of nurses, precarious and informal employment conditions, limited transparent and reliable data, lack of mass testing and long‐standing structural issues and biases have affected nursing for too long. Conclusions: These issues are reflected in the limited capacity of many national public health information systems to collect, monitor and report on the health of the largest group of health workers. Political will, accountability and public data transparency at different levels are essential to adequately protect nurses at work. Implications for nursing practice, and nursing and health policy: Building on current momentum in the nursing field, immediate political action is required to strengthen existing nursing and midwifery policies, standards and regulatory capacity, as well as existing public health services and information and surveillance systems. The generation of up‐to‐date, context‐specific knowledge is needed to inform and monitor political decisions related to the protection of nurses, and the improvement of their employment conditions, as well as to strengthen accountability for these areas at various levels. [ABSTRACT FROM AUTHOR]

Aim: To examine the extent to which the type of financial assistance (personal resources, social programmes and earnings) and source country influence the length of time for internationally educated nurses to secure employment as regulated nurses in Canada. Background: Internationally educated nurses must professionally recertify in order to work as regulated nurses in Canada. For many, it can be a lengthy, cumbersome and costly process that delays employment, while others recertify and secure employment quickly. Financial assistance in the form of personal resources, or from social programmes or earnings from working could contribute to the length of time to recertify. When internationally educated nurses cannot readily recertify, they turn to survival jobs where they can remain and never practice their profession in Canada or leave the country to work in jurisdictions where it easier to obtain professional credentials. Methods: Data were collected via cross‐sectional survey of internationally educated nurses (n = 1186) who were immigrants, permanent residents and employed as regulated nurses. Multiple linear regression was employed to examine the influence of the type of financial assistance (personal resources, social programmes and earnings) and source country on time to regulated nurse employment. Results: Regression model explained 9.3% of variance in time to regulated nurse employment. Three predictors were statistically significant: source country, social programmes and earnings. Personal resources was not a significant predictor. Conclusion: Financial assistance helps internationally educated nurses survive the regulated nurse employment gap. The type of financial assistance and source country influences the length of time to regulated nurse employment. Implication for nursing and social policy: Provides initial evidence to support the development of policies, and educational and social programmes to assist internationally educated nurses with financially surviving the gap in regulated nurse employment. [ABSTRACT FROM AUTHOR]

Aim: To engage the global nursing community in sharing knowledge, experiences, and lessons learned about credentialing of individual nurses to improve nursing practice, patient safety, and quality of care. Background: Although the United States has a long and robust history of credentialing individual nurses, the opportunity exists to expand the dialogue globally, and is supported by globally focused governing bodies who call for increased or expanded investment in nursing certification and credentialing. Foundational work to define and operationalize certification for research purposes and develop an administrative home for stakeholders interested in certification can be leveraged by countries and regions globally. Existing frameworks for credentialing research may be used to drive theory‐based research in the future. Sources of Evidence: PubMed, International Council of Nurses, National Academies of Sciences, Engineering, and Medicine, World Health Organization, American Nurses Association, American Nurses Credentialing Center, and the authors' own experiences. Discussion: Credentialing as a form of self‐governance, as a method for public protection, and as a foundational element in the increasingly new forms of healthcare delivery is intensifying in importance. Credentials provide an opportunity to evaluate relationships between key elements such as nursing practice, environments where nursing care is delivered, and nursing programs with outcomes of interest for the profession such as safety, quality of care, and patient outcomes. Conclusions: Establishing rigorous credentials for nurses demonstrates a commitment to excellence. Credentialing frameworks that are universally applied could enable nurses to move seamlessly across geographic boundaries, permit regulators and employers of nurses to have a common set of standards and expectations, and ensure a level of competency for nursing practice that can be interpreted and trusted by various stakeholders. Implications for Nursing Policy: Policymakers have a pivotal role in advancing credentialing in nursing worldwide. Countries developing credentialing programs in nursing need to study their results to help inform how practice might be required to change over time. [ABSTRACT FROM AUTHOR]

Aim: To describe the impact of the COVID‐19 pandemic on stress, resilience and depression in health professionals from a public hospital in Barcelona, Spain after the first peak of pandemic. Background: The COVID‐19 pandemic in Spain has pushed boundaries in health systems and, especially, for health professionals. Analysis of resilience as an individual resource and it is essential to understand the mechanisms that make staff react unfavourably to stressors caused by the pandemic. Design: A descriptive cross‐sectional study was designed. Participants: Health professionals supervised by the nursing department, including registered nurses, health care assistants, health technicians, final year nurse student nurses, foreign nurses, and other nurse‐related health workers. Methods: The study complies with the STROBE checklist for cross‐sectional studies. An online survey was administered to all health professionals supervised by the nursing department between 6 and 27 May 2020. The survey included the ER‐14 Resilience Scale, the widely‐used PHQ‐9 depression scale, the Spanish version of the Nursing Stress Scale, and an ad‐hoc questionnaire to obtain sociodemographic and occupational variables. Results: A total of 686 participants answered the survey. Resilience was high or very high in health professionals, with an inverse correlation with stress and depression scores. Personal on fixed shifts showed better resilience. The most stressed health professionals were full‐time registered nurses, followed by health care assistants. Up to 25% of nursing professionals had depression. Conclusion: Our study showed a high degree of resilience among nurse professionals despite the overwhelming nature of the COVID‐19 pandemic. Relevant signs of depression and stress were detected among participants. Occupational factors heavily influenced nurses' resilience, stress and depression. Implications for Nursing & Health Policy: Government policy shifts are needed in Spain to improve nurses' workforce conditions, enhance the ratio of nurses to patient numbers, and avoid workforce losses. Maintaining the resilience of health professionals would assist in improving their health and their capacity to possible future emergency situations. [ABSTRACT FROM AUTHOR]