Creating academic structures to promote nursing's role in global health policy

Facilitating a Virtual International Experience for Undergraduate Students: Creating Global Awareness and Connection

BACKGROUND

Preparing nursing students for practice is supported by developing a global perspective of health care delivery models. However, many schools of nursing and students lack the resources for study abroad.

METHOD

Using a virtual stay-in place model, 42 international students applied an evidenced-based approach to study statistics, research, transitions in care, and elder care models that supported collaboration among peers from Austria, Switzerland, Chile, the United Kingdom, and the United States. Students explored social, economic, and reimbursement factors not encountered in the typical classroom.

RESULTS

Student beliefs and perspectives changed after completing a program with global peers. Survey results and themes in reflection papers indicated increased ability to conceptualize content in new ways, including holistic elder care, cultural practices and reimbursement options, and effects on future practice.

CONCLUSION

Virtual international learning experiences are an effective education innovation that allows student to connect and learn from one another using a stay-in place model. [J Nurs Educ. 2023;62(11):647-649.].

Enhancing nursing education to bolster nurse governance: insights from nurse managers

Aim

In South Korea, the level of nursing governance is moving toward shared governance. This study sought to explore nursing education contents in undergraduate nursing programs necessary to improve the governance of nurses from the perspectives of nurse managers.

Methods

The study employs thematic analysis following the guidelines outlined in the Consolidated Criteria for Reporting Qualitative Research utilizing a qualitative research design. Our investigation involves general or tertiary hospital nurse managers intending to gain valuable insights and perspectives.

Results

Interview data from 14 nurse managers were analyzed. A total of one main and four sub-themes were derived from the qualitative data analysis. Analysis revealed the main theme, "occupational socialization." The four sub-themes were education on "nurse-patient and nurse-colleague communicative interaction," "humanity," "career development," and "nurses as politicians."

Conclusion

The findings are valuable in suggesting critically needed educational content in undergraduate nursing programs to improve nursing governance. Future research should investigate the effects of the abovementioned themes on nursing governance among clinical nurses or nursing students for several years of follow-up data collection.

Improvements in the infrastructure for nursing research in universities in Kazakhstan

AIM

This study aimed to describe the status and analyze the improvements made by universities in Kazakhstan to nursing research infrastructure in the following services: library, internationalization, finance, information and communication technology (ICT), and research, development, and innovation (RDI).

BACKGROUND

In higher education institutions (HEIs), a strong research infrastructure is a necessity for academic education and research. In Central Asian countries, nursing is regarded as an assistive field to medicine, affecting nursing research infrastructures.

METHODS

In this descriptive study, following benchmarking and a recommendations report, an interview of nursing faculty members was used to obtain data regarding nursing research infrastructure in ten universities in Kazakhstan. The SQUIRE-EDU was used to ensure the quality of reporting.

RESULTS

The Kazakhstani universities providing nursing education are still in the process of developing their nursing research infrastructure. They have not acquired access to nursing databases, and only one textbook concerning nursing research can be found from their libraries. None of the universities have joined international nursing networks. The participation of the university staff and students in conferences with nursing themes has increased. The universities are investing in staff capacity building, but not yet in nursing research projects.

DISCUSSION AND CONCLUSION

Kazakhstani universities have the autonomy to develop nursing research and its infrastructure. Active measures by the university management, such as financing access to nursing databases, international cooperation, and international projects, are necessary.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Research infrastructures' quality strongly impacts the development of nursing science and practice in any country. It is crucial to increase the volume of research that demonstrates the effectiveness of clinical nursing and its contribution to health outcomes. To enable the faster development of nursing science in Central Asian countries, this development should be supported through international collaboration.

Participation of nurse managers in the health policy process: a qualitative study of barriers and facilitators

AIM

To explore the barriers and facilitators concerning nurse managers' participation in the health policy-making process.

BACKGROUND

Despite encouragement for participation in policy-making, nurse managers are seldom involved in this process.

METHODS

A qualitative descriptive research design based on purposive sampling was conducted. Semi-structured one-to-one interviews were conducted with nurse managers and key informants (n = 16). Interviews were digitally recorded, transcribed verbatim, and analyzed by thematic analysis. The Standards for Reporting Qualitative Research (SRQR) checklist was applied to study reporting.

FINDINGS

Three levels of barriers were found to nurse managers' participation in health policy-making. The individual level included weakness in characteristics of nurse managers, and the organizational level constituted the inefficient structure. In addition, the environment-related level encompassed external barriers to the organization. Finally, three facilitators with the potential were identified for improving nurse managers' participation in the policy-making process, including improvements in collaboration and communication, governmental and non-governmental organizational activities, and reforms in the health policy-making process.

CONCLUSION

Nurse managers need to use the window of opportunity to participate in health policy-making. More importantly, they should be informed about health policy in order to meet the demands of the rapidly changing healthcare environment. Drawing upon their professional organizations and positions, nurse leaders require to network and make a space to stimulate their participation in the policy.

IMPLICATIONS FOR NURSING POLICY AND HEALTH POLICY

Nurse managers need to develop political skills and utilize strategies to help their participation in health policy-making, leading to better implementation of policies, efficiency, and effectiveness in the health system.

Assessment of Global Health Competence of Nursing Faculty in Prelicensure Programs

BACKGROUND

Global Health is an emerging field that refers to the health and well-being of the world's population. It is crucial that the next generation of nurses is prepared as global health advocates. There is no prior research of self-assessed global health competencies among nursing faculty in U.S. prelicensure programs. The aim of this study was to determine the level of global health competencies (knowledge and skills) of nursing faculty in U.S. prelicensure programs.

METHOD

Attendees at the National League for Nursing Education Summit completed the Global Health Competencies survey.

RESULTS

Survey participants (N = 161) reported a 66.76% confidence in their knowledge of global health and 61.4% confidence in global health skills with patients from different backgrounds. Three areas of educational needs were identified: (a) the relationship between health and access to clean water, sanitation, and nutrition; (b) cultural competency; and (c) understanding the relationship between health and human rights.

CONCLUSION

Nursing faculty participants identified several areas for improvement in their knowledge of global health issues. [J Nurs Educ. 2021;60(1):20-24.].

The Related Factors of Nurses' Participation and Perceived Benefits and Barriers in Health Policy Making

BACKGROUND

Nurses play a critical role in providing good health services.

PURPOSE

The aim of this study was to examine the factors related to the participation of nurses in the provision of health services and the perceived benefits and barriers to their participation in health policy making.

METHODS

A cross-sectional descriptive study was conducted in several hospitals affiliated with the Iran University of Medical Sciences during the first half of 2018 on a sample size of 220 people. A standard, self-management questionnaire was used to collect the data, and SPSS 21.0 software was used for data analysis. None of the demographic characteristics were found to be significantly associated with nurse participation in or the perceived barriers and benefits to health policy making.

RESULTS

The results of this study show that the participants were involved only moderately in health policy making. "Providing written reports on problems or receiving consultation from a related official" was the performance item most frequently cited by the participants in terms of involvement, whereas "Disappointment in work procedures" was the most frequently cited barrier item affecting involvement.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Despite the importance of the nursing role in health polices, this study indicates that nurses participate at only a moderate level in health policy-making activities. Providing more information to nurses regarding health policies, enhancing nurses' image of their job and their perceptions about the importance of their participation in the health policy, increasing partnerships with nurses at the upper levels of health services management, and supporting nursing professional organizations in the field of health policy are potential strategies for encouraging greater nursing participation in health policy making.

Development and Application of a Program for Reinforcing Global Health Competencies in University Nursing Students

Purpose: With globalization, the importance of global health is being stressed. Although nurses are indispensable healthcare professionals, programs to develop nurses with global health competencies and relevant studies are rare. Accordingly, this study was designed to develop a program to increase global health competencies and global leadership in nursing students and test its effect.

Methods: A single group pre- and post-test study design was used. A 13-weeks program was developed and implemented with 204 students. Data were analyzed using paired t-test. The program to promote global health competencies was designed to improve nursing students' knowledge of global health, global leadership, global health competencies, critical thinking ability, and student-student partnership.

Results: Global health competencies (t = −19.96, p < 0.001), self-assessed global leadership (t = −7.67, p < 0.001), and critical thinking ability (t = −7.67, p < 0.001) all significantly increased.

Discussion: The study findings of increased global health competencies and global leadership in nursing students after participation in the program indicated ways in which global health competencies of nurses need to be developed. Therefore, the following aspects should be considered. First, nursing educators should understand the need and importance of global health education and accordingly, current nursing curriculums should be revised to include courses about global health. A systematic course of studies about global health should be developed and implemented based on discussions among experts and researchers. Second, as future health care professionals, nursing students should take an interest in global health problems and recognize various issues that need to be solved beyond borders between countries. To develop global health competencies, various efforts and systematic curriculum revisions are necessary.

Towards standardisation of evidence-based clinical care process specifications

There is a strong push towards standardisation of treatment approaches, care processes and documentation of clinical practice. However, confusion persists regarding terminology and description of many clinical care process specifications which this research seeks to resolve by developing a taxonomic characterisation of clinical care process specifications. Literature on clinical care process specifications was analysed, creating the starting point for identifying common characteristics and how each is constructed and used in the clinical setting. A taxonomy for clinical care process specifications is presented. The De Bleser approach to limited clinical care process specifications characterisation was extended and each clinical care process specification is successfully characterised in terms of purpose, core elements and relationship to the other clinical care process specification types. A case study on the diagnosis and treatment of Type 2 Diabetes in the United Kingdom was used to evaluate the taxonomy and demonstrate how the characterisation framework applies. Standardising clinical care process specifications ensures that the format and content are consistent with expectations, can be read more quickly and high-quality information can be recorded about the patient. Standardisation also enables computer interpretability, which is important in integrating Learning Health Systems into the modern clinical environment. The approach presented allows terminologies for clinical care process specifications that were widely used interchangeably to be easily distinguished, thus, eliminating the existing confusion.

Internationalizing nursing curricula in a rapidly globalizing world

Rapid transformations in our globalizing world means there is an urgency for nurse educators to revitalize curricula to prepare nurses better for practice and the emphasis on achieving global health for all has never been greater. Nurses are being urged to collaborate across borders to achieve the United Nations' Sustainable Development Goals, through research, practice, policy and education. Thus, nurse educators and leaders need to consider the critical importance of internationalizing nurses' education at all levels, as well being committed to their roles in curricula reform and using innovative technology. There are challenges to internationalization, but the benefits include helping nurses to grow cultural competence, developing strength in nursing voices globally, capacity building in global health, health policy and advocacy, growing scholarship in nursing across borders, developing the skills and knowledge of nurses from low-income countries, and forming partnerships to work together to achieve global health.

Systems leadership doctor of nursing practice: global relevance

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.

Essential global health competencies for baccalaureate nursing students in the United States: A mixed methods Delphi study

AIMS

To reach consensus among experts on global health competencies for baccalaureate nursing students in the USA.

DESIGN

A three-round modified Delphi study using a mixed methods research approach.

METHODS

In the first round, the original list of competencies (Wilson et al., 2012, Journal of Professional Nursing, 28, 213-222) was revised based on prior research, a review of literature and the Nursing Global Health Competencies Framework developed by the fist author. Nine global health domains and 52 competencies were identified in Round One. In Round Two, two surveys were conducted for validation of the revised list of global health competencies using a group of six nurses with expertise in global health and baccalaureate nursing education, which produced modifications in the competencies used for the third phase of the study. In Round Three, 41 participants completed a survey to rate the extent to which they thought the competencies obtained in Round Two were essential for baccalaureate nursing education in the United States. Data collection took place from May 2017 - January 2018.

RESULTS

A group of experts in global health and baccalaureate nursing education from the United States achieved consensus that 40 global health competencies were essential for baccalaureate nursing education in the United States.

CONCLUSION AND IMPACT

The domains and competencies derived in this study can be used to guide undergraduate nursing curriculum development in global health and provide a framework for both clinical instruction and evaluation of global health student experiences.

Social Media and Health Policy

The current era is characterized by the vibrant and rapidly evolving communication technologies. Communication in any form has evolved and now includes media such as Facebook, Twitter, and Instagram to report a few. Communicating and consuming information has shifted from the more traditional ways to new ones as part of this communication evolution. Cancer is an area of healthcare where such social media have been championed either to promote public awareness and drive campaigns or influence political decision-making. Although health-care lags behind many other industries in adopting social media as a part of a business or policy strategy, the increasing engagement of patients, the public, and the policymakers in social media raised the need for integrating these tools as a part of an overall program to support the strategic imperatives of the health care. As these and other new ways to communicate are introduced to the world and injected into our cultural and political systems, the question that raises here is: “How successful are social media in influencing health policy?”

Developing and validating learning domains, competencies, and evaluation items for global health clinical immersion practicums for graduate-level nursing programs

AIM

To develop and validate learning domains, competencies, and evaluation tool for graduate-level experiential nursing global health programs.

BACKGROUND

Standard competencies have not been synthesized and delineated nor have evaluation tools been developed for global health programs at the graduate level.

DESIGN

A combination of a documentary literature review and expert consensus panel to validate results was used as a design for this study.

METHODS

The NLM and CINAHL databases were searched for articles published between 2007 - 2017 relevant to graduate-level global health nursing programs. Data were extracted and coded, from which themes regarding learning domains, competencies and evaluation items were derived. We then used a three-step expert panel to refine and form a statistical representation (>0.78 agreement on importance, relevance and clarity) of the learning domains, competencies, and evaluation items.

RESULTS

Relevant articles (N = 26) were included for the documentary review, 18 concerning learning domains of global health immersion programs and eight concerning interdisciplinary global health competencies specific to nursing. These learning relationships were then formatted into a table subdivided between learning categories for expert panel consensus. After expert panel review, a compendium of learning domains, competencies, and evaluation items resulted.

CONCLUSION

Global health clinical learning practicums are essential for graduate-level preparation of nurses. Learning domains, competencies, and evaluation tools need to be adopted and empirically tested by international and national nursing associations. The results of this study need further testing to aid these associations.

Using Simulation to Enhance Global Nursing

In light of the technological, social, and political changes taking place in the world today, it is important that nurses are not just culturally competent but globally informed and engaged. The goal of this paper is to help nurses help their patients and themselves to benefit from globalization. The use of guided simulation, virtual reality, and augmented reality learning experiences is considered for each of five areas of global nursing; global aesthetics, global intelligence, global ethics, global politics, and global health. This approach invites nurses and student nurses to discern new patterns, take charge of their learning, and build multiple iterations to facilitate the processing of new and different information and "realities."

The nursing profession in Sri Lanka: time for policy changes

AIM

We address issues and challenges in nursing in Sri Lanka with the aim of identifying where and how policy changes need to be made.

BACKGROUND

Increased global interconnectivity calls for professional leadership, research, education, and policy reform in nursing as these are identified as enhancing health workforce performance and professionalization, thereby improving health systems.

SOURCES OF EVIDENCE

We draw on first-hand knowledge of health care and nursing in Sri Lanka and a recent survey of nurses at a large urban government hospital in Sri Lanka, followed by discussion and proposed action on themes identified through analysis of published and unpublished literature about the nursing profession.

DISCUSSION

Policy and action are needed to: (a) establish mandatory nurse licensure in the public and private healthcare sectors; (b) implement realistic policies to further develop nursing education; (c) develop a professionalization process to support nursing autonomy and voice; and (d) promote systematic processes for educational accreditation, curriculum revision, continuing professional development, evidence-based practice, research, leadership, and information systems.

CONCLUSION

There is a policy vacuum that requires careful analysis and strategic planning by formal nurse leaders.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Implementing change will require political and professional power and strategic, innovative, and evolutionary policy initiatives as well as organizational infrastructure modifications best achieved through committed multidisciplinary collaboration, augmented research capacity, bolstered nursing leadership, and promotion of partnerships with policy makers.

Using social media to engage nurses in health policy development

AIMS

To explore nurses' views on future priorities for the profession and to examine social media as an engagement tool to aid policy discussion and development.

BACKGROUND

Nurses are often not directly involved in policy creation and some feel it is a process they cannot easily influence.

METHODS

A descriptive mixed methods study of a Twitter chat hosted by the Chief Nursing Officer for Scotland was undertaken. Data were gathered using an analytics platform and NCapture software. The framework approach aided thematic analysis to draw out themes.

RESULTS

Sixty-four people took part in the Twitter chat (#CNOScot) and posted 444 tweets. Nurses called for investment in technology, nursing research, education and mental health. Primary care and advanced practice roles to support older adults with complex health and social care needs were also seen as vital to develop further.

CONCLUSION

Social media can help reach and engage nurses in policy discussion and ensure there is better continuity between policy and practice but some groups risk being excluded using this digital medium.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing leaders should consider social media as one of many engagement strategies to ensure nurses and other stakeholders participate in policy debate that informs health strategy development.