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Aim: To present and discuss our experiences of learning how to establish and maintain an international collaboration as early career nurse researchers residing in the United States and Australia. Background: International research collaborations require additional startup time given the complexities of navigating cultural differences, obtaining ethics committee approvals in different countries and collecting human subject data. International collaborations may be daunting for early career researchers given their inexperience and pragmatic focus on research projects that lead to outputs achievable on short timelines for career advancement. Design: Discussion paper. Data Sources: Evidence from international literature about global collaborations across numerous disciplines, including potential factors that could facilitate or constrain early career researcher efforts to engage in international collaborations, were combined with authors' lived experiences as early career researchers. Discussion: Our collaboration began in July 2022 through a professional introduction spurred by a call for applications to fund global nursing education collaborations. Interpersonal, logistical and organizational factors played a role in our lived experiences of beginning an international collaboration. Our experiences are consistent with published literature about the time and complexity involved in conducting international research. Conclusion: Investing time building interpersonal relationships strengthens international research and supports collaborative learning and intercultural understanding. These professional relationships can be built over time to develop significant bodies of research with international impact. Early career researchers need to be resilient, persistent and tenacious as they 'jump through hoops' to establish international research collaborations. Impact: Building relationships during international research collaborations supports collaborative learning for intercultural understanding and strengthens research to address emerging global problems. International nursing research collaborations could encourage greater curiosity, innovative ideas and solutions to international problems that could not be achieved in isolation. Patient or Public Contribution: There was no patient or public involvement in the design and development of this paper. [ABSTRACT FROM AUTHOR]

Background: Patient assessment is a core component of nursing practice and underpins safe, high-quality patient care. HIRAID TM an evidence-informed emergency nursing framework, provides nurses with a structured approach to patient assessment and management post triage. In Australia, HIRAID , an evidence-informed emergency nursing framework, provides nurses with a structured approach to patient assessment and management post triage. In Australia, HIRAID TM resulted in significant improvements to nurse-led communication and reduced adverse patient events., Objectives: First, to explore United States (US) emergency nurses' perceptions of the evidence-informed emergency nursing framework, HIRAID TM ; second, to determine factors that would influence the feasibility and adaptability of HIRAID TM into nursing clinical practice in EDs within the US., Methods: A cross-sectional cohort study using a survey method with a convenience sample was conducted. A 4-hour workshop introduced the HIRAID TM framework and supporting evidence at the Emergency Nurses Association's (ENA) conference, Emergency Nursing 2022. Surveys were tested for face validity and collected information on nurse-nurse communication, self-efficacy, the practice environment and feedback on the HIRAID TM framework., Results: The workshop was attended by 48 emergency nurses from 17 US States and four countries. Most respondents reported that all emergency nurses should use the same standardised approach in the assessment of patients. However, the greatest barriers to change were a lack of staff and support from management. The most likely interventions reported to enable change were face-to-face education, the opportunity to ask questions and support in the clinical environment., Conclusion: HIRAID TM is an acceptable and suitable emergency nursing framework for consideration in the US. Successful uptake will depend on training methods and organizational support. HIRAID TM training should incorporate face-to-face interactive workshops., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [ABSTRACT FROM AUTHOR]

Aim: The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice. Background: Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future. Design: A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta‐analyses Scoping Review extension (PRISMA‐ScR) guidelines. Results: One hundred fifty‐five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation. Conclusion: There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work‐ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work‐ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence‐based. [ABSTRACT FROM AUTHOR]

Summary Background Presentations to emergency departments (EDs) and patient acuity continue to increase. Whilst strategies to deliver safe patient care in the ED are evolving, emergency nurses need to be well educated through specialist qualifications to enable delivery of advanced patient care. This paper presents a comparative analysis of available international practice and competency standards for nurses graduating from emergency nursing courses in Australia, Canada, New Zealand, the United Kingdom, and the United States. Methods CINAHL, Scopus, Ovid MEDLINE, and Embase were searched for papers, published in English, using the terms: ‘emergency’, ‘accident and emergency’, ‘nursing’, ‘competency’, ‘practice standards’, ‘scope of practice’, ‘regulation’, and ‘specialist standards’. Secondary sources from relevant reference lists and professional websites were also searched. Results The standards from the five countries were common across five domains: clinical expertise, communication, teamwork, resources and environment, and legal. None of the standards were specific to the emergency nursing graduate, and there was variability in the level of expertise required for which the standards apply. Conclusions The available practice standards demonstrated some commonality. Consideration of the utility of a universal framework for informing the development of emergency nursing practice standards and emergency nursing curriculum for nurses wishing to specialise is needed. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To explore the health workforce responses to COVID‐19. Design: Analysis of job advertisements. Methods: We collected advertisements for healthcare jobs which were caused by and in response to COVID‐19 between 4 March–17 April 2020 for the United States, Canada, United Kingdom, Australia and New Zealand. We collected information on the date of the advertisement, position advertised and location. We categorized job positions into three categories: frontline, coordination and decision support. Results: We found 952 job advertisements, 72% of which were from the United States. There was a lag period between reported COVID‐19‐confirmed cases and job advertisements by several weeks. Nurses were the most advertised position in every country. Frontline workers were substantially more demanded than coordination or decision‐support roles. Job advertisements are a novel data source which leverages a readily available information about how workforces respond to a pandemic. The initial phases of the response emphasise the importance of frontline workers, especially nurses. [ABSTRACT FROM AUTHOR]

While the nursing profession recognizes the importance of leadership behaviors, limited evidence exists on essential clinical leadership behaviors that nursing students should exhibit upon graduation. The purpose of this study was to determine if there were common leadership behaviors exhibited by recently graduated baccalaureate clinical staff nurses in the United States and Australia. A quantitative descriptive study with a comparative design was conducted using The Clinical Leadership Survey. Similar clinical leadership behaviors were reported by nurses from the two countries though there was a statistically significant difference in the overall frequency of behaviors between the two groups. Behaviors in the 'challenging the process' domain were less commonly practiced in both countries, identifying a clinical gap and opportunity for student development. This study identifies the central behaviors that should be included in baccalaureate nursing education curriculum in order to prepare students for successful transition into practice. [ABSTRACT FROM AUTHOR]

Aim: To determine factors associated with nurses' intent to leave their positions and absenteeism. Background: There is a recognized global shortage of nurses but limited data describing and determining factors associated with nurse absenteeism and intent to leave. Methods: This study involved a secondary analysis of the results from direct‐care registered nurses' responses to the MISSCARE Survey, with data from seven countries included. Multi‐level modelling was used to determine nurse characteristics and working environment factors associated with nurse absenteeism and intent to leave. Results: The level of absenteeism and intent to leave varied significantly across countries, with registered nurses in Lebanon reporting the highest intention to leave within 12 months (43%) and registered nurses in Iceland and Australia the highest level of absenteeism (74% and 73%, respectively). Factors associated with outcomes included perceived staffing adequacy of unit, job satisfaction, and age of the nurse. Conclusions: A significant difference between countries was identified in nurse absenteeism and intent to leave. Increased perception of unit staffing inadequacy, lower job satisfaction, less nurse experience, and younger age were significant contributors to nurse absenteeism and intent to leave. Implications for Nursing Management: These findings suggest that regardless of country and hospital, by ensuring that units are adequately staffed and increasing job satisfaction, younger, less experienced nurses can be retained and absenteeism reduced. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to achieve profession-wide consensus on an Australian nurse practitioner specialty framework. Background Since its introduction in 1998, the Australian nurse practitioner profession has grown to over 1300 endorsed practitioners, representing over 50 different specialties. To complement better a generalist learning and teaching framework with specialist clinical education, prior research proposed a broad framework of Australian nurse practitioner specialty areas termed metaspecialties. Design This study employed an online three-round modified Delphi method. Method Recruitment using purposive sampling and snowballing techniques identified an eligible sample from a population of nurse practitioners with at least 12 months' postendorsement experience ( n = 966). Data were collected using online survey software from September 2014-January 2015 and analysed using descriptive statistics and content analysis. The Content Validity Index and McNemar's Test for Change were used to determine consensus on the nurse practitioner metaspecialties. Results One-fifth of the total eligible population completed the study. Participants achieved high consensus on four metaspecialties, including: Emergency and acute care, primary health care, child and family health care and mental health care. Two metaspecialties did not achieve consensus and require further investigation. Conclusion A large sample of nurse practitioners achieved consensus on an Australian metaspecialty framework, increasing the likelihood of widespread acceptance across the profession. This technique may be appropriate for use in jurisdictions with smaller populations of nurse practitioners. Ongoing research is needed to re-evaluate the metaspecialties as the profession grows. [ABSTRACT FROM AUTHOR]

Aims This systematic review aimed to synthesise the existing evidence of working time use and the division of labour among nurses and health-care workers in hospital wards. Background The environment of nursing work is changing. Health systems are becoming more complex and costly, and highly skilled health-care professionals are transferring to new, more demanding tasks. Changes require a division of labour that is based on the efficient use of working time. Evaluation Sixteen studies were identified for the final analysis through a systematic search. Key issue The use of working time was examined mainly through six categories: direct care, indirect care, documentation, unit-related work, personal time and non-nursing duties. The division of labour was examined from the perspective of different occupational groups. Conclusions Despite nurses' different educational backgrounds, certain similarities could be observed. All working groups seem to spend less than half of their working time in direct patient care. Implications for nursing management Nurse managers could influence the increasing nursing workload by supporting the right division of labour and focusing the nurses' working time use so that it benefits the patient. [ABSTRACT FROM AUTHOR]

Aim To explore the concept of sustainability in nursing using social media as a vehicle for discussion on the topic. Background There is a need for an increased awareness among nurses of the issues that are crucial for the healthcare sector to prepare for climate change and contribute to sustainable development. However, topics about sustainability and climate change are not a requirement of nursing curricula in Europe; social media provides an opportunity to raise issues and promote discussion. Design A thematic analysis of a Twitter discussion. Methods A Twitter discussion session hosted by @WeNurses took place on 24 March 2015 over 1 hour. Data were gathered via this online discussion hosted on Twitter, a social media platform. Following the discussion a thematic analysis of the posted Tweets was conducted. Findings One hundred and nineteen people posted nine hundred and ninety six Tweets, a reach of 3,306,368. Tweets broadly followed the questions posted by the team. Several threads related to the sustainable use of healthcare resources and the need to reduce waste was evident. A Word Cloud of the Tweets highlighted prominent words in the discussion: sustainability, nursing/nurses, curriculum, important, waste, practice, resources, student, plastic, health, gloves. Conclusion Social media is an effective way of engaging nurses and students in a discussion on challenging issues. Sustainability appears to be important for nurses, with a particular emphasis on resource use and the importance of sustainability topics in nurse education. [ABSTRACT FROM AUTHOR]

Aim Examine metrics and policies regarding nurse workforce across four countries. Background International comparisons inform health policy makers. Methods Data from the OECD were used to compare expenditure, workforce and health in: Australia, Portugal, the United Kingdom ( UK) and the United States ( US). Workforce policy context was explored. Results Public spending varied from less than 50% of gross domestic product in the US to over 80% in the UK. Australia had the highest life expectancy. Portugal has fewer nurses and more physicians. The Australian national health workforce planning agency has increased the scope for co-ordinated policy intervention. Portugal risks losing nurses through migration. In the UK, the economic crisis resulted in frozen pay, reduced employment, and reduced student nurses. In the US, there has been limited scope to develop a significant national nursing workforce policy approach, with a continuation of State based regulation adding to the complexity of the policy landscape. The US is the most developed in the use of nurses in advanced practice roles. Ageing of the workforce is likely to drive projected shortages in all countries. Limitations There are differences as well as variation in the overall impact of the global financial crisis in these countries. Conclusion Future supply of nurses in all four countries is vulnerable. Implications for nursing and health policy Work force planning is absent or restricted in three of the countries. Scope for improved productivity through use of advanced nurse roles exists in all countries. [ABSTRACT FROM AUTHOR]

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

Aims To compare nurse turnover rates and costs from four studies in four countries ( US, Canada, Australia, New Zealand) that have used the same costing methodology; the original Nursing Turnover Cost Calculation Methodology. Background Measuring and comparing the costs and rates of turnover is difficult because of differences in definitions and methodologies. Design Comparative review. Data Sources Searches were carried out within CINAHL, Business Source Complete and Medline for studies that used the original Nursing Turnover Cost Calculation Methodology and reported on both costs and rates of nurse turnover, published from 2014 and prior. Methods A comparative review of turnover data was conducted using four studies that employed the original Nursing Turnover Cost Calculation Methodology. Costing data items were converted to percentages, while total turnover costs were converted to US 2014 dollars and adjusted according to inflation rates, to permit cross-country comparisons. Results Despite using the same methodology, Australia reported significantly higher turnover costs ($48,790) due to higher termination (~50% of indirect costs) and temporary replacement costs (~90% of direct costs). Costs were almost 50% lower in the US ($20,561), Canada ($26,652) and New Zealand ($23,711). Turnover rates also varied significantly across countries with the highest rate reported in New Zealand (44·3%) followed by the US (26·8%), Canada (19·9%) and Australia (15·1%). Conclusion A significant proportion of turnover costs are attributed to temporary replacement, highlighting the importance of nurse retention. The authors suggest a minimum dataset is also required to eliminate potential variability across countries, states, hospitals and departments. [ABSTRACT FROM AUTHOR]

Background: ACP involving a facilitated conversation with a health or care professional is more effective than document completion alone. In policy, there is an expectation that health and care professionals will provide ACP support, commonly within their existing roles. However, the potential contributions of different professionals are outlined only broadly in policy and guidance. Research on opportunities and barriers for involving different professionals in providing ACP support, and feasible models for doing so, is currently lacking. Methods: We identified twelve healthcare organizations aiming to offer system-wide ACP support in the United States, Canada, Australia and New Zealand. In each, we conducted an average 13 in-depth interviews with senior managers, ACP leads, dedicated ACP facilitators, physicians, nurses, social workers and other clinical and non-clinical staff. Interviews were analyzed thematically using NVivo software. Results: Organizations emphasized leadership for ACP support, including strategic support from senior managers and intensive day-to-day support from ACP leads, to support staff to deliver ACP support within their existing roles. Over-reliance on dedicated facilitators was not considered sustainable or scalable. We found many professionals, from all backgrounds, providing ACP support. However, there remained barriers, particularly for facilitating ACP conversations. A significant barrier for all professionals was lack of time. Physicians sometimes had poor communication skills, misunderstood medico-legal aspects and tended to have conversations of limited scope late in the disease trajectory. However, they could also have concerns about the appropriateness of ACP conversations conducted by others. Social workers had good facilitation skills and understood legal aspects but needed more clinical support than nurses. While ACP support provided alongside and as part of other care was common, ACP conversations in this context could easily get squeezed out or become fragmented. Referrals to other professionals could be insecure. Team-based models involving a physician and a nurse or social worker were considered cost-effective and supportive of good quality care but could require some additional resource. Conclusions: Effective staffing of ACP support is likely to require intensive local leadership, attention to physician concerns while avoiding an entirely physician-led approach, some additional resource and team-based frameworks, including in evolving models of care for chronic illness and end of life. [ABSTRACT FROM AUTHOR]