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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]

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: 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]

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 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]

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 report on the outcomes of the European project ENS4Care, which delivered evidence‐based guidelines enabling implementation of eHealth services in nursing and social care. Background: Within a policy context of efficiency, safety and quality in health care, this project brought together a diverse group of stakeholders from academia, industry, patient and professional organizations to lead the development of five eHealth guidelines in the areas of prevention, clinical practice, integrated care, advanced roles and nurse ePrescribing. Sources of evidence: Data were collected through a cross‐sectional, online, questionnaire survey of health professionals from 21 countries. Quantitative data were analysed using descriptive and summary statistics, while comments to open questions underwent a process of content analysis. Discussion: Representing an evidence‐based consensus statement, the five guidelines outline key steps and considerations for the deployment of eHealth services at different levels of enablement. Through analysis of the data, and sharing of best practices, common deployment processes and implementation lessons were identified. Conclusion: Findings reveal the richness, diversity and potential that eHealth holds for enabling the delivery of safer, more efficient and patient‐centred health care. Nurses and social care workers as the main proprietors of such practices hold the key to a healthier future for citizens across Europe. Implications for nursing and health policy: The preparation, agreement and dissemination of the ENS4Care guidelines will enable European Union leaders to diagnose the organizational changes needed and prescribe the development of new skills and roles in the workforce to meet the challenge of eHealth. Nurses and social care workers, with the right knowledge and skills will add considerable value and form an important link between technological innovation, health promotion and disease prevention. [ABSTRACT FROM AUTHOR]

Aim: We highlight key components of emerging academic structures in global health nursing and explain how this investment can expand nursing's broader engagement in global health policy development. Background: Engaging nursing in global health policy development is vital to ensure the scale‐up of effective health programmes. Globally, nurses promote development of interprofessional healthcare teams who are responsible for translating sound global health policy and evidence‐based programming into practice. However, the role of nurses within policy forums and on influential decision‐making bodies within the global health space remains limited, which reinforces suboptimal global health policy implementation. Introduction: Investment in globally engaged academic structures is an important way to expand participation of nursing in global health policy development. Sources of evidence: A review of the current knowledge and substantive findings related to academic structures promoting global health nursing was conducted, and included a directed search of institutional websites, related grey and peer‐reviewed literature, and communication with top‐tier schools of nursing in the United States, to identify specific developments in global health nursing academic structures. Discussion/Conclusion: Effective academic structures promoting global health nursing include a framework of four critical components – Research, Education, Policy and Partnership. Academic structure type and core activities vary depending on institutional priorities. Implications for nursing, health and social policy: Increasingly, global health research, driven by individual nursing investigators, is expanding; however, in order to translate these advances into expanded involvement in global health policy development, academic structures within schools of nursing need to systematically expand educational opportunities, bolster research capacity and promote partnership with policymakers. [ABSTRACT FROM AUTHOR]

The article presents information about key concepts for five nursing policy statement which were approved by the Canadian Nurses Association's Board of Directors. The concepts include comprehensive school health, providing primary health care to children and young adults, the use of investigational pharmaceutical products, the role of the nurse in organ and tissue donation, retrieval and transplantation, nurse involvement in screening for alcohol or other drugs in the workplace, and environmentally responsible activity in the health sector.

Background Immigration and globalization processes have contributed to the international dissemination of practices such as female genital mutilation. Between 100 and 400 million girls and women have been genitally mutilated, and every year 3 million girls are at risk of being subjected to female genital mutilation. Objectives The objective of this study was to describe the attitudes towards the practice of female genital mutilation in relation to different health systems and the factors that favour its discontinuation. Methods An integrative review was performed of publications from the period 2006 to 2013 included in the Med Line, Pub Med, LILACS, SciELO, CINAHL and CUIDEN databases. Results We selected 16 studies focusing on diverse contexts that assessed the attitudes of both men and women regarding the perpetuation of this practice. Ten corresponded to studies conducted in countries of residence. Several areas of investigation were explored (factors contributing to the continuation of female genital mutilation, factors contributing to its discontinuation, feelings about the health system). Limitations It is possible that the relevant studies may not have been included given the limitations of the literature review and the invisibility of the phenomenon studied. Conclusions This review demonstrates the strong social pressure to which women are subjected as regards the practice of female genital mutilation. However, many other factors can contribute to eroding beliefs and arguments in favour of this practice, such as the globalization, culture and social environment of countries in the West. Implications for nursing and health policy Nurses occupy an essential position in detecting and combating these practices. [ABSTRACT FROM AUTHOR]

Comments on revisions to the global health policy of the World Health Organization and their impact on nursing and nurses in 1997. Role to be played by nurses and other health professionals amidst changes in global health policy; Analysis of pertinent topics and relevant issues; Implications on nursing and health care.

Focuses on the release of a draft guidelines by the International Council of Nurses to assist member organizations to work on health policy matters. Importance of continuing education in the nursing profession; Role of women in the society; Changes in the health care needs of the society.

Focuses on the need for nurses to face problems in hospitals; Impact of the changing resources on health policy; Need for a policy that uses the workplace as a primary setting for a comprehensive program of illness prevention and health promotion, Effect of limitations on resources on the nursing practice.