The evaluation of evidence‐informed changes to an internationally educated nurse registration process

Abstract

Aim To evaluate effectiveness of specific policy and practice changes to the process of registration for internationally educated nurses. Background Little research exists to inform registration policy for internationally educated health professionals. Introduction Internationally educated nurse employment can help address nursing shortages. Regulators assess competencies for equivalency to Canadian‐educated nurses, but differences in health systems, education and practice create challenges. Methods The study setting was a Canadian province. We used a mixed methods approach, with a pre–post‐quasi‐experimental design and a qualitative evaluation. Previous analysis of relationships between applicant variables, registration outcomes and timelines informed changes to our registration process. Implementation of these changes composes the intervention. Comparisons between pre‐ and post‐implementation exemplar subgroups and timeline analyses were conducted using descriptive statistics, univariate analysis and non‐parametric tests. Data were collected from complete application files before (n = 426) and after (n = 287) implementation of the intervention. Interviews, focus groups and consultations were completed with various stakeholders. Findings The time between steps in the process was significantly reduced following implementation. Stakeholders reported an increase in perceived efficiency, transparency and use of evidence. Discussion Results indicated that initial impacts of the policy changes streamlined the process for applicants and staff. Conclusion Maintaining a consistent and systematic review of an organization's data coupled with implementation of findings to effect policy and practice change may have an important impact on regulatory policy. Implications for Nursing Policy These findings represent the beginning of an international policy conversation. Policy changes based on organizational data can underlie major process improvement initiatives. Ongoing nursing shortages across the globe and increasing mobility of nurses make it important to have efficient and transparent regulatory policy informed by evidence.

Regulation of nursing professionals in Cambodia: strategies to overcome underpinning challenges

“…Moreover, data were collected from different informants and triangulated to improve the credibility of data (Gerrish et al 2015). Collection of recordings and transcripts supported the credibility of data and the thematic analyses making qualitative findings verifiable by an audit trail (Kwan et al 2019). In addition, credibility of the findings was supported through the coding, categorization and interpretation by the first, second and third authors with comprehensive local contextual knowledge.…”

Talent management of international nurses in healthcare settings: A systematic review

“…Nurses’ own acknowledgement of their professional skills and competencies are key in ensuring that they can practice in a safe way; and this is specifically important in preparing nurses for the demanding process of migration [ 52 ]. The process of moving and travelling to support professional development is challenged when difficulties arise in the nurse registration process in the host country [ 53 ]. In recognising this, the Canadian regulator developed, implemented and evaluated changes to internationally educated nurses’ registration policies and practices at the College and Association of Registered Nurses of Alberta with positive results.…”

“…In recognising this, the Canadian regulator developed, implemented and evaluated changes to internationally educated nurses’ registration policies and practices at the College and Association of Registered Nurses of Alberta with positive results. Having an efficient and transparent regulatory policy informed by evidence, streamlined the registration process resulting in positive experiences for applicants with reduced waiting periods for approval [ 53 ]. This is an action that could be replicated in other jurisdictions supporting nurses’ professional development while also reinforcing recruitment strategies for healthcare organisations.…”

Surviving the employment gap: a cross‐sectional survey of internationally educated nurses

“…As such, evidence suggests financial challenges are one of the most significant barriers to professional recertification for IENs and other internationally educated health professionals (Covell et al 2016). Accordingly, the challenging process and expense of professional recertification is reflected in the time it takes IENs to secure Registered Nurse employment (Kwan et al 2019).…”

“…To become regulated nurses in Canada IENs are required to be professionally recertified by a nursing regulatory body of the province or territory where they plan to work (Kwan et al 2019). For IENs, professional recertification involves having their professional credentials verified and assessed, demonstrating English or French language proficiency, and passing a nursing credentialing examination (Covell et al 2017).…”