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JOURNAL OF NURSING REGULATION VOLUME 10 · SPECIAL ISSUE · JANUARY 2020 THE OFFICIAL JOURNAL OF THE NATIONAL COUNCIL OF STATE BOARDS OF NURSING JOURNAL Volume 10 Volume OF • Special Issue Issue Special NURSING • January 2020 January REGULATION Advancing Nursing Excellence for Public Protection A Global Profile of Nursing Regulation, Education, and Practice National Council of State Boards of Nursing Pages 1–116 Pages JOURNAL OFNURSING REGULATION Official publication of the National Council of State Boards of Nursing Editor-in-Chief Editorial Advisory Board Maryann Alexander, PhD, RN, FAAN Mohammed Arsiwala, MD MT Meadows, DNP, RN, MS, MBA Chief Officer, Nursing Regulation President Director of Professional Practice, AONE National Council of State Boards of Nursing Michigan Urgent Care Executive Director, AONE Foundation Chicago, Illinois Livonia, Michigan Chicago, Illinois Chief Executive Officer Kathy Bettinardi-Angres, Paula R. Meyer, MSN, RN David C. Benton, RGN, PhD, FFNF, FRCN, APN-BC, MS, RN, CADC Executive Director FAAN Professional Assessment Coordinator, Washington State Department of Research Editors Positive Sobriety Institute Health Nursing Care Quality Allison Squires, PhD, RN, FAAN Adjunct Faculty, Rush University Assurance Commission Brendan Martin, PhD Department of Nursing Olympia, Washington Chicago, Illinois NCSBN Board of Directors Barbara Morvant, MN, RN President Shirley A. Brekken, MS, RN, FAAN Regulatory Policy Consultant Julia George, MSN, RN, FRE Executive Director Baton Rouge, Louisiana President-elect Minnesota Board of Nursing Jim Cleghorn, MA Minneapolis, Minnesota Ann L. O’Sullivan, PhD, CRNP, FAAN Treasurer Professor of Primary Care Nursing Adrian Guerrero, CPM Nancy J. Brent, MS, JD, RN Dr. Hildegarde Reynolds Endowed Term Area I Director Attorney At Law Professor of Primary Care Nursing Cynthia LaBonde, MN, RN Wilmette, Illinois University of Pennsylvania Area II Director Philadelphia, Pennsylvania Lori Scheidt, MBA-HCM Sean Clarke, RN, PhD, FAAN Area III Director Executive Vice Dean and Professor Pamela J. Para, RN, MPH, Jay P. Douglas, MSM, RN, CSAC, FRE NYU Rory Meyers College of Nursing CPHRM, ARM, DFASHRM Area IV Director New York, New York Risk and Regulatory Specialist Valerie J. Fuller, PhD, DNP, AGACNP-BC, Chicago, Illinois FNP-BC, FAANP, FNAP Anne Coghlan, MScN, RN Director-at-Large Executive Director and Chief Carolyn Reed, RN, MA, FCNA Elizabeth Lund, MSN, RN Executive Officer Chief Executive/Registrar Director-at-Large College of Nurses of Ontario Nursing Council of New Zealand Cathy Borris-Hale, RN, MHA Toronto, Ontario, Canada Wellington, New Zealand Director-at-Large Mark Majek, MA, PHR, SHRM-CP Sandra Evans, MA, Ed, RN Carol A. Romano, PhD, RN, Director-at-Large Emeritus Board Member FACMI, FAAN Anne Coghlan, MScN, RN National Council of State Boards of Nursing Dean and Professor Boise, Idaho Uniformed Services University of the The Journal of Nursing Regulation is a quarterly, peer-reviewed professional journal published by Elsevier and supported by the National Health Sciences, Daniel K. Inouye Council of State Boards of Nursing (NCSBN), a not-for-profit Suzanne Feetham, PhD, RN, FAAN Graduate School of Nursing organization. NCSBN can be contacted at: 111 East Wacker Drive, Suite 2900 Nursing Research Consultant Bethesda, Maryland Chicago, IL 60601-4277 Children’s National Health System Telephone: 1-312-525-3600 Fax: 1-312-279-1032 Washington, DC Linda R. Rounds, PhD, RN, FNP, FAANP https://www.ncsbn.org Professor/Betty Lee Evans Distinguished Copyright © 2020. Produced and printed in the USA. All rights reserved. Patty Knecht, PhD, RN, ANEF Professor of Nursing University of Texas No part of this publication may be reproduced or transmitted in any form, whole or in part, without the permission of the copyright holder, Vice President, Integration Services Medical Branch School of Nursing the National Council of State Boards of Nursing. ATI Nursing Education/Ascend Learning Galveston, Texas Disclaimer The Journal of Nursing Regulation is a peer-reviewed journal. Leawood, Kansas Statements, views, and opinions are solely those of the authors and persons quoted. Such views do not necessarily reflect those of the publisher. The publisher disclaims all responsibility for any errors or any injuries to persons or properties resulting from the use of information or advertisements contained in the journal. Subscription, advertising, reprints Go to www.journalofnursingregulation.com or [email protected]. ISSN 2155-8256 Special Issue A Global Profile of Nursing Regulation, Education, and Practice National Council of State Boards of Nursing CONTENTS January 2020 • Volume 10 • Special Issue A Global Profile of Nursing Regulation, Education, and Practice 3 The Global Regulatory Atlas . 3 Data Collection . .3 Global View of Regulatory Atlas Data 5 Regulation and Governance . .5 Nursing Regulatory Bodies . .5 NRB Mandates . .6 Composition and Qualifications of NRB . 6 Licensure and Registration Requirements to Practice. 8 Authorization to Practice . 8 Fitness to Practice. .9 National Examination Requirements . .9 Advancing nursing excellence Nurse Mobility: Compacts and Mutual Agreements . 11 for public protection Nurse Types and Titles . .12 Other Titles, Roles, and Responsibilities . 13 Education . .15 Nursing Program Approval. 15 Continuing Competence. 17 Practice . 17 Discipline . .18 Regional View of the Global Regulatory Atlas Data 19 Africa 19 The Americas 25 Canada . 25 The Caribbean Community (CARICOM). 28 CARICOM Member States . .28 Associate Member States . .30 Non-CARICOM Nations . .31 Central America . .33 Mexico . .34 South America . .35 Mission The Journal of Nursing Regulation provides a The United States of America . .38 worldwide forum for sharing research, Asia 41 evidence-based practice, and innovative strategies and solutions related to nursing China and East Asia . .41 regulation, with the ultimate goal of Central Asia and India. 43 safeguarding the public. The journal Southeast Asia. 47 maintains and promotes National Council of State Boards of Nursing’s (NCSBN’s) Australia and Oceania 50 values of integrity, accountability, quality, Europe 53 vision, and collaboration in meeting readers’ Eastern Europe . .53 knowledge needs. Nordic Region. 55 Manuscript Information Western and Central Europe . 57 The Journal of Nursing Regulation accepts timely articles that may advance the science The Middle East 60 of nursing regulation, promote the mission Appendix A: Glossary of Terms 64 and vision of NCSBN, and enhance com- munication and collaboration among nurse Appendix B: Jurisdictions Not Included in Data Analysis 66 regulators, educators, practitioners, and the Appendix C: Educational Requirements for Entry into Nursing Programs scientific community. Manuscripts must be original and must not have been nor will be by Regions 67 submitted elsewhere for publication. See Africa. 67 www.journalofnursingregulaton.com for The Americas. 73 author guidelines and manuscript submis- sion information. Asia. 86 Letters to the Editor Australia and Oceania. .100 Send to Maryann Alexander at Europe . 103 [email protected]. Middle East . 109 Appendix D: Global Regulatory Atlas Questionnaire 112 2 Journal of Nursing Regulation A Global Profile of Nursing Regulation, Education, and Practice Keywords: Nursing regulation, nursing education and practice, nursing regulation worldwide, Global Regulatory Atlas From its inception, nursing has been a global profession. Nurses have cared for patients in their respective countries and traversed the planet to provide care where needed. The World Health Organization (WHO) has designated 2020—the bicentennial of Florence Nightingale’s birth—as the “Year of the Nurse and Midwife.” Nightingale embodied the cosmopolitanism that still infuses the nursing profession. By the age of 34 years, Florence was internationally famous for her service in Turkey as part of the British Army’s employ- ment of female nurses during the Crimean War. Nightingale and her fellow nurses practiced in the crosshairs of this flashpoint far beyond the confines of Victorian society traditionally placed on women and introduced hospital reforms and regulations. As we reflect on the 200 years that elapsed since the advent of modern nursing, the National Council of State Boards of Nursing (NCSBN) reaffirms its commitment to regulatory excellence by forging the Global Profile of Nursing Regulation, Education, and Practice, an innovative initiative for information sharing and data collection among nurse regulators worldwide. The Global Regulatory Atlas In fall 2016, NCSBN hosted the landmark Regulation 2030 Conference. Regulation 2030 brought together nursing regulators and lead- ers from eight countries, nursing professional organizations, the Federation of State Medical Boards, the U.S. Federal Trade Commission, the Organization of Economic Cooperation and Development, and other groups. These attendees were tasked with mapping the future of nursing regulation in the following categories: (a) governance, (b) processes, (c) licensure and registration, (d) workforce, (e) education, (f) fitness for practice, and (g) technology. The Regulation 2030 Conference identified data, collaboration, and standardization as major thematic requirements that would enable the evolution of nursing regulation. Specifically, participants imagined the harmonization of regulatory processes around the world, including the optimized capture and sharing of data across nations and continents. As a step toward