Effective nursing regulation is vital for maintaining a competent, agile, and safe nursing workforce. Yet, the evidence available to inform nursing regulation within the Canadian context is largely descriptive and fragmented, with limited utility to support decision-making. While nursing regulators, which exist at the provincial and territorial levels, continue to engage in pan-Canadian policy initiatives, no coordinated research agenda exists to drive nursing regulatory science forward. To address this gap, we conducted a virtual deliberative dialogue with diverse system partners across Canada to co-create a pan-Canadian nursing regulation research agenda. Examples of research areas of interest identified by the participants include strategies for regulatory harmonization, evaluation of regulatory reforms, licensure policy development, improved regulatory data management, and regulatory approaches for new and emerging practices. Barriers to collaboration centered on jurisdictional differences in legislative frameworks and priorities, lack of resources and time, poor role clarity, and legislative barriers to data collection. Examples of facilitators include leveraging existing collaborative networks, addressing barriers to data sharing, and enhancing partnerships between regulators and researchers. Guided by the learning health system framework, we explore strategic opportunities to create a “learning regulatory system” by highlighting scientific, social, technological, policy, legal, and ethical considerations. Insights from our dialogue reinforce the need for intentional investment in collaborative infrastructure to support continuous improvement and innovation in nursing regulation.

Background: Although RNs play a critical role in achieving the United Nations' 17 Sustainable Development Goals (SDGs), their contributions are not widely recognized, even among nurses themselves or within the nursing profession. To achieve the SDGs by 2030, governments, civil society, academics, and the private sector must all work together to deliver innovative and integrated solutions. While much work is needed to increase and sustain RNs' engagement with the SDGs, there is evidence that RNs are contributing to the SDG targets worldwide at individual, organizational, and systems levels. Purpose: The main purpose of this global study was to describe RNs' self-reported actions to advance the SDGs, exploring the ways RNs contribute to their achievement. A secondary goal was to identify recommendations for further action. Methods: This qualitative descriptive cross-sectional study used convenience and snowball sampling to recruit an international sample. Data were collected anonymously via an online survey. Each participant was asked to name and describe one action they had taken within the past year to advance the SDGs. Free-text responses were analyzed using directed content analysis. The social-ecological model provided a framework for analysis. Results: A total of 309 participants from 25 countries responded to the survey. Through our analysis, RNs' SDG-related actions were initially grouped into three categories--individual, community/organization, and systems/policy--with each containing subcategories. A fourth category was added to reflect responses indicating no action. Some examples of actions taken included visiting policymakers, donating to local food banks, educating students, recycling, reducing disparities, conducting research on gender, increasing awareness of inequalities, and using telehealth to increase access to health care. Conclusions: Findings from this study provide a better understanding of RNs' contributions toward achieving the SDGs. This evidence can be used to inform the development of recommendations that aim to spread and scale RNs' contributions to the sustainable development agenda.

Nursing regulators must uphold their mandate to protect the public amid increasing scrutiny and shifting expectations. As understandings of the public interest evolve, so too must regulatory policy and practice. In this commentary, we explore the role of nursing regulation in addressing system-level challenges, including workforce dynamics, racism, misinformation and planetary health. Stronger investment by governments and nursing leadership in regulatory research, as well as support for partnerships between regulators and researchers, can help build an evidence base demonstrating the unique role of regulation in not only supporting a safe, competent workforce but also advancing equity and sustainability in health systems.

It's no surprise to anyone to have us say that we are living in challenging times. Though some may have thought that a postpandemic world would see the recovery and stabilization of economies, healthcare systems and workforces, at times it feels somewhat similar to a never-ending era of calamity. We continue to live in a time of polycrisis - from economic instability exacerbated by ongoing global trade wars, struggling health workforces impacting the accessibility and availability of healthcare services, to worsening planetary health exacerbating food and water insecurity, physical and mental health issues, health inequities and forced migration and displacement. We are severely off track to meet the United Nations' Sustainable Development Goals (SDGs) by 2030 (UN 2015). Nurses and nurse practitioners are leaving the profession at record numbers, with many leaving just within the first few years of being licensed (Faubert 2025). Working conditions remain a challenge across provincial and territorial health systems (CFNU 2025). Yet, while the future may look bleak, these wicked problems are not impossible to fix. Indeed, this is our new normal - a constantly changing world that, now more than ever, needs our resolve to create a healthier future for all.

Health profession regulators are operating in increasingly disruptive and complex environments. Heightened public scrutiny, evolving system-wide risks, and growing expectations for evidence-informed regulation have intensified the need for research that is both rigorous and relevant. Despite growing scholarship in health professional regulation, disconnects between academic research and regulatory policy and practice persist. Drawing on literature and the authors’ experiences working with health profession regulators and system partners, this commentary article reflects on the values, challenges, and opportunities related to strengthening research partnerships between academic researchers and regulators to advance the science and practice of professional regulation.

Background The development, maintenance, and enforcement of Continuing Competence Programs (CCPs) is a core function of nursing regulators in Canada. Although regulators invest significant resources into these programs, there is limited evidence about how they impact workforce and patient safety outcomes. Furthermore, nursing regulators across Canada operate within their unique jurisdictional and professional contexts and have varied regulatory approaches. Purpose This study aimed to identify the similarities and differences in CCP features across Canadian nursing regulators to inform the development of targeted research questions and thus advance theory-informed CCPs. Methods Between January and March 2025, we conducted an environmental scan of 22 nursing regulators across Canada using publicly available information posted on regulators’ websites. Data were extracted using a structured extraction form and analyzed using directed content analysis to compare program structures and features. Results All 22 nursing regulators in Canada require registrants to participate in annual CCPs as a regulatory requirement. While the core features of completing a self-assessment, learning plan, learning activities, and evaluation are consistent, differences exist in the level of guidance offered, the prescriptiveness of requirements, and audit practices. Conclusions Additional research is needed to inform the design of CCPs for optimal impact. There is no one-size-fits-all approach, and adopting a realist approach to future research can drive the development of theory-informed programs and strategies to understand which strategies work, for whom, and when. Evidence generation can help regulators move toward rigorous and responsive regulation.

The integration of genomics in oncology care is accelerating in Canada, presenting new opportunities for nurses to improve cancer outcomes through enhanced screening, diagnosis, and targeted therapies. However, nurses have identified that they require policy guidance to clarify their roles and responsibilities as members of interprofessional teams delivering genomic services. In response, the Canadian Nursing and Genomics Initiative, in collaboration with the Canadian Association of Nursing in Oncology/Association Canadienne des Infirmières et Infirmiers en Oncologie, and an interdisciplinary working group developed the first pan-Canadian position statement to guide genomics-informed oncology nursing practice. To support further engagement and use of the position statement, we outline the rationale for developing the position statement and the role of position statements in supporting nursing practice and innovation in genomics-informed oncology nursing. We describe the governance structure and co-design methodology that facilitated its collaborative interdisciplinary development, and how this approach is critical for nursing advocacy, integrated knowledge translation, and ongoing engagement. Finally, we offer recommendations for oncology nurses to translate the position statement into practice changes. This position statement is a preliminary step toward advancing genomics integration in cancer care and ensuring nursing practice remains at the forefront of innovation.

Between 2022 and 2024, Canadian nursing regulators significantly reformed licensure pathways for Internationally Educated Nurses (IENs) to address worsening workforce shortages. Since then, pathways have continued to evolve, illustrating a dynamic policy area. The objective of this article is to examine factors shaping changes to IEN licensure policy discourse and pathway design between 2024 and 2026. A comparative qualitative policy analysis of six nursing regulators across four provinces was conducted using publicly available grey literature, guided by the 3I + E framework and the READ approach. The findings suggest that IEN licensure reforms continue to be shaped by ongoing labour mobility, political, and economic pressures. Regulatory pathways increasingly emphasize substantial equivalence pathways with increased verification and competency oversight measures. Despite an increased supply of licensed nurses, ongoing integration challenges indicate that licensure is only one component of the solution. Findings also highlight the need for adaptive and coordinated policy responses across interconnected workforce, immigration, education, and healthcare systems.

Background Amid longstanding nursing shortages, exacerbated by the COVID-19 pandemic, federal, provincial, and territorial governments across Canada prioritized the recruitment of internationally educated nurses (IENs). As a result, nursing regulators were strongly encouraged to implement a range of policy shifts to reduce licensure barriers. The nature and scope of these reforms have varied across jurisdictions. Objective To identify and compare the policy processes, drivers, and outcomes of IEN licensure reforms in the Canadian jurisdictions of British Columbia, Alberta, Ontario, and Nova Scotia between January 1, 2020, and November 28, 2024. Methods A qualitative comparative policy analysis of six nursing regulators in four Canadian provinces was conducted using publicly available documents. The study was conducted using the 3I+E framework, guided by an analysis of power and the punctuated equilibrium model of policy change. Results Although the implementation of new licensure pathways varied in design and implementation across provinces, the underlying factors driving reforms were consistent. Licensure policies and processes were identified as both barriers to and mechanisms for improving the integration of IENs. Most reforms occurred rapidly between 2022 and 2023, driven by nursing workforce shortages, political attention and public pressure, actor power dynamics, and differences in regulators’ re-interpretations of risk and the public interest. Conclusions The rapid implementation of licensure reforms illustrates the growing tensions between government direction and regulatory autonomy, shifting conceptualizations of what constitutes public interest, the importance of harmonized approaches across nursing regulators in a federated system, and the value of continuous improvement and innovation in regulation.

Introduction Primary care nurses (PCNs) are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PCNs (ie, nurse practitioners, registered nurses, licensed/registered practical nurses) to leverage one another’s expertise to work to optimal scope; the extent to which this happens depends on multiple context-dependent factors. We will conduct an umbrella review to synthesise and compare international knowledge syntheses focused on scope of practice enactment (ie., roles and activities) of PCNs in primary care.Methods and analysis We will conduct the umbrella review according to the Joanna Briggs Institute methodology, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines, and using the Nursing Care Organization Framework as guidance. We will search a wide range of scientific electronic databases and grey literature sources, and consider articles published in English and French by the Organization for Economic Cooperation and Development and designated key partner countries for inclusion, with no publication date limits. Two independent reviewers will screen titles, abstracts and full-text articles, and any disagreements will be resolved through discussion or by a third reviewer. We will use the Risk of Bias Assessment Tool for Systematic Reviews to assess the quality and risk of bias in the included systematic and scoping reviews.Ethics and dissemination Results will be presented in a PRISMA Scoping Review flow diagram. We will synthesise data from included studies in a detailed literature review table and develop visual aids to communicate the shared and unique roles and activities of PCN scope of practice. We will disseminate the results of the review through peer-reviewed publications and conferences related to this field. Ethics approval is not required.

Background Racism remains pervasive in healthcare systems, driving inequalities for racialized healthcare professionals and clients. The role of health practitioner regulators is to protect the public; however, their actions or inactions may also perpetuate racism. Though there is increasing recognition of regulators’ role in addressing racism, there is currently no synthesized understanding of existing knowledge on this topic. Methods A scoping review following JBI guidelines explored the literature on racism and health practitioner regulation. Six databases were searched: Ovid MEDLINE, Ovid Embase, CINAHL, Scopus, Web of Science Core Collection, and ProQuest Dissertations and Theses Citation Index. Leading global regulatory organizations were searched for grey literature. Findings Fifty-four sources were included in the review, with 57 % categorized as scholarly literature and 43 % as grey literature. While underdeveloped, this scholarship has grown consistently since 2020. Sources were predominantly from the United Kingdom and the United States, followed by Canada, Australia, and New Zealand. Racism and/or racial discrimination can be manifested and perpetuated within regulators’ organizational practices, complaints and conduct processes, licensure requirements, practice standards or guidelines, education program approval or accreditation processes, and continuing competence programs. Health practitioner regulators can create anti-racist healthcare systems by addressing their organizational governance structures and processes and attending to their core regulatory functions. Conclusions While progress has been made toward anti-racist health practitioner regulation, further critical analysis and empirical evidence are needed to inform effective strategies. Clarifying concepts, collecting race-based data, partnering with racialized groups, and integrating anti-racism into regulatory performance frameworks can drive impactful reforms.

BACKGROUND:RNs are integral to achieving the United Nations' 17 Sustainable Development Goals (SDGs). Professional nursing organizations can play a significant role in educating and preparing nurses to work more effectively toward achieving the SDGs. While there is much literature that speaks to the importance of nurses engaging in these goals, there is a lack of research that has explored nurses' perceptions of the role of professional nursing organizations in promoting SDG-related knowledge and engagement. Since 2012, Sigma Theta Tau International Honor Society of Nursing (Sigma) has been formally accredited as a nongovernmental organization with special consultative status to the United Nations Economic and Social Council. As such, Sigma is committed to educating RNs about the SDGs and engaging them in working to advance the goals. PURPOSE:This study examined RNs' learning preferences regarding the SDGs, and their perceptions of their professional nursing organization's engagement in advancing these goals, its recognition of nursing's contributions to these goals, and its impact on increasing nurses' knowledge of these goals. METHODS:This descriptive cross-sectional study used convenience and snowball sampling methods to recruit participants from multiple countries. Data were collected via an anonymous online survey. Descriptive and nonparametric statistics were used for data analysis. RESULTS:The majority (84%) of Sigma members enrolled in this study believed Sigma should be actively engaged in advancing the SDGs. Forty-eight percent were aware of Sigma's engagement and 44% reported that Sigma had increased their knowledge of the SDGs. When comparing participants who were Sigma members to those who were not, Sigma members had significantly higher levels of perceived knowledge of the SDGs and higher levels of belief that nurses are integral to SDG advancement. There were no significant between-group differences regarding nurses' desire to know more about the goals, what nurses are doing to advance them, and how to take action themselves. Participants' top 3 preferred means of learning about the SDGs were emailed and online newsletters (28.8%), webinars and online presentations (24.3%), and internet websites (14.9%). CONCLUSIONS:The results of this study underscore the importance of professional nursing organizations' efforts to increase nurses' engagement with the SDGs and can be used in developing multilevel strategies to further educate nurses about the SDGs.

Background: Licensure pathways for internationally educated nurses (IENs) in Canada have historically been criticized for being too lengthy, complex, and costly. Reforms to streamline IEN licensure have been inconsistent across Canadian jurisdictions, with limited evidence regarding which licensure pathways best support equitable and ethical regulatory policies for IENs. Purpose: The present study aimed to map the regulatory landscape to identify key characteristics, similarities, and differences in IEN licensure requirements and explore the options available to meet these requirements across Canadian nursing regulators. Methods: We conducted an environmental scan of 20 Canadian nursing regulators' websites. Data were extracted and organized into Excel spreadsheets to facilitate comparisons and were analyzed using directed content analysis. Results: Findings were organized into two broad categories: licensure requirements and options for meeting these requirements. Licensure requirements were broadly similar across jurisdictions and nursing designations (e.g., licensed practical nurses, registered nurses, registered psychiatric nurses), with certain notable exceptions, including recency or currency of practice requirements and expedited pathways available for IENs from specific countries. The options available to meet licensure requirements varied significantly, creating a potentially confusing patchwork of reforms across nursing regulators that could create inequities in IEN licensure and integration. Conclusion: The variation in options to meet licensure requirements highlights the need for greater efforts to harmonize and simplify IEN licensure across Canada. Further research is required to evaluate the impact and feasibility of reforms to identify long-term, sustainable, ethical, and equitable solutions.

Health practitioner regulation plays a fundamental role in public protection by overseeing and governing healthcare professionals to ensure they deliver safe health services. It also serves as a strategic lever to strengthen broader health system goals such as improving the accessibility of services, the sustainability of health workforces, and health system resilience. Although the goals of health practitioner regulation are easily articulated, achieving and evaluating these goals are far more challenging. Performance measurement and evaluation of professional regulators and regulatory systems are critical to improving regulatory processes and functions. This is especially important where there is rising government, public, and professional skepticism and mistrust of the effectiveness and efficiency of regulators across global jurisdictions. Although there is evidence that some health practitioner regulators and regulatory systems engage in performance measurement and evaluation, the similarities and differences remain unclear. The objective of this scoping review is to explore the nature, extent, and range of scholarship related to health practitioner regulatory performance measurement and evaluation. It will explore existing performance measurement and evaluation frameworks; the key principles and areas of focus of these frameworks; and the indicators, metrics and outcomes used to evaluate performance. The review will be conducted in accordance with the JBI guidelines for scoping reviews and will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Database searches will include Ovid MEDLINE, Ovid EMBASE, CINAHL, Scopus, and Web of Science Core Collection. Gray literature will be identified through leading regulatory organizations, consortiums, and think tanks. Two independent reviewers will screen titles and abstracts followed by full-text and disagreements will be resolved by a third reviewer. Data will be analyzed using descriptive statistics and conventional content analysis. Results will be presented using evidence tables and a narrative summary. Open Science Framework Registration: https://doi.org/10.17605/OSF.IO/WABTF.

Canadian nursing regulators have implemented various innovations to reform regulatory approaches to address workforce challenges, system demands, governance reforms, and a drive for efficiency. Given the significant role that regulators play in influencing patient safety, workforce, and health system outcomes, decision-making must be evidence-informed. This review examined the nature, extent, and range of literature related to nursing regulation in Canada and how the existing scholarship aligns with emerging regulatory and health system trends to inform the development of a research agenda. The review was conducted following the JBI methodology for scoping reviews and with the support of a medical research librarian. A total of 195 sources, including scholarly (n = 156, 80%) and grey literature sources (n = 39, 20%), were included and reviewed. Just over half of the included scholarly sources were empirical studies (n = 80, 51.3%). The number of publications has steadily increased over the last few decades, and the majority of sources were situated in a provincial/territorial context (n = 104, 53.3%), followed by the national (n = 67, 34.4%) and global context (n = 24, 12.3%). The majority of the literature was led by scholars or professional groups unaffiliated with nursing regulators (n = 129, 66.2%). In contrast, nursing regulators led, commissioned, or were involved in a smaller portion of sources (n = 66, 33.8%). The largest category of literature focused on regulatory models, governance structures, and reforms (n = 59, 30.3%); followed by registration and licensure (n = 57, 29.2%); nursing roles and standards (n = 53, 27.2%); conduct, complaints, and discipline (n = 13, 6.7%); continuing competence programs (n = 11, 5.7%); and education program approval/accreditation (n = 2, 1%). The current literature base related to nursing regulation in Canada is largely descriptive and non-empirical and may not provide sufficient evidence to inform regulatory decision-making. This highlights opportunities for regulators and researchers to enhance collaboration to co-create research agendas that can maximize knowledge development and mobilization efforts.

BackgroundSignificant reforms are occurring in health practitioner regulation across Canada. Within the nursing profession, growing workforce challenges and health system demands have accelerated the pace of changes to nursing regulation policies and practices. There is significant political investment to modernize and harmonize nursing regulation across Canada, and evidence is needed to guide regulatory decision-making. To better understand the current state of scholarship and the gaps that exist, a comprehensive understanding of the available literature informing nursing regulation in Canada is first warranted. ObjectiveThe objective of this scoping review is to examine the nature, extent, and range of literature focused on nursing regulation in Canada. MethodsThe review will be conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. We will search electronic databases, including Ovid MEDLINE, Ovid EMBASE, CINAHL, Scopus, and Web of Science Core Collection. We will also search for grey literature using the websites of Canadian nursing regulatory bodies, nursing organizations, and other leading Canadian regulatory organizations. No limitations will be placed on the year of publication. The review will include papers that explore nursing regulation in Canada, including topics such as education program accreditation or approval, licensure, standards of practice and code of conduct/ethics development and enforcement, continuing competence, discipline and conduct, regulatory models, governance, and reform. We will extract data using a predeveloped tool. Data will be analyzed using descriptive statistics and conventional content analysis. ResultsA preliminary search in Ovid MEDLINE was undertaken on December 7, 2023, and a full search was conducted in 5 academic databases on March 15, 2024. Findings will be presented using evidence tables and a narrative summary. Reporting will follow the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. This scoping review is expected to be completed in early 2025. ConclusionsThe results will be disseminated through conference presentations and a publication in a peer-reviewed journal. The findings will provide a comprehensive overview of the state of nursing regulation literature across Canada and inform the development of a focused research agenda. Trial RegistrationOpen Science Framework osf.io/3qk8t; https://osf.io/bm7jv International Registered Report Identifier (IRRID)DERR1-10.2196/56163

A skilled nursing workforce can ensure that Canadians have safe and equitable access to genomics-informed healthcare. Evidence-informed frameworks designed to support the implementation of genomics across nursing indicate that leadership and collaboration are critical to success. However, siloed provincial and territorial healthcare systems create challenges for harmonizing efforts. In this article, we discuss a solution to bring together nurse leaders across jurisdictions and domains of practice to co-create pan-Canadian strategic directions for genomics integration. We highlight the importance of national collaboration and the value it brings to nursing workforce development in rapidly changing social and technological contexts.

Global health, with its focus on health equity, will advance with the active involvement of advanced practice nurses (APNs). There are multiple venues, organisations, and groups that would benefit from APN involvement and contributions, including well-known international bodies like the United Nations, the World Health Organization, and UNICEF. There are other groups and organisations that APNs may be less familiar with but where advocacy and interaction can impact global health, like the UN Academic Impact, the International Labour Organisation, and others. There are opportunities for APNs within their professional organisations like the International Council of Nurses and others to take action. There are also individual opportunities with some groups where an APN can provide direct care. For all these opportunities, APNs will benefit from further knowledge about these organisations. For the major international bodies, this chapter provides an overview of the history and the complex structures. It also identifies existing organisations that have formal relationships as well as critiques of these bodies. Finally, the APN who wants to have direct care opportunities is cautioned to do so in a way that is ethical and sustainable.

AIM:To learn from two jurisdictions with mature genomics-informed nursing policy infrastructure-the United States (US) and the United Kingdom (UK)-to inform policy development for genomics-informed oncology nursing practice and education in Canada. DESIGN:Comparative document and policy analysis drawing on the 3i + E framework. METHODS:We drew on the principles of a rapid review and identified academic literature, grey literature and nursing policy documents through a systematic search of two databases, a website search of national genomics nursing and oncology nursing organizations in the US and UK, and recommendations from subject matter experts on an international advisory committee. A total of 94 documents informed our analysis. RESULTS:We found several types of policy documents guiding genomics-informed nursing practice and education in the US and UK. These included position statements, policy advocacy briefs, competencies, scope and standards of practice and education and curriculum frameworks. Examples of drivers that influenced policy development included nurses' values in aligning with evidence and meeting public expectations, strong nurse leaders, policy networks and shifting healthcare and policy landscapes. CONCLUSION:Our analysis of nursing policy infrastructure in the US and UK provides a framework to guide policy recommendations to accelerate the integration of genomics into Canadian oncology nursing practice and education. IMPLICATIONS FOR THE PROFESSION:Findings can assist Canadian oncology nurses in developing nursing policy infrastructure that supports full participation in safe and equitable genomics-informed oncology nursing practice and education within an interprofessional context. IMPACT:This study informs Canadian policy development for genomics-informed oncology nursing education and practice. The experiences of other countries demonstrate that change is incremental, and investment from strong advocates and collaborators can accelerate the integration of genomics into nursing. Though this research focuses on oncology nursing, it may also inform other nursing practice contexts influenced by genomics.