1. Ferguson, Stephanie L. PhD, RN, FAAN


In this month's column, Stephanie Ferguson, PhD, RN, FAAN, Director, International Council of Nurses' (ICN) Leadership for Change Programme; Facilitator, ICN Global Nursing Leadership Institute; ICN Consultant for Nursing and Health Policy; and World Health Organization Consultant, provides a perspective on the importance of global nursing excellence and highlights the American Nurses Credentialing Center's strategic global quest for nursing excellence.


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The global quest for nursing excellence is a priority for all nurse leaders, managers, and nurses. Whether delivering healthcare, teaching the next generation of nurses and midwives, engaging in research aimed at strengthening nursing practice, or being active in health policy, excellence is the collective goal.

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Global Healthcare Challenges

When confronting worldwide challenges to human health, nurses and midwives are in a position of strength. They are also vulnerable to broader instabilities in societies, which threaten to undermine nursing's professional effectiveness.


A sharp divide exists between developed and developing nations, with vastly differing healthcare resources and outcomes. The developing nations are saddled with challenges that overwhelm current health system response capabilities. Poor governance, stalled economies, disease, conflict, and natural disasters prevent developing nations from mustering the resources to provide for the health and well-being of their populations. Health systems in which neither positive outcomes nor professional fulfillment is possible are further undermined by the migration of nurses and midwives to developed countries, where work environments and remuneration are more commensurate with their professional expectations.


In both developing and developed nations, poor management and lack of investment in healthcare workers, nurses, and midwives undercut the effectiveness of healthcare systems and standards of public health. Undereducation also threatens the transforming power that nursing holds.


The Future of Nursing

The pursuit of excellence in nursing practice through education, research, leadership, advocacy, and regulation is the primary building block of healthcare environments where both patients and professionals flourish. They are also the goals of American Nurses Credentialing Center (ANCC) and the Magnet Recognition Program(R).


The future of nursing, which includes an expanded definition of nurses' roles, will shape the future of healthcare as a whole. Simply put, empowered nurses equal effective healthcare.


The World Health Organization (WHO) has outlined a road map for strengthening nursing and midwifery roles to ensure that the design, delivery, and performance of healthcare systems meet population needs by 2015.1 The WHO calls for increased research in support of evidence-based practice in nursing and midwifery as well as concerted investment in nurse/midwife education. In addition, it advocates empowering nurses and midwives to take on leadership positions at every level in healthcare systems and that policies designed by nurses and midwives inform overall health policy making.


Likewise, in the United States, the Institute of Medicine (IOM) recognizes the centrality of nursing in global healthcare and the need for nurses to take on expanded roles better reflecting the scope and quality of their education.2 The IOM values nurses as equal partners with physicians and other healthcare professionals in designing policy and redefining healthcare.


Nursing Transformation: Pushing Progress Forward

Clearly, the challenges are immense. That is the nature of healthcare. It is not a finite process but a system in which professionals position themselves to provide lifelong care to the public. As healthcare's scope broadens in concert with resources and expectations, nurses and midwives must advance initiatives to strengthen their position within existing contexts while seizing the opportunity to push forward progress in education, research, leadership, advocacy, and regulation.


The ANCC stands to play a vital role in overseeing the expansion of education in nursing science. It is essential that governments, international and national organizations, educational establishments, and other elements within society work hand in hand to do the same.


Today, the field of nursing regulation is thriving. International organizations such as the Commonwealth Nurses Federation and the International Council of Nurses, in association with national nurses' groups, support a vibrant network of regulation. They are joined by organizations such as ANCC that are dedicated to promoting and recognizing excellence in nursing practice.


Transforming nursing is an effort of tremendous importance for healthcare systems everywhere, yet it is still a work in progress. It is our responsibility to push forward the progress of our predecessors while recognizing the strengths we have inherited from them. The transformation is not an overhaul but an actualization of the myriad powerful skills we already possess in pursuit of greater unity, greater leadership, and greater achievements in our professional practice.


The programs of ANCC garner respect because they promote and recognize excellence in a field where it is particularly tangible. Positive outcomes that result from nursing excellence are intrinsically beneficial at every level. The Magnet(R) Model of ANCC incorporates the same building blocks that push progress forward: transformational leadership; structural empowerment; new knowledge, innovations, and improvements; and exemplary professional practice. The strategic plan of ANCC includes a goal to grow internationally and to share the framework for nursing excellence around the world.


As a result, ANCC has expanded its reach, designating 6 international Magnet hospitals and 11 international accredited providers of nursing continuing education. The new 2014 Magnet Manual includes international equivalent standards for selected Sources of Evidence.3 Areas where international hospitals continue to strive for global nursing excellence include continuous professional development, nurse satisfaction, nurse-sensitive indicators, and patient satisfaction. The Commission on Magnet Recognition has offered guidance to international applicants on how to achieve nursing excellence in the context of these sources of evidence. The work of ANCC to "Innovate, Involve, and Inspire" is driving a global quest for excellence among nurses around the world.




1. World Health Organization. Health Professions Networks, Nursing and Midwifery Office, Department of Human Resources for Health. Nursing & Midwifery Services Strategic Directions 2011-2015. 2011. Accessed August 22, 2013. [Context Link]


2. Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2011. [Context Link]


3. American Nurses Credentialing Center. 2014 Magnet(R) Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2013. [Context Link]