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A National Initiative to Support Internationally Educated Nurses: Implementation and Policy Insights from the PNAA Cy
Mary Joy Garcia-Dia1, Reynaldo R Rivera2,3, Maria Luisa B Ramira4
1Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA.
Abstract:
Background: The integration of internationally educated nurses (IENs) into healthcare workforces is expanding globally, yet organization-led support models remain understudied. Successful IEN integration requires ethical recruitment, structured onboarding, workforce support, and stakeholder engagement in policy discussions related to transition and retention. Objective: To examine the conceptualization, implementation, and policy implications of the Philippine Nurses Association of America Cy Pres Task Force's national initiative to support IEN onboarding and transition into U.S. healthcare. Methods: This descriptive program evaluation utilized governance documents, program planning records, policy summit materials, aggregated survey findings, PNAA Human Rights Committee resources, and the Handbook for Filipino Nurses Immigrating to the United States to examine initiative development, implementation processes, and program outputs. A descriptive narrative synthesis was used to characterize program structure, stakeholder engagement, and policy priorities. Findings: The PNAA Cy Pres governance model was built around ethical recruiting, workforce integration, and advocacy. The work began with policy summits with nurse leaders, health care organizations, recruitment agencies, and policy experts, focusing on hiring, onboarding, legal issues, and staff retention. Stakeholder engagement, interdisciplinary collaboration, and appreciative inquiry were used to identify best practices and goals. Key outputs included the establishment of a national governance structure, implementation of national and regional policy summits, and identification of policy priorities related to ethical recruitment, onboarding, workforce integration, and governance. Conclusions: The PNAA Cy Pres initiative provides an implementation-informed approach that may help guide future workforce integration efforts. The study illustrates how ethical recruitment, workforce integration, and stakeholder engagement can help translate workforce policy principles into practice. Policy & Practice Implications: Healthcare institutions, policymakers, and professional organizations need to work together to standardize onboarding, ethical recruitment, and support mechanisms to facilitate the integration and sustainability of the IEN workforce.
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