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To critically examine the safety, sustainability and ethical dimensions of recruiting internationally qualified nurses to Australia. A Global Justice Framework focusing on the political ethics of care is applied to the complexity and practical application of issues raised by the urgent nursing workforce needs in the health and aged care sectors.
A discursive paper based on a critical reading of the literature.
Based broadly on a narrative review, this paper provides a critical analysis of relevant literature identified through CINAHL and PubMed databases. These included peer-reviewed articles, government reports, international guidelines and policy documents. Key issues identified included patient safety, sustainability and ethical considerations pertaining to international nurse migration.
Australia has rigorous standards for assessing the professional competency of Internationally Qualified Registered Nurses to ensure safety. Challenges persist, however, regarding professional integration, retention and adherence to ethical recruitment practices. While nurse migration alleviates workforce shortages in Australia, it exacerbates healthcare deficits in source countries facing critical shortages. Sustainability concerns include ensuring long-term workforce stability and maintaining high-quality care standards. Bilateral agreements must consider the needs of both source and host countries.
Addressing Australia's nursing workforce shortages requires ethical and sustainable recruitment strategies. Workforce demands must be balanced to ensure global health equity while upholding public safety and professional standards for all countries.
Ethical recruitment practices are essential for developing policies and practices that support internationally qualified nurses' professional integration and retention. Establishing robust support systems enables these nurses to adapt effectively to Australian healthcare settings. Strengthening retention strategies fosters workforce stability, minimises attrition and may contribute towards consistent delivery of high-quality and safe patient care.
In Tanzania, acute myocardial infarction (AMI) is underdiagnosed, and uptake of evidence-based care is suboptimal. Using an implementation science approach, an intervention was developed to address local barriers to care: the Multicomponent Intervention for Improving Myocardial Infarction Care in Tanzania (MIMIC).
This sequential cohort design trial was conducted in a single northern Tanzanian emergency department (ED). During the preintervention phase (February–August 2023) and the postintervention phase (September 2023–August 2024), adults presenting with chest pain and/or dyspnoea were prospectively enrolled and their ED care was observed. AMI was defined by the Fourth Universal Definition criteria. Telephone follow-ups were conducted to ascertain 30-day mortality. Pearson’s ² was used to compare care before and after MIMIC implementation.
A total of 275 participants were enrolled in the preintervention phase and 577 were enrolled in the postintervention phase. Following MIMIC implementation, significant increases were observed in ECG testing (89.4% of postintervention participants vs 55.3% preintervention, OR 6.82, 95% CI 4.79 to 9.79, p
The MIMIC intervention was associated with large increases in uptake of AMI testing, case identification and evidence-based treatment in a single Tanzanian ED. Multisite studies are needed to evaluate the effect of MIMIC on AMI care in diverse settings across Tanzania.
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