Eswatini Nursing Council Regulatory Reforms: Process towards Entry to Practice Examination

Abstract

To identify and to measure entry level competencies (knowledge, skills, attitudes, judgements) for nurses to practice safely and effectively in the Kingdom of Eswatini. Introduction: Eswatini, formerly known as Swaziland, is a small sub-Saharan country between South Africa and Mozambique. There are four nursing programs approved by the Eswatini Nursing Council (ENC) that provide nursing education in the areas of general nursing, midwifery, mental health and community health. The mandate of the ENC is to protect the public and to this end licensed nurses must be able to meet standardized entry level requirements. Methods: We identified gaps in expected competencies of new nurses led to comprehensive strategies by many stakeholders to close the gaps. Nursing competencies were categorized into seven learning domains with specific, measurable indicators included in each domain. Specific clinical skills essential for entry to practice were identified.

Design, delivery and effectiveness of health practitioner regulation systems: an integrative review

“…Four UK-authored systematic reviews examined whether NLEs assure practitioner competence or improve patient safety and found the evidence was weak [ 131 – 134 ]. Several studies from LMICs highlighted factors contributing to the pressure to introduce an NLE, such as the rise in private sector education providers resulting in a surplus of graduates and uncertain standards, the need to standardize training and entry to the public service, and to improve quality of care [ 71 , 77 , 135 – 138 ]. These studies also highlighted the complexities of introducing NLEs, including in the context of mutual recognition agreements that seek to harmonize entry requirements to promote fairness, the common market, and freedom of movement [ 77 ].…”

“…There is evidence that establishing HPE accreditation in LMICs has been prioritized in regulatory strengthening programs, particularly for nurses and midwives. The largest group of studies was associated with regulatory strengthening programs in sub-Saharan African countries [ 66 , 135 , 186 , 191 , 194 , 206 , 207 ]. There were also studies from Cambodia, India, Nepal and Vietnam [ 68 , 208 , 209 ].…”

Design, operation and strengthening of health practitioner regulation systems: A rapid integrative review

“…comparing key features such as the scope and governance of schemes or speci c regulatory functions, sometimes including a historical perspective (5,20,74,91,340). Some studies evaluated speci c regulatory interventions, such as NLEs (73), mandated CPD (131), maintenance of certi cation schemes (171), processes for dealing with misconduct (264), mandatory reporting obligations (285), and the application of administrative sanctions (76). Academic and grey literature provide frameworks for comparative studies of HPR regimes that can be used to strengthen methodologies and standardize outcome measurement (19,85,86).…”

“…Four UK-authored systematic reviews examined whether NLEs assure practitioner competence or improve patient safety and found the evidence was weak (127)(128)(129)(130). Several studies from LMICs highlighted factors contributing to the pressure to introduce an NLE, such as the rise in private sector education providers resulting in a surplus of graduates and uncertain standards, the need to standardize training and entry to the public service, and to improve quality of care (67, 73,[131][132][133][134]. These studies also highlighted the complexities of introducing NLEs, including in the context of mutual recognition agreements that seek to harmonize entry requirements to promote fairness, the common market, and freedom of movement (73).…”

“…There is evidence that establishing HPE accreditation in LMICs has been prioritized in regulatory strengthening programs, particularly for nurses and midwives. The largest group of studies was associated with regulatory strengthening programs in sub-Saharan African countries (62,131,182,187,190,201,202). There were also studies from Cambodia, India, Nepal and Vietnam (64,203,204).…”