From Fragmentation to Focus: An Intentional Research Agenda for the Global Nursing Workforce

Preface

Over the last several decades, the nursing profession has assumed expanding responsibility for delivering care across diverse settings and contexts worldwide. Recognizing nursing’s essential role in advancing health and strengthening health systems, the Global Nursing Workforce Centre was established under the joint auspices of the International Council of Nurses and TruMerit (formerly CGFNS International).

The future of health systems is inseparable from the future of nursing. Yet across high-, middle-, and low-resource settings alike, workforce decisions are too often made in environments where evidence is incomplete, difficult to access, or not comparable across countries and regions. Although substantial nursing workforce research exists, it remains fragmented and unevenly distributed—particularly in under-resourced regions. The challenge is not a lack of inquiry, but a lack of cohesion: there is no unified mechanism to systematically gather, analyze, and synthesize global evidence to inform nursing workforce policy, education, regulation, and practice.

That gap defines the Centre’s purpose. As a global clearinghouse for nursing workforce research, the Centre curates and organizes existing studies, analyzes findings to identify trends, summarizes policy-relevant insights, and highlights persistent data gaps. By translating dispersed information into accessible and actionable knowledge, the Centre enables evidence to more consistently shape policy, improve working conditions, and strengthen the quality of patient care across diverse health systems.

This brief builds on the Centre’s inaugural publication, which reviewed global nursing education pipeline research from 2014 to 2025 and identified critical gaps that must be addressed to adequately support and sustain the profession worldwide. Brief Number 1 revealed, for example, a lack of rigorous, country-level evidence on nursing education “sufficiency”—including data on schools, faculty, enrollment, graduation, and employment outcomes—and highlighted the uneven global distribution of research, with limited evidence from many low- and middle-income settings where needs are often greatest.

This second brief advances that work by presenting, as a standalone publication, the conceptual framework first introduced in the annex of Brief Number 1. The framework provides a structured and practical approach to organizing future inquiry in service of both the profession and the populations it serves. Developed in collaboration with the Centre’s globally diverse Strategic Advisory Council, the framework spans four core domains—education, practice, regulation, and policy—while adding a fifth, systemic issues, to capture crosscutting challenges that shape all aspects of the nursing workforce. The framework includes 98 research questions, with particular emphasis on under-resourced regions where data gaps are most pronounced. Together, these questions are intended to guide scholarship, illuminate persistent challenges, and support more equitable and effective workforce planning worldwide.

Closing nursing workforce research gaps is, fundamentally, a capacity-building strategy for the global profession. Stronger, more accessible evidence enables educators to design and scale sustainable pipelines; regulators to modernize approaches that protect the public while supporting mobility and effective practice; employers and system leaders to improve retention, well-being, and care quality; and policymakers to invest with confidence—especially where resources are scarce and decisions carry the highest stakes.

We offer this framework as a call to collective action. Researchers, professional associations, governments, educators, regulators, employers, and partners all have a role in building the next generation of nursing workforce evidence. By working from a shared agenda, we can accelerate learning across borders and better prepare nursing to meet evolving population needs.