Preparing and Empowering Global Nurses to Deliver the Highest-quality Pediatric Healthcare

Partners in Securing the Future of Global Pediatric Healthcare

National Association of Pediatric Nurse Practitioners (NAPNAP) is a U.S.-based professional association for pediatric nurse practitioners (PNPs) and all pediatric-focused advanced practice registered nurses (APRNs). Established in 1973, NAPNAP was the first national professional society in the U.S. for nurse practitioners and remains the only U.S. organization dedicated to both advancing the APRN role and improving the quality of health care for infants, children, and adolescents. NAPNAP is recognized as the global leader, trusted authority, and indispensable resource on comprehensive pediatric advanced practice nursing. Our vision is for all infants, children, adolescents, and young adults to receive equitable, high-quality pediatric health care. Our mission is to optimize the health and well-being of all infants, children, adolescents, and young adults and to empower our community of pediatric experts.

CGFNS (Commission on Graduates of Foreign Nursing Schools) was created in 1977 to solve significant nursing shortages in the U.S. The American Nurses Association, the National League for Nursing, and the U.S. Department of Education jointly invented CGFNS to provide an examination—the CGFNS Qualifying Exam—to measure the entry-to-practice applied knowledge, skills, and behaviors of first-level, general nurses educated outside the U.S. without U.S. standards. As it expands its mission to support healthcare workforce development on a global scale, CGFNS International recently changed its name to TruMerit™. It comes in response to calls to invigorate capacity building of the healthcare workforce so it can meet the needs of people in a rapidly evolving global health landscape. TruMerit, a reference to “genuine excellence,” points to the organization’s role in validating the meritorious achievements of global healthcare workers. It will continue to be a worldwide leader in providing these services while broadening its mission to strengthen research and advocacy in support of healthcare workforce development solutions, including global standards and frameworks for specialty certifications that will empower career pathways for healthcare workers, regardless of where they choose to work.

Current Challenges Exposing Children’s Welfare to Significant Risks

“Amid an unprecedented health workforce crisis, and with an increasing number of health workers being displaced by the impacts of climate change and armed conflict, the patchwork quilt of standards and qualifications between countries threatens to prevent health workers from practicing to their capacities, much less helping to alleviate workforce shortages in high-need countries and improve healthcare access for underserved populations,” said Peter Preziosi, President and CEO of TruMerit. Additionally, global workforce providers who have the pediatric specialty training necessary to meet the unique healthcare needs of infants, children, and adolescents are in extremely short supply, resulting in lasting generational deficits.

The outcomes we aim to achieve through this partnership include:

1. Lifting future generations up across the world by expanding pediatric-focused health education to improve access to high-quality pediatric health care, regardless of world region or income level;
2. Applying global pediatric micro-certification/credentialing standards to recognize pediatric health workers’ competence—attesting to what they know and what they can do for infants, children and adolescents;
3. Advocating for role-recognition to support credential portability across geopolitical borders and disciplinary boundaries;
4. Fostering inclusive, evidence-based research to drive global certification/credentialing concepts and product development to meet pediatric healthcare workforce needs;
5. Reimagining pathways for the global health workforce to support care model evolution;
6. Addressing the current gap between global nurse training and pediatric specialty education; and
7. Addressing the challenges in accessing health care due to provider shortages, and other determinants of health (conflict, transportation, and others).

Proposed Action Plan:

To level the playing field for all nurses worldwide, an exam-based global pediatric micro-credential approach, measuring applied knowledge, skills, and behaviors to validate pediatric nursing competence against a set of global standards centered on patient safety, serves a useful purpose as a portable credential of role-recognition and work-readiness on an international scale. Equipped with this global credential, nurses will have more mobility within the profession, across employment opportunities, authorities, and geopolitical boundaries throughout their career. NAPNAP will provide the necessary education on the fundamentals of pediatric health care, and TruMerit will ensure the necessary psychometric integrity and usability of the micro-credential.

To create this global micro-credential for first-level, general nurses, NAPNAP will guide subject matter experts in the development of modules addressing the foundations of high-quality pediatric healthcare delivery. TruMerit will apply rigorous psychometric standards to the engineering process of a micro-credential examination. We will conduct this project guided by a global taskforce of pediatric nursing subject matter experts. We intend to draw these experts from all world regions and all income levels. We are asking our nursing colleagues to self-identify, or to recommend other experts from different countries and world regions, who may be interested in contributing to this global project.

Project Timeline: We expect this project development to take a 12-18 month cycle to complete, with the majority of the work to be completed in Q3-Q4 of 2025. We will consult with Taskforce members as warranted over the various stages of test development.

Taskforce Size: 15-30 pediatric nursing subject matter experts from across the world.

Time commitment: The Taskforce will provide guidance and decisions at various stages of the project. Taskforce meetings will be conducted virtually. Taskforce members will give guidance, review materials, and provide feedback. We estimate five 2-hour meetings on Zoom.

We will also be asking Taskforce members to help identify additional subject matter experts to serve as global field reviewers, who will help screen items for relevance, suitability, and cultural appropriateness.