Strategies to support Internationally Educated Nurses from non-English speaking backgrounds transition into the Western healthcare workforce: a systematic review

BACKGROUND: The globalisation of the healthcare workforce has led to a growing proportion of Internationally Educated Nurses within health care organisations. While their contributions are invaluable, many face challenges in adapting to new professional environments, highlighting the urgent need for organisations to implement evidence-based strategies to support their successful integration. OBJECTIVE: The aim of this review was to identify and describe workplace support strategies shown to be helpful in supporting Internationally Educated Nurses from non-English-speaking backgrounds transitioning into the Western healthcare workforce. STUDY DESIGN AND METHODS: A systematic review was conducted including primary research studies reporting qualitative and/or quantitative data. The population of interest was Internationally Educated Nurses from non-English speaking backgrounds who were employed in Western health care settings including Australia, New Zealand, Canada, United States of America and the United Kingdom. The intervention of interest was strategies that could be put in place by the workplace to improve outcomes for the nurse or the workplace. Three databases (Medline, PsycInfo, CINAHL) and grey literature were searched in November 2024. Risk of bias was assessed using corresponding tools from the Joanna Briggs Institute. Results were tabulated and presented in a narrative synthesis. RESULTS: A total of 20 studies were included with most (n = 13) being qualitative. Studies were conducted in a range of countries with nurses from a range of different cultural backgrounds. Nine key approaches were identified to support successful integration, spanning organisational strategies (e.g., anti-racism policies and equitable career pathways), educational programs on cultural competence for all nurses, and structural supports such as tailored orientation and mentoring. CONCLUSIONS: We were unable to identify any experimental studies which provided quantitative data on the effects of strategies to support Internationally Educated Nurses. The included studies provided information about a range of different ways to enhance transition. CLINICAL TRIAL NUMBER: Not applicable.