The Registered Nurse Forecasting (RN4CAST) consortium collects data of the nursing work environment and deployment of the nursing staff through the hospital administration and through nurses themselves. The goal of this study is to investigate how features of the nursing work environment and nursing staff deployment affect nurse recruitment, retention, and productivity and patients outcomes.  The consortium includes 15 countries worldwide (Belgium, Finland, Germany, Greece, Ireland, Poland, Spain, Sweden, Switzerland, The Netherlands, the UK, the USA, Botswana, China, and South Africa), making it the largest consortium ever in this domain. Research teams of the European countries will study at least 30 hospitals each, for an overall minimum of 330 hospitals and 15000 nurses and data from tens of thousand of patients.  The University of Pennsylvania is the worldwide authority on this research domain. This 3 year project, funded by the European Commission’s Seventh Framework Programme, started at the beginning of 2009.  The project is coordinated by the Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Belgium with the Center for Health Outcomes and Policy Research from the University of Pennsylvania as vice-coordinator.

In such a large population center as China, health care reform is essential. A study funded by the China Medical Board has been started to encourage nursing education and research in China. Last year the Nursing Network decided to collaborate in the replication of a study of hospital quality of care and the nurse workforce that has been carried out successfully in other countries with good policy results. Under the direction of Dean You at Sun Yat-sen University (SYSU), each of the 8 Network Schools is collecting data within each region of China.  The study will have data on 180 hospitals, 9000 nurses, and 4500 patients, making it one of the largest studies of nursing in China.  SYSU in collaboration with the University of Pennsylvania will analyze the data across all sites and each school will analyze data and write papers based upon the data for their locale.  The scale of the study should capture the attention of leaders and government officials.  The process of the study is building ties across schools needed for the Network to become a viable and functional entity. Finally the study is part of a larger study being conducted by the European Union that will create international networks for Chinese nurse researchers.  We hope this study will “jump start” policy research in nursing in China. 

Another current study concerns nursing in South Korea. The University of Pennsylvania has created a partnership with Yonsei University for a new national study on the outcomes of hospital nursing. Linda Aiken and Eunhee Cho are the co-directors for the study lasting from 2007 to 2010. The study is the first major policy-relevant nursing outcomes study conducted in Korea. This study is funded by the University of Pennsylvania School of Nursing Office of Global Health ($20,000) and Center for Nursing Outcomes Research Pilot grant, a $10,000 grant from NINR and an $80,000 grant from the Korea Science and Engineering Foundation. This partnership creates great opportunities for collaboration and cross-national comparison between Yonsei and Penn. Another exciting result is that the major teaching hospital of Yonsei University, Severance Hospital, has been interested in becoming a Magnet Hospital.

Another Magnet Hospital project with the center's support is underway in Dubai. CHOPR is involved in University Hospital Dubai: an R&D project with collaboration between University Hospital, Mass General, and ANCC to create a magnet hospital in the UAE and conduct a national study replicating RN4CAST. A new Magnet Hospital in such a rapidly growing urban center is vital to provide quality medical care in the Middle East. As the UAE has a shortage of nurses (a third of America's nursing to population ratio), health care and education reform is necessary to increase the ratio of nurses and thus provide superior medical and nursing service. The study took a baseline study of UAE hospitals and will compare the results to a restudy in 2012 after the University Hospital opens. If the hypotheses are correct, the University Hospital will not only be the employer of choice with excellent nurse and patient outcomes consistent with magnet hospitals, but the overall standard of nurse work environment and workforce outcomes will improve in the region as well.