Taking steps toward nursing excellence worldwide

Pediatric oncology nurses are central to caring for children with cancer, administering treatments, supporting families and providing compassionate, continuous care throughout a child’s treatment journey. Specialized nursing education and competency equip these nurses to provide safe, high-quality care, but access to this expertise remains limited in many parts of the world.

In resource-limited countries, where more than 90% of children with cancer live, gaps in pediatric oncology nursing education and resources can make it difficult for health systems to provide the complex care these children need. Addressing these gaps can reduce preventable complications, enhance care quality and improve patient outcomes.

The St. Jude Global Nursing Transversal Program aims to strengthen pediatric oncology nursing worldwide and improve care for children with cancer and other catastrophic diseases. The program addresses gaps in nursing education, expertise and leadership through an integrated capacity-building strategy grounded in education, collaboration and shared expertise.

This strategy develops expertise at every career stage, beginning with strengthening clinical nursing competencies, preparing nurse educators to train others and developing leaders in evidence-based practice to improve care. Additional initiatives extend this work by supporting institutions and countries. Together, these programs create a pathway from individual nursing competency to institutional and health system transformation.

“The major goal of Global Nursing is to improve capacity for nurses globally, working with nurses and nurse leaders across the globe to improve competencies and support quality improvement projects within their hospitals,” explained Monnie Abraham, PhD, MSN, FISQua, CPHQ, St. Jude Global Nursing Transversal program director, Department of Global Pediatric Medicine.

The first step is building knowledge

Pediatric oncology nursing requires specialized knowledge and skills, yet nurses around the world enter the field with varying levels of training and access to professional development. As part of their capacity-building strategy, St. Jude Global Nursing helps pediatric oncology nurses build expertise through a tiered nurse education program with learning opportunities that range from foundational education to advanced professional development. This approach allows nurses to develop the knowledge and skills needed at each stage of their careers so that they can deliver high-quality pediatric oncology care in their communities.

The pathway begins with Foundations in Pediatric Hematology/Oncology Nursing, a flexible program designed to establish the core principles of pediatric oncology care across an institution’s entire pediatric oncology nursing workforce. A key innovation in this program is its institution-wide approach. By educating whole teams, the program standardizes the knowledge and skills that promote consistent nursing practice so that every child receives the same high-quality nursing care.  

The program combines self-paced online learning with interactive discussions led by regional nursing leaders. The flexible course design allows nurses to strengthen their knowledge while continuing to care for patients. After completing the online coursework, select participants continue with hands-on clinical training at established pediatric oncology centers within their region. These nurses return to their home institutions prepared to apply what they have learned and share their knowledge with colleagues, helping expand access to high-quality pediatric oncology care throughout their communities. By building expertise across nursing teams, the program helps standardize practices and strengthen care at the institutional level. 

St. Jude Global Nursing provides additional opportunities to build on this foundation through initiatives such as Standardized Chemotherapy/Biotherapy Certificate Education for Nurses, developed in partnership with the Association of Pediatric Hematology/Oncology Nurses (APHON). The program teaches nurses how to safely administer complex cancer treatments and support children throughout their treatment journey.

Walking the path to empowered nurse leadership

Educating individual nurses is a critical building block for ensuring care worldwide, but sustainable progress also requires empowering nurses to become educators, mentors and leaders within their institutions. The Competency-Based Nurse Educator Program is an international professional development initiative that equips experienced pediatric hematology-oncology nurses to become nurse educators. 

Launched in Latin America in 2008, the program has evolved to meet the growing need for nurses who can lead education and build capacity within their institutions. In 2022, the curriculum was redesigned to align with World Health Organization’s nurse educator core competencies. Participants learn to design education programs, mentor colleagues and develop resources that support the continued growth of nursing teams. After completing the program, they return to their institutions prepared to train colleagues and strengthen pediatric oncology nursing practice in their communities.

“This course builds sustainable capacity by training nurses across the region and empowering pediatric oncology teams to continue sharing knowledge within their own institutions,” said Lorena Segovia-Weber, BSN, CPHON, Global Nursing program coordinator, Department of Global Pediatric Medicine.

By preparing nurses to educate and mentor their colleagues, the program extends the impact of training beyond individual participants and strengthens pediatric oncology teams across institutions.

Taking strides together to advance care 

Once trained nurses have stepped into the role of nursing educators, the next step on the path to quality nursing care is equipping these leaders with the skills to evaluate evidence, identify opportunities for improvement and implement practices that advance pediatric oncology care. Through the International Evidence-Based Practice (EBP) Nursing Fellowship, Global Nursing, in collaboration with St. Jude Nursing and the Division of Nursing Research, prepares pediatric oncology nurses to become EBP Leaders and advocates within their health care systems.  

Adapted from the St. Jude Nursing Evidence-Based Practice Fellowship, the international fellowship enables participants to identify challenges in their practice settings, develop evidence-based solutions, and visit St. Jude to learn alongside nursing teams and strengthen their skills as change agents. By applying evidence to real-world challenges, nurses return prepared to improve care, advance nursing practice and create lasting change within their institutions.

For example, a fellow from Kenya developed an evidence-based prevention bundle to address chemotherapy extravasation, which occurs when chemotherapy leaks from a vein and can damage surrounding tissue. The project reduced extravasation rates from 54% to 13%, sparking broader institutional change and resulting in the launch of a “Quality Improvement Café” — a platform where resident nurses can develop their own evidence-based quality improvement initiatives.

The dissemination of knowledge does not end with a single nurse or institution. As fellows share their knowledge with other nurses, practices developed in one setting can spread and multiply impact across many institutions. An evidence-based practice study originating in India explored the effectiveness of Buzzy, a small vibrating device used to reduce pain during intravenous cannulation in children with cancer. After the findings were presented at a national conference, another institution adopted the practice, turning one nurse-led solution into a change that extended far beyond where it began.

“Our goal is to improve their skills and make them leaders of evidence-based practice in their own countries,” said Sangeetha Samuel, MSN, Global Nursing program coordinator, Department of Global Pediatric Medicine. “When it comes to low- and middle-resourced countries, we cannot just do the same thing that is done elsewhere. We need to adapt evidence-based practice to the needs of each setting.”

Global Nursing further supports this exchange of knowledge through regional nursing networks, which connect pediatric oncology nurses across countries to share experiences, discuss challenges and learn from one another. Together, these connections create a global community of nursing leaders working toward the shared goal of advancing nursing care and improving outcomes for children with cancer worldwide.

Transforming systems at the end of the road

With highly trained pediatric oncology nurses who can educate their peers and champion evidence-based practices, health care systems in resource-limited settings are better positioned to transform care and achieve lasting improvements for children with cancer. The Improving Children’s Oncology-Hematology Nursing (ICON) initiative extends this capacity-building work to institutions and countries by assessing their pediatric oncology nursing landscape and informing strategies for strengthening them.

Through situation analyses, policy reviews and collaboration with local partners, ICON identifies priorities for strengthening pediatric oncology nursing. Since launching in 2022, ICON has been implemented in 27 pediatric hematology-oncology hospitals in Brazil, one in Mozambique and 15 in Pakistan, with expansion underway in Cameroon and India. Challenges identified at participating hospitals include gaps in nursing education, workforce shortages and limited recognition of pediatric oncology nursing as a specialty. Findings from participating hospitals have informed strategic actions and advocacy efforts tailored to local needs.

“ICON helps us understand the current situation of pediatric oncology nursing in each country, identify the gaps and develop strategic plans to strengthen nursing education, leadership and practice over time,” said Samuel.   

Ultimately, the impact of the St. Jude Global Nursing program is measured not only by the nurses trained, leaders developed or systems strengthened, but by the quality of the care children and families receive. By building knowledge, developing nursing leaders and strengthening health systems, this work helps ensure that every child, regardless of where they live, receives safe, evidence-based and compassionate care from a skilled pediatric oncology nursing team.

“Nursing excellence begins with passionate, motivated nurses who are empowered with knowledge, tools and support to make a difference,” said Abraham. “By building knowledge, strengthening partnerships and advancing evidence-based practices, we can create a future where every child with cancer has access to high-quality, compassionate care, regardless of where they live.”