Enhancing internationally educated nurses’ confidence and skills in suicide prevention: a quality improvement project

BackgroundOne of the longstanding challenges experienced by health and care services in the UK is persistent staff shortages (O'Brien and Ackroyd 2012), with a report by the Health Foundation et al (2018) underscoring the severity of this issue in the NHS.Historically, nurses from overseas primarily entered the NHS as trainees, integrating into its education and training frameworks (Culley and Mayor 2001).However, workforce trends highlight a strong and continued reliance on international recruitment to fill staffing gaps (Laing and Smythe 2025).Although this trend has recently slowed, international recruitment remains a key component of the nursing and midwifery workforce, with healthcare organisations continuing to depend on it (Bond et al 2020, Nursing and Midwifery Council (NMC) 2024).As of September 2025, around 209,800 nurses, midwives and nursing associates on the NMC register were internationally educated, representing approximately 24% of the UK nursing and midwifery workforce (House of Commons Library 2026).Despite their clinical expertise, internationally educated nurses (IENs)