A team of U.S. and Danish researchers designed a competency-based continuing education framework to standardize emergency nursing care and training in the four emergency departments (EDs) of Denmark's Region Zealand. A multi-phased strategic approach combined a needs assessment, semi-structured interviews, self-evaluation of skills of 290 regional emergency nurses and a poll of nursing competency attained by emergency nurse leadership. Emergency nursing education, training and evaluation tools were developed and integrated into the EDs over 18 months. The education has had a positive effect, based on initial feedback. The yearly competency day program has been fully institutionalized within the regional emergency nursing continuing education program. The framework has also grown beyond the ED to other regional nursing fields. "This program development can serve as a model for region-wide or health care system-wide collaborations in other countries," the authors report.