Effectiveness of intervention programs aimed at improving the nursing work environment: A systematic review

Abstract

Background: The nursing work environment can be compromised due to workload, stress and many other issues. A good nursing work environment is needed to for the health and wellbeing of nurses and therefore measures are developed to improve nursing work environment.

Aim: To determine whether measures designed to improve the work environment for nursing professionals are effective.

Methodology: Online research in the Medline, Scopus, Web of Science, ERIC, CINHAL, PsycINFO, and American Doctoral Dissertations databases, along with manual search, was carried out. Primary experimental studies made up of intervention and control groups were included, with pre-/post-measure evaluation in the nursing team, based on the effects of the interventions. Risk of bias was calculated using the Cochrane tool.

Results: A total of 1997 studies were examined; 19 clinical trials met the inclusion criteria. A total of 1427 nurses participated in the selected studies. The fields of application of the interventions were personal and environmental. Out of the fields targeting individuals, three methodologies were identified: cognitive-behavioral techniques, stress management, channeling anxiety and physical well-being; and those aimed at environmental fields: aromatization and organization. The most evaluated characteristic was teamwork, and the most analyzed symptom was stress. Most of the interventions concluded with at least one significant improvement.

Conclusions: Interventions aimed at enhancing the work environment are effective ways of increasing job satisfaction. The heterogeneity of the data did not allow us to determine which intervention is the most effective. The combination, type, and duration are variables that affect efficacy.

Implication for nursing and nursing policy: This systematic review provides resources for improving the work environment that affects nursing staff, other professionals, and patients. Encouraging a healthy atmosphere leads to excellence in care and improved safety.

Keywords: Intervention; job satisfaction; nursing; systematic review; work environment.