International Benchmarks for the Practice Environment Scale of the Nursing Work Index: A Meta-Analysis

The Practice Environment Scale of the Nursing Work Index has been used worldwide to measure nurse work environments. International benchmark values for this scale can assist managers in assessing their work environment. The objective was to conduct a meta-analysis of this instrument's composite and subscale values across continents, nursing unit types, and time. Studies published up until September 30, 2023 were identified in CINAHL, MEDLINE, and Embase. One-hundred and sixty publications representing 38 countries were included. Most studies were rated as high certainty and low to moderate risk of bias. The pooled point estimate (2.70) indicated that hospital work environments were modestly positive. The weakest work environment domain was Staffing and Resource Adequacy (2.47). Europe had significantly weaker work environments than Asia and North America. Africa and South America had few studies. Better work environments were reported in neonatal intensive care, as compared to medical surgical and critical care units. A small, positive slope over time, which was detected in the three continents, was significant in North America. To promote evidence-based management globally, benchmark values are now available by setting and continent.