Nursing Practice Environment in the Armed Forces: Scoping Review

Area of Science:

• Nursing Science
• Healthcare Management
• Military Medicine

Background:

• The nursing practice environment significantly impacts healthcare quality, patient safety, and nurse well-being.
• Military healthcare settings pose unique challenges affecting nursing practice, such as hierarchy and deployment rotations.
• Understanding these factors is crucial for optimizing care in military institutions.

Purpose of the Study:

• To conduct a scoping review of the nursing practice environment in military healthcare.
• To identify factors influencing the nursing practice environment within military settings.

Main Methods:

• JBI (Joanna Briggs Institute) methodology was followed for the scoping review.
• Searches were conducted across four databases, including English, Portuguese, and Spanish literature.
• Two independent reviewers performed data selection.

Main Results:

• Eleven studies (2010-2025), primarily from the US, were included.
• Key influencing factors were categorized as structural (leadership, development, staffing), relational (collaboration, conflict), and outcome-related (well-being, retention, safety).
• Favorable environments correlated with higher nurse satisfaction and retention; unfavorable ones with turnover intention and moral distress.

Conclusions:

• Adaptive leadership, interprofessional collaboration, professional development, and adequate staffing are vital for nurse satisfaction and care quality.
• Hierarchical structures, deployments, and mobility uniquely characterize military nursing practice environments.
• Addressing these factors can improve nurse well-being and patient outcomes in military healthcare.