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Nursing Practice Environment in the Armed Forces: Scoping Review.

Mafalda Inácio^1,2, Maria Carvalho¹, Ana Paulino¹

¹Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, 1600-190 Lisbon, Portugal.

Nursing Reports (Pavia, Italy)

|November 26, 2025

Summary

The military nursing practice environment is shaped by leadership, staffing, and collaboration. Positive factors enhance nurse satisfaction and retention, while hierarchy and deployments can negatively impact outcomes and patient safety.

Keywords:

leadership military nursing nursing administration research scoping review work environment

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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.