Nursing Practice Environment in the Armed Forces: Scoping Review

Background: The nursing practice environment is a critical determinant of healthcare quality, patient safety, and nurse well-being. Military healthcare settings present unique challenges, including rigid hierarchical structures, deployment rotations, and resource constraints, which may significantly affect the nursing practice. This scoping review mapped the available scientific evidence on the nursing practice environment in military healthcare institutions and identified its influencing factors. Methods: Following JBI methodology, a scoping review was conducted according to the PCC framework: nurses (Population), the nursing practice environment (Concept), and military healthcare settings (Context). Papers in English, Portuguese, or Spanish were included without date restrictions. Searches were performed in 4 databases (September 2025) and data selections were conducted independently by two reviewers. Results: Eleven studies (2010-2025), mainly from the United States, met the inclusion criteria. Thematic analysis revealed three main components influencing the nursing practice environment: structural (leadership, professional development, staffing), relational (collaboration, conflict management), and outcome-related (well-being, retention, patient safety). Favourable environments were associated with higher satisfaction, retention, and reduced burnout. Conversely, unfavorable environments, often influenced by rank hierarchy, deployment rotations, and organizational rigidity, were linked to turnover intention, moral distress, and compromised patient outcomes. Conclusions: Evidence from the included studies indicates that adaptive leadership, interprofessional collaboration, professional development and staffing adequacy are recurrent factors associated with nurses' satisfaction, retention, and perceived quality of care. Hierarchy structures, deployments, and mobility also appear to influence the specific characteristics of military nursing practice environments.