Experiences and Impacts of Working in Organisations Undergoing Regulatory Scrutiny: An Integrative Review

To explore the experiences of healthcare staff in organisations undergoing regulatory scrutiny and to identify the professional and organisational impact.

Integrative review.

Medline, CINAHL, Scopus, and Google Scholar.

This review followed Whittemore and Knafl's framework, adhering to PRISMA guidelines. Searches identified peer-reviewed studies from 2010 to 2025 examining healthcare staff under regulatory scrutiny. Studies employing diverse methodologies were included and synthesised using the constant comparison method to identify and refine key themes.

Eight studies were included. Four interrelated themes were identified: (1) workforce wellbeing, autonomy, and professional identity; (2) regulatory culture, organisational adaptation, and quality improvement; (3) communication and relationships; and (4) impact on patient care and contextual variation.

Regulatory scrutiny profoundly shapes healthcare quality and professional culture but can unintentionally undermine workforce adaptability and innovation essential for effective care. These findings highlight the need for nursing-sensitive regulatory approaches that support professional autonomy, reduce burden, and enhance patient-centred care.

This evidence will inform nursing and midwifery policy and practice globally by providing support to inform nuanced, context-sensitive regulatory approaches that safeguard professional autonomy, reduce administrative burden, and promote safe, person-centred care across diverse healthcare settings. It will assist policymakers, healthcare leaders, and educators worldwide in enhancing workforce sustainability, patient safety, and care quality, facilitating the transfer of learning to varied healthcare environments and systems.

Not applicable.