From Evidence to Strategic Insight: Preliminary Model Development and Validation for Exploring Potential Changes and...

To develop a dynamic analytical framework integrating nursing work performance types and their influencing factors and explore potential changes under different management strategies.

Nursing work performance directly influences healthcare quality and patient safety. However, existing research has not yet established an analytical framework that systematically integrates nursing work performance types, their influencing factors, and the dynamic mechanisms.

A systematic literature review and system dynamics (SD) approach were applied. Expert evaluation and parameter perturbations were used to assess the structural rationality and stability of the model.

Of 2289 records identified, 1619 unique records were screened, and 47 studies were included. Five types of nursing work performance were extracted and synthesized: Quality Safety, Rescue Efficiency, Patient Satisfaction, Job Satisfaction, and Process Optimization. Seven organizational factors were identified: Cultural Climate, Leader Attitude, Supervisory Governance, Incentives and Support, Resource Allocation, Task Allocation, and Education and Training. Three individual factors were identified: Physiological State, Professional Competence, and Psychological State. Based on these findings, an SD model was constructed using causal loop and stock-and-flow diagrams to represent the relationships among these components. Expert evaluation indicated that the model structure was generally reasonable and that the model outputs maintained broadly consistent directional trends under parameter perturbations and simulation scenarios. Finally, scenario simulations were conducted to analyze potential changes in nursing work performance under different management strategies.

This study presents a preliminary, hypothesis-generating SD framework for representing potential relationships among organizational factors, individual factors, and nursing work performance. Future studies should validate the model's generalizability across different healthcare settings and countries and incorporate real-world implementation outcomes to further evaluate its practical effectiveness.

This model identified organizational factors and nursing work performance outcomes that warrant priority testing in future empirical research. Because the model has not been externally calibrated or validated using real-world longitudinal data, its results should primarily be used to generate research hypotheses rather than directly inform the design of specific management interventions.