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The aim of this integrative review is to critically appraise and synthesise empirical evidence on the clinical applications, outcomes, and implications of generative artificial intelligence in nursing practice.
Integrative review following Whittemore and Knafl's five-stage framework.
Systematic searches were performed for peer-reviewed articles and book chapters published between 1 January 2018 and 30 June 2025. Two reviewers independently screened titles/abstracts and full texts against predefined inclusion/exclusion criteria focused on generative artificial intelligence tools embedded in nursing clinical workflow (excluding nursing education-only applications). Data were extracted into a standardised matrix and appraised for quality using design-appropriate checklists. Guided by Whittemore and Knafl's integrative review framework, a constant comparative analysis was applied to derive the main themes and subthemes.
CINAHL, MEDLINE, and Embase.
Included literature was a representative mix of single-group quality improvement pilots, mixed-method usability and feasibility studies, randomised controlled trials, qualitative descriptive and phenomenological studies, as well as preliminary and proof-of-concept observational research. Four overarching themes emerged: (1) Workflow Integration and Efficiency, (2) AI-Augmented Clinical Reasoning, (3) Patient-Facing Communication and Education, and (4) Role Boundaries, Ethics and Trust.
Generative artificial intelligence holds promise for enhancing nursing efficiency, supporting clinical decision making, and extending patient communication. However, consistent human validation, ethical boundary setting, and more rigorous, longitudinal outcome and equity evaluations are essential before widespread clinical adoption.
Although generative artificial intelligence could reduce nurses' documentation workload and routine decision-making burden, these gains cannot be assumed. Safe and effective integration will require rigorous nurse training, robust governance, transparent labelling of AI-generated content, and ongoing evaluation of both clinical outcomes and equity impacts. Without these safeguards, generative artificial intelligence risks introducing new errors and undermining patient safety and trust.
PRISMA 2020.
To report organisational factors known to positively contribute to nurses' well-being in the workplace.
Integrative literature review.
Peer-reviewed journal articles using various methodological approaches, and theoretical works, published in English with a focus on organisational factors and nurses' well-being were included. Papers reporting on other healthcare professional groups and/or nursing students were excluded. Data were synthesised into an integrative review, with findings organised theoretically, according to the PERMA model (Positive emotions, Engagement, Relationships, Meaning, Accomplishment), otherwise known as The Well-being Model.
Relevant papers published between May 2020 and April 2025 were identified using CINAHL and PsycINFO electronic databases. Search date, April 24, 2025.
The review included 18 articles, mostly from Europe and the United States, examining workplace factors that contribute to the health and well-being of nurses. Mapping findings to the PERMA domains showed that organisational support and individual strategies together foster flourishing among nurses.
This review highlights both individual factors (such as self-care, strength use and adaptive coping) and organisational structures (including supportive environments, professional development and recognition) that are essential for nurses' well-being and flourishing. However, effective interventions require systemic change, with leadership and education playing key roles in supporting nurses to flourish in the workplace.
This review addressed the need to go beyond deficit models of nurses' well-being to pinpoint specific organisational factors that can help nurses to flourish. Prioritising nurse well-being is vital for high-quality, safe and sustainable healthcare systems. Investing in environments where nurses can flourish benefits both individuals and the broader healthcare system.
This integrative review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
To report the current state of nurses' engagement in professional and organisational citizenship behaviours worldwide and identify the factors that enable or hinder these discretionary, value-adding actions.
Integrative literature review.
Peer-reviewed empirical studies, theoretical works and editorials published in English between January 2015 and April 2025 were eligible. Reports had to examine nurses' engagement in professional citizenship behaviours or organisational citizenship behaviours. Conference abstracts, dissertations and studies centred on non-nursing workforces were excluded. Quality was appraised with the mixed methods appraisal tool; data were synthesised narratively using constant-comparison techniques.
CINAHL Complete and MEDLINE were searched on 30 April 2025.
Nineteen articles met the inclusion criteria: seventeen empirical studies (sixteen cross-sectional surveys; one randomised controlled trial) and two editorials. Research emerged across eight countries, including Asia, the Middle East, Europe and North America. For organisational citizenship, six inter-locking themes emerged: (1) psychological resources and personality, (2) attitudinal and affective mediators, (3) leadership effects, (4) ethical, fair and supportive climate, (5) outcomes (patient safety, job satisfaction, retention) of organisational citizenship and (6) sparse intervention evidence (one neurolinguistic programming RCT). No empirical studies directly measured professional citizenship; evidence is limited to two conceptual papers calling for civic, policy and professional association engagement. Thus, the main theme was (7) professional citizenship as a nascent (i.e., emerging) field. Overall, citizenship flourished when nurses felt psychologically resourced, fairly treated and supported by transformational or ethical leaders. Burnout, incivility and destructive leadership suppressed organisational citizenship behaviours.
Nurses' organisational citizenship behaviours yield important benefits for patients, staff and healthcare organisations, including improved safety, satisfaction and retention. In contrast, professional citizenship behaviours remain largely conceptual, highlighting the need for foundational research to define and operationalise this construct. Advancing both organisational and professional citizenship should be a strategic priority for health systems worldwide to sustain the nursing workforce and strengthen care quality.
Embedding citizenship behaviours in education, leadership development and policy can strengthen workforce retention, enhance patient-safety culture and drive professional advocacy. Priority actions include routine assessment of organisational citizenship behaviours, leadership coaching and instrument development, plus intervention trials targeting professional citizenship behaviours.
To explore healthcare professionals' experiences of providing compassionate care and identify care situations considered challenging, with attention to the factors that contribute to these challenges.
A cross-sectional qualitative study was conducted involving 878 healthcare professionals in New Zealand who completed an anonymous online survey between February and May 2022. Of these, 115 participants provided detailed narrative responses describing patient care situations that challenged the provision of compassionate care. These qualitative responses were analysed using content analysis, guided by the Transactional Model of Physician Compassion and reported following the COREQ qualitative reporting guidelines.
Three major themes emerged: (1) fragmented services, resource constraints, and compartmentalisation of care; (2) clinician compassion needs and motivations; and (3) patient-related challenges impacting compassionate care. Over 90% of narratives described barriers to compassionate care that were linked to interconnected patient, clinician, clinical, and systemic factors—rather than being focused on individual patient influences alone.
Challenges to compassionate care are rarely attributable to individual patient characteristics alone. Instead, they reflect complex interactions among patient, provider, clinical, and systemic factors, underscoring the need for multilevel interventions to foster equitable, compassionate care.
This study highlights that barriers to compassionate care are embedded in complex systemic, clinician, and patient domains. Findings underscore the need for interprofessional collaboration, resilience-building strategies, and integrated approaches to enhance compassionate and equitable healthcare delivery.
None.
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