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To present the current evidence on the nature and principles of Equity, Diversity and Inclusion (EDI) in Nursing Education Institutions (NEIs).
Five databases (CINAHL, Medline, Scopus, ERIC and Educational Research Complete) and websites of Canadian nursing education institutions were searched for studies and grey literature on EDI. Information was analysed using the Diversio Diversity and Inclusion Survey (DDIS) framework to highlight the nature and principles of EDI in NEIs. A content analysis guided by a deductive approach informed the data synthesis.
Eighty-eight studies (90 papers) published between 1999 and 2025 were included from 1301 identified articles in the database search. The websites of seven nursing institutions in Alberta, Canada, were examined. The review revealed facilitators, barriers and gaps. The results illustrated the presence and need for diversity, inclusion, equal opportunity and fairness, employing the DDIS framework across participant groups, curricula and contexts.
The literature on EDI in NEI is diverse and provides many facilitators, barriers, challenges and gaps. This review reveals the need for intervention and review studies to highlight specific practices that can lead to successful EDI implementation in NEIs.
These results show that further research is required to refine the definition of EDI within the nursing academy. Evidence must be advanced to develop nursing theories, frameworks and methods specific to EDI implementation.
Promoting EDI is a vital goal for the nursing profession, and there is a need to understand how EDI behaves in NEIs. This review revealed facilitators, challenges, barriers, gaps and principles of EDI that exist within NEI in the literature. This data can support policy and practice change within NEIs and promote EDI within those organisations.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was adhered to in this review.
This study did not include patient or public involvement in its design, conduct, or reporting.
This study examined associations between pregnancy-related fear and stress, occupational exposures, and workplace modifications among pregnant registered nurses in the United States engaged in direct patient care.
A cross-sectional design was used with data collected via an online survey between November 2021 and April 2022. Participants (n = 358) were recruited through social media and listservs. Log-binomial regression models, adjusted for age and parity, estimated prevalence ratios and confidence intervals for associations between occupational exposures and workplace modifications with prevalence of pregnancy-related stress at work and fear of pregnancy or infant complications. Stress, a non-specific physical/psychosocial response to demands, and fear, an emotional response to perceived threat, functioned as distinct constructs.
Emotional and physical environmental hazards were associated with increased prevalence of stress. Emotional and environmental hazards, as well as physical movement, administering antineoplastic medications, infectious disease transmission and scans, were associated with increased prevalence of fear. Each additional occupational exposure increased prevalence of stress by 4% and fear by 12%. Nurses also mitigated risks by implementing workplace modifications. Stress was associated with changing work schedules, while fear was statistically significantly associated with taking extra infection precautions and seeking assistance for CPR.
Findings highlight the need for interventions that address modifiable occupational hazards and improve access to modifications that reduce stress and fear among pregnant nurses.
Strengthening workplace protections could reduce occupational stress, improve nurse retention and enhance patient care quality.
Pregnant nurses face significant occupational hazards, yet limited research has examined their psychosocial effects and mitigation strategies. This study identified key exposures associated with increased stress and fear and showed that workplace modifications varied by stress/fear levels and pregnancy trimester, informing policies to better protect pregnant nurses.
Authors adhered to the STROBE checklist for cross-sectional studies.
This study did not include patient or public involvement in its design, conduct or reporting.
There is an increased focus on healthcare workers' bullying due to various individual, organisational, and social factors that may elevate the risk of bullying among healthcare employees. This scoping review aims to identify knowledge gaps regarding the theorising of bullying and the prevention and management of bullying in healthcare settings.
A scoping review of systematic reviews and meta-analyses was conducted using PRISMA guidelines.
Systematic reviews and meta-analyses (N = 18) involving healthcare workers (i.e., doctors, nurses, and allied health professionals) were identified through a vigorous search of ProQuest Central, PubMed, PubMed Central, Google Scholar, Scopus, PsycINFO (PsycNet), and Web of Science databases.
The included reviews were explored to identify theoretical explanations of bullying and strategies for bullying prevention and management. Thematic analysis was applied to synthesise findings.
The results indicated that workplace culture, hierarchy within healthcare organisations, inactive institutional power, and conflict are key theoretical constructs that may explain bullying among healthcare workers. Further, a comprehensive approach of individual and organisational-level factors, involving organisational policies and procedures, creating awareness to promote effective reporting of bullying, and the role of leaders and managers, was identified as critical for preventing and managing bullying.
The scoping review emphasises the need for integrating theoretical frameworks that consider both individual and systemic aspects of bullying in healthcare organisations. Addressing these aspects can improve the effectiveness of strategies for bullying prevention and management.
Understanding the theoretical approaches to explain bullying of healthcare employees can provide a concrete foundation for targeted interventions and organisational policies that address bullying at multiple levels, therefore improving healthcare workers' wellbeing and workplace culture.
No direct patient or public contribution was related to the scoping review.
To analyse the relationship between authentic nursing leadership and safety climates across hospital settings during the COVID-19 pandemic.
Authentic nursing leadership shapes the safety climate by fostering positive perceptions of workplace policies, processes, procedures and practices that influence how safety is prioritised and addressed within an organisation.
A cross-sectional study.
Our study was conducted from December 2021 to December 2022 in six Brazilian hospitals. Participants were nursing staff working in General Medicine Units, Intensive Care Units (ICU) and Emergency Departments (ED) who provided care to patients with COVID-19. The Authentic Leadership Questionnaire and the Safety Attitudes Questionnaire were used to measure nursing staff perceptions of authentic leadership and safety climates. Data were analysed using descriptive and inferential statistics.
391 nursing staff across six hospitals participated. Self-awareness significantly enhanced perceptions of the safety climates. Additionally, being a Registered Nurse and working in the ICU were positively associated with achieving safe climates in the working environment. In contrast, working in EDs was significantly negatively related to safety climates.
The COVID-19 pandemic underscored a lack of authentic nursing leadership and unsafe climates. Therefore, it is critical to implement educational strategies that foster authentic leadership, particularly focusing on self-awareness, to promote more positive safety climates. Ensuring that leadership and safety climates are relationship-focused is critical to enhancing patient outcomes.
Nursing staff's perceptions of authentic leadership and safety climates are important in making more informed decisions about patient management.
Since self-awareness increases positive perceptions of safety climates, nursing staff should exercise it to guide their actions in facing future health crises.
STROBE guidelines.
Higher self-awareness in relationships with others is a predictor of safety climates and can lead to enhanced patient outcomes.
To describe the co-creation of the ‘Desired Dementia Care Towards End of Life’ (DEDICATED) approach to improve person-centred palliative care for individuals with dementia and to describe the experiences of healthcare professionals during the approach's implementation.
A needs assessment, comprising both qualitative and quantitative studies, informed palliative care needs of healthcare professionals, family caregivers and individuals with dementia. The approach was co-created with healthcare and education professionals, guided by the findings. Then, healthcare professionals were trained to implement the approach in their organizations. From April to June 2022, semi-structured interviews with actively engaged professionals were analysed using Conventional Content Analysis.
The needs assessment yielded six key themes: (1) raising palliative care awareness, (2) familiarization with a person with dementia, (3) communication about future care preferences, (4) managing pain and responsive behaviour, (5) enhancing interprofessional collaboration in advance care planning and (6) improving interprofessional collaboration during transitions to nursing homes. Interviews with 17 healthcare professionals revealed that active involvement in co-creating or providing feedback facilitated implementation. Overall, the DEDICATED approach was perceived as a valuable toolkit for optimizing palliative care for people with dementia and their loved ones.
Co-creating the DEDICATED approach with healthcare professionals facilitated implementation in daily practice. The approach was considered helpful in enhancing person-centred palliative dementia care.
This study underscores the importance of active involvement of healthcare professionals in the research and development of new interventions or tools for palliative care, which can influence the successful implementation, dissemination and sustained usage of the developed tools.
The developed approach can improve person-centred palliative care for individuals with dementia, ultimately improving their quality of life and that of their loved ones.
This study used the Consolidated Criteria for Reporting Qualitative Research.
No patient or public contribution.
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