The Determinants of Nurses’ Empowerment: A Systematic Review

Abstract

Nurses’ empowerment has been widely acknowledged as a vital factor influencing their professional performance, well-being, and retention, as well as the overall quality and safety of healthcare delivery. Encompassing structural, psychological, and professional dimensions, empowerment in nursing is shaped by organizational systems, leadership practices, workplace environments, and broader contextual conditions. Although the literature on nursing empowerment has expanded significantly, the evidence remains fragmented across diverse study designs and healthcare settings. This systematic review synthesized empirical and review-based findings to identify key determinants of nurses’ empowerment and to examine its associated outcomes at the professional, organizational, and individual levels. Following PRISMA 2020 guidelines, a comprehensive search of major academic databases was conducted, including quantitative, qualitative, mixed-methods studies, and systematic reviews focused on nurses or nursing students. A narrative synthesis approach was adopted due to heterogeneity in study designs and measures. The findings revealed that nurses’ empowerment is driven by various behavioral, organizational, and contextual factors, including leadership styles, characteristics of the work environment, access to resources, participation in decision-making, and professional autonomy. Empowerment was consistently associated with beneficial outcomes such as increased job satisfaction, work engagement, organizational commitment, motivation, self-efficacy, innovation, and perceived care quality, along with reduced burnout and intention to leave. Overall, nurses’ empowerment emerges as a multidimensional and influential construct essential to achieving positive workforce and healthcare system outcomes. Its reinforcement requires strategic, integrated efforts targeting structural frameworks, supportive leadership, and contextual enablers to enhance nurse well-being, workforce sustainability, and quality of care