Healthcare Staff Engagement and Patient Safety Outcomes: A Systematic Review with Implications for Critical Care Nursing

Abstract

Aim: To synthesize evidence on the association between healthcare staff engagement and patient safety outcomes and to consider implications for critical care nursing.

Design: Systematic review of quantitative observational and interventional evidence.

Methods: The thesis records report searches of MEDLINE, CINAHL, PsycINFO, Embase, the Cochrane Library, and National Institute for Health Research journals for English-language studies published from 1999 to 2024. Eligible studies measured staff engagement and a patient safety culture, error, incident, or adverse-event outcome. Study characteristics were narratively synthesized. The present manuscript was structured according to PRISMA 2020; however, search exports and screening records require verification before submission.

Results: Fourteen studies from hospitals and nursing homes were reported, including nurses, physicians, and mixed professional groups. Most studies found that stronger engagement or organizational commitment was associated with a more positive safety culture or fewer reported errors. Associations varied by measure, setting, and level of analysis. The evidence was predominantly cross-sectional, heterogeneous, and not specific to intensive care nurses.

Conclusion: Staff engagement may support patient safety, but causal conclusions are not justified. Prospective and intervention studies using validated engagement and objective safety measures are needed, particularly in intensive care nursing.