The Association Between Nurses’ Perceptions of Teamwork and Nurse and Patient Outcomes in Hospital Settings: A Systematic Review

BACKGROUND: Teamwork has been recognized as a potentially important organizational factor associated with nurse- and patient-related outcomes. Previous studies have been conducted to examine the association between nurses' perceptions of teamwork and various outcomes in hospital settings. However, no systematic review has yet summarized this evidence. Therefore, this study aimed to summarize the available evidence on the association between nurses' perceptions of teamwork and nurse and patient outcomes in hospital settings. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted using the keywords "teamwork," "group work," and "nurse," along with their synonyms, across PubMed, Scopus, Web of Science, CINAHL, and the Google Scholar search engine. The quality of selected studies was assessed using the Critical Appraisal Skills Programme (CASP) checklists. The narrative synthesis method was used to summarize and classify the results. RESULTS: A total of 33 studies met the inclusion criteria for this systematic review. The analysis identified two overarching themes: nurse-related outcomes and patient outcomes. Twenty-two studies (66.7%) reported that nurses' positive attitudes toward teamwork were associated with more favorable levels in 17 nurse outcomes, which were categorized into four groups: (1) job attitudes and retention; (2) patient safety attitudes and competency; (3) occupational stress, fatigue, and conflict; and (4) ethical values and moral practice. Additionally, fourteen studies (42.4%) reported that such attitudes were linked to more favorable patient-related outcomes, categorized as (1) nursing care processes; (2) adverse events reporting and occurrence; (3) quality and safety of care; and (4) patient-centered and caring behaviors. CONCLUSION: Teamwork may be considered an important factor associated with more favorable nurse and patient outcomes. To promote collaboration, hospital administrators and nursing educators may consider implementing strategies to support teamwork within clinical settings. Nevertheless, further research employing longitudinal and interventional designs is necessary to clarify causal pathways and better understand the relationship between teamwork and these outcomes.