Evidence map›Paper›PMID 42015364›Full record

ReviewJournal of nursing management2026

Unsteady Foundations: The Effects of Environmental Instability on Nurses and Implications for Nursing Management-An Integrative Review.

Ryan Page, Gregory Carter

Abstract readReview
In one paragraph

Review in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Ryan PageSchool of Nursing, Indiana University Indianapolis, Indianapolis, Indiana, USA.ORCID https://orcid.org/0009-0009-3081-9360
Gregory CarterSchool of Nursing, Indiana University Indianapolis, Indianapolis, Indiana, USA.ORCID https://orcid.org/0000-0001-9974-5587

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo determine the state of the science of how instability in the nursing practice environment affects nurses.

backgroundThe COVID-19 pandemic, workforce shortages, and an aging population have highlighted the critical need to build and maintain stable nursing practice environments. Factors such as staffing inconsistencies, fluctuating workloads, and workplace violence create instability. While research has explored nursing practice environments broadly, limited research has been conducted on how instability affects nurses.

methodsAn integrative review was conducted using CINAHL, PsycINFO, and PubMed, with search terms related to instability and fluctuations in the nursing practice environment. Articles from 2014 to 2026 were included if they addressed instability in the nursing practice environment and its impact on nurses in hospital settings. Fifteen studies were included in this integrative review.

findingsInstability in the nursing practice environment has many sources. Organizational support plays a significant role in determining the magnitude and management of environmental instability. Adverse nurse outcomes from instability in the nursing practice environment include decreased well-being, increased turnover, and workplace violence. IMPLICATIONS FOR NURSING MANAGEMENT: Effective leadership and management are necessary to create and maintain positive nursing practice environments, manage environmental instability, and improve nurse well-being and retention. Targeted strategies such as collaborating with policymakers, strengthening the nursing workforce pipeline, and supporting nurses in their practice environments can mitigate environmental instability and its adverse effects on nurses.

conclusionsInstability is a common feature of nursing practice environments. Excessive instability can cause adverse nurse outcomes. Nurse leaders are optimally situated to mitigate environmental instability and provide leadership support to improve nurse outcomes.

Indexed as

NursesWorkplaceCOVID-19HumansLeadershipOrganizational CulturePersonnel TurnoverWorking Conditions

Identifiers

PMID42015364
PMCPMC13099598

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.