Initiatives to support nursing workforce sustainability: A rapid umbrella review.

Introduction: Despite the global shortage of nurses, there is limited literature that comprehensively maps interventions to support, stabilize, and enhance the nursing workforce. Purpose: This umbrella review aimed to identify structures, interventions, and health system arrangements that healthcare systems have put in place to stabilize, support, and sustain the nursing workforce. Methods: The review is guided by the Effective Practice and Organization of Care (EPOC) taxonomy and aimed to synthesize review-level evidence relevant to nursing workforce planning and policy development within a policy-relevant timeframe. Reviews that evaluated one or more interventions to stabilize, support, or enhance the nursing workforce within healthcare systems were considered for inclusion. We conducted academic literature searches in MEDLINE, Embase, CINAHL, and Scopus on March 11, 2024, and conducted grey literature searches in Google from April 11-16, 2024. The search strategy combined controlled vocabulary and keywords related to nurses, recruitment and retention, and review study designs. Searches were limited to sources published between January 2014 and March 11, 2024, and to English and French. Two reviewers independently screened and extracted each identified article.We used the JBI critical appraisal checklist for systematic reviews and research synthesis to appraise the included reviews, applying it pragmatically across the heterogeneous review designs in the sample. This approach was selected to provide a single, transparent review-level appraisal process across the included sample; however, it was used as a pragmatic indicator of methodological and reporting completeness. Findings: We categorized the included interventions using the EPOC taxonomy. Following screening, we selected 69 studies for inclusion, the majority of which addressed implementation strategies (n = 60) or delivery arrangements (n = 8). The findings directly addressed the primary objective of identifying interventions used to support nursing workforce sustainability and highlighted important evidence gaps related to rural and remote settings, diversity and representation, population needs, equity, and governance and financial arrangements. Discussion/Conclusion: The findings of this umbrella review suggest that there is no one-size-fits-all approach for supporting the nursing workforce; rather, a multi-level, multi-pronged approach may be more appropriate to collectively have the most impactful outcomes.Limitations of this review include the heterogeneity of the included review designs and the pragmatic use of a single appraisal approach across those designs, which limits direct cross review quality comparisons. Future studies should incorporate rigorous implementation and evaluation plans, focusing on the long-term impacts of strategies.The targeted grey literature search was designed to identify review-level synthesis.