Compassion Fatigue and Patient-Facing Care Delivery Among Hospital Nurses: A Scoping Review of Empirical Relationships and Work-Related Conditions.

Purpose: Compassion fatigue is an occupational concern among hospital nurses, but evidence regarding its relationship with patient-facing care remains fragmented. This scoping review aimed to map empirical relationships between compassion fatigue and patient-facing care delivery, characterize the work-related conditions represented within this evidence, and identify formally tested indirect associations. Methods: This scoping review followed Joanna Briggs Institute guidance and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, MEDLINE Ultimate via EBSCOhost, and CINAHL via EBSCOhost were searched from database inception, with the updated search completed in September 2026. Peer-reviewed empirical studies were eligible when they involved practicing hospital nurses, explicitly identified, conceptualized, measured, or analyzed compassion fatigue, and examined its relationship with a predefined patient-facing care outcome. Evidence was synthesized descriptively, with direct care relationships, work-related context, and formal indirect effects classified separately. No formal methodological quality or risk-of-bias appraisal was undertaken. Results: Twenty-two studies from 10 countries were included. Patient-facing outcomes were mapped across caring and relational care (n = 12), quality and completeness of nursing care (n = 5), missed or unfinished nursing care (n = 2), and patient safety or nurse-sensitive outcomes (n = 3). Inverse relationships with compassion fatigue were more frequently reported for caring and relational care, whereas findings for care quality were heterogeneous and evidence for missed care and patient safety remained limited and inconsistent. Work-related conditions were frequently represented, but only two cross-sectional studies formally tested indirect associations involving a work-related condition, compassion fatigue, and patient-facing care. Conclusion: Inverse relationships between compassion fatigue and caring or relational aspects of nursing care were more frequently reported than relationships involving other patient-facing domains. Evidence concerning broader care quality, missed care, and patient safety remained heterogeneous, limited, or inconsistent. Because formal indirect-effect evidence was sparse and cross-sectional, the findings should be interpreted as descriptive associations rather than evidence of temporal or causal mechanisms. Prospective and appropriately linked studies are needed to clarify these relationships.