Association between the nurse work environment and severe maternal morbidity in high-income countries: A systematic review protocol

Abstract

Background The United States has the highest maternal mortality and morbidity rates compared to its high-income peer nations. In high-income nations, a considerable amount of maternal morbidity cases are preventable and linked to provider-related factors. Better nurse work environments are associated with positive patient outcomes, but little is known about its impact on maternal morbidity. In this systematic review, we aim to identify the association between nurse work environment and maternal morbidity, specifically in high-income countries. Methods This systematic review will include original articles on the association between nurse work environment and maternal morbidity. CINAHL, PubMed/Medline and the Cochrane Central Register of Controlled Trials will be searched to retrieve potential original articles that are published between 1990 and 2019 in English language. Citations will be screened by two reviewers, in two rounds, for inclusion based on a priori inclusion and exclusion criteria. Data extraction templates will be populated with data to evaluate the methodological and reporting quality of each study. A combination of structured narrative synthesis and quantitative summaries in tabular format will allow for discussion and recommendations for future research. Discussion Results from this systematic review will provide evidence to elucidate the association between nurse work environment and maternal morbidity. While there is strong evidence demonstration the relation between nurse work environment and general patient outcomes, less is known about its influence on maternal morbidity. Findings from this review will help to guide research in the field and nursing professional in the development of targeted practices and policies aimed at reducing the rates of maternal morbidity.