title: The effect of structural empowerment of nurses on quality outcomes in hospitals: a scoping review.
abstract: OBJECTIVE
  To assess and synthesise studies reporting direct associations between the structural empowerment of frontline nurses and quality outcomes, and to identify gaps in the current literature.
  
  
  BACKGROUND
  The empowerment of nurses seems essential for delivering high-quality patient care. Understanding the relationship between empowerment and quality outcomes would enable nurse managers to make informed choices on improving the quality of care.
  
  
  METHODS
  A scoping review examining the relationship between the structural empowerment of nurses and the quality, effectiveness, safety, efficiency and patient-centredness of care in hospitals. Searching in MEDLINE, CINAHL, Business Source Premier and Embase identified 672 potentially relevant articles. Independent selection, quality assessment, data extraction and analysis were completed.
  
  
  RESULTS
  Twelve cross-sectional studies originating from North America were included. These studies showed a variety of quality outcomes and statistics used. All studies reported positive associations between the structural empowerment of nurses, nurse assessed quality of care and patient safety climate, and work and unit effectiveness.
  
  
  CONCLUSIONS
  Nurses having access to empowering structures positively affects the quality outcomes, i.e. quality, effectiveness, safety, efficiency and patient-centredness of patient care in hospitals.
  
  
  CONCLUSIONS
  Nurse managers and leaders should ensure empowering work conditions for nurses in order to increase hospitals' quality of patient care.
authors.affiliation: Academic Medical Centre (AMC), Amsterdam, the Netherlands.|Athena Institute, VU University, Amsterdam, the Netherlands.
authors.forename: Nicole S
authors.initials: NS
authors.lastname: Goedhart
authors.affiliation: Spaarne Gasthuis Academy, Spaarne Gasthuis, Hoofddorp, the Netherlands.
authors.forename: Catharina J
authors.initials: CJ
authors.lastname: van Oostveen
authors.affiliation: ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.|Department of Surgery, Academic Medical Center at the University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Hester
authors.initials: H
authors.lastname: Vermeulen
mesh_terms: D006761:Hospitals / Q000592:standards; D006801:Humans; D007588:Job Satisfaction; D009656:North America; D009726:Nurses / Q000523:psychology*; D015279:Organizational Culture; D017063:Outcome Assessment, Health Care / Q000592:standards; D011209:Power, Psychological; D017009:Professional Autonomy; D011785:Quality Assurance, Health Care / Q000379:methods*; D000078329:Workforce; D017132:Workplace / Q000523:psychology / Q000592:standards
keywords: Empowerment; Nursing; organisational outcomes; quality of health care; work environment