Background: With staffing shortages affecting increasing numbers of health services globally, and predictions that shortages will worsen in the future, there is broad consensus that leaders at all levels must do more to support and develop current employees. However, the wide range of attributes of a healthy work environment identified in the literature and the financial implications of creating healthy work environments make it challenging to determine which elements of the nursing work environment are the most important in terms of workforce sustainability. This is a significant gap in our knowledge, and there is no consensus in the literature regarding definition and explanation of work environment factors in a way that facilitates prioritisation. Objectives: The aim of this review was to synthesise and evaluate the evidence of the factors which may have an effect on intention to stay and role of the work environment in enhancing nurses’ intention to stay in the work environment in acute healthcare. Design and methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. A comprehensive search was performed for relevant articles published between 1990 and December 2017 using the following electronic databases: Allied and Complementary Medicine Database (AMED), Excerpta Medica dataBASE (EMBASE), ProQuest Nursing & Allied Health Source, ProQuest theses and dissertations, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, MEDLINE (Ovid) and PsycINFO. The reviewers independently screened the abstracts and full texts, extracted data, and assessed the methodological quality of the included papers using appropriate tools. Results: A total of 4968 studies were screened by title, abstract, and full-text review, and 29 studies were included in this review. The identified determinants of nurses’ intention to stay were grouped into four main categories: individual indicators (personal and professional), organisation/profile, work environment, and patient-related. Several working environment variables identified in this review were significantly associated with the nurses’ intention to stay. Conclusion: Despite the limitations of this review, the evidence indicates that attention to meso-level variables such as organisational characteristics and work environment is vital if the working environment is to improve and nurses’ intention to stay is to increase. The multifaceted nature of the concept of intention to stay makes it difficult to present definitive conclusions based on the findings of this review. However, the identified theoretical models were instrumental in differentiating intention to stay from other concepts such as intention to leave, turnover and retention, theoretically, and operationally.

Background. With projected nursing shortages, an aging workforce, and the imminent retirement of nurse leaders, nursing leadership shortages are a concern. While several studies have indicated the interest of nurses in pursuing leadership positions, limited research has focused on examining the influence of the leadership practice environment on nurses’ motivation to lead. Aim. The aims of the study were to (1) assess the relationship between the leadership environment and the motivation of nurses to lead and (2) determine whether there are particular aspects of the leadership environment that influence motivation to lead. Methods. A cross‐sectional research design was used to collect data from 435 nurses working in 16 public and private hospitals in Oman. Leadership Environment Scale and Motivation to Lead Scale were used to assess participants’ perceived leadership environment and their motivation to engage in formal leadership roles, respectively. Multivariate linear regression was used to assess the relationship between the perceived leadership environment and the motivation of nurses to undertake leadership roles. Findings. Nurses reported a mean scale value of 3.208 out of 5 (SD = 0.467) for their motivation to lead, which exceeds the midpoint, indicating a strong motivation to engage in formal leadership roles. Nurses reported a mean score of 3.194 out of 4 (SD = 0.661), which exceeds the midpoint, suggesting a favorable perception of leadership environment. The findings showed a significant relationship between the leadership environment and nurses’ motivation to lead. Specifically, self‐organization (β = 0.185, p = 0.001, CI = 0.086–0.378), agents (β = 0.221, p = 0.002, CI = 0.124–0.474), and transformative exchange (β = 0.100, p = 0.037, CI = 0.101–0.142) were characteristics of the leadership environment that were associated with greater motivation to engage in leadership. Conclusion. This study emphasizes the importance of cultivating a supportive leadership environment as a potential strategy to attract nurses to assume formal nursing leadership roles. Implications for Nursing Management. Strategies to improve nurses’ motivation to lead in a complex healthcare environment include improving nurses’ active involvement in their organization, creating a collegial supportive and mentoring leadership culture, and improving transformative exchange by supporting career and educational advancement.

Background: Effective leadership is essential for high-performing healthcare systems, yet many leadership training programs lack contextual and cultural adaptability. In Oman, leadership development has historically focused on clinical expertise rather than strategic competencies. This study describes the development and implementation of a culturally adapted leadership training program tailored to the needs of Omani healthcare professionals. Methods: A multiphase project-based learning approach was used to design and assess the program. A needs assessment survey was conducted among healthcare leaders to identify competency gaps. The program was then developed based on international best practices and customized to the Omani healthcare system. A rigorous selection process involved psychometric testing, personal leadership statements, and structured interviews. The eight-month program incorporated evidence-based leadership training, mentorship, and project-based labs. Evaluation was guided by the Kirkpatrick model, assessing knowledge, skills, and behavioral change. Post-program qualitative interviews explored participant experience. Results: The needs assessment (n = 16 senior hospital managers) identified gaps in strategic decision-making, crisis management, and interdisciplinary collaboration. The program addressed these needs through eight structured modules. Of 177 applicants, 38 were selected via a multilevel assessment process. Post-program interviews with a purposive sample revealed improvements in self-awareness, strategic capabilities, team collaboration, and leadership accountability. Participants emphasized the program’s contextual relevance and its value in bridging theory and real-world practice. Conclusion: This study demonstrates the feasibility and impact of a culturally tailored leadership development program in a healthcare setting. By integrating context-specific training with global leadership principles, the program addresses critical competency gaps and strengthens leadership capacity in Oman’s healthcare system. Post-program feedback provided insights into the program’s transformative potential. Future studies should examine the long-term impact of such programs on healthcare performance and patient outcomes.

This study explores the relationship between nurses' active involvement in healthcare policy development and their intention to stay in their current roles. It aims to assess how this involvement in healthcare policy activities influences their intention to stay in their current. Employing a cross-sectional design, the study surveyed nurses across five major publicly funded teaching hospitals in Oman using an online self-administered questionnaire titled the "Involvement in Health Policy Scale." Analytical methods included descriptive statistics, bivariate correlation analysis, and multiple regression analysis to identify predictors of nurses' intention to stay. Of the 1200 distributed surveys, 1017 responses were usable (85% response rate). The sample was predominantly female (87.9%), with an average age of 35 years. Nurses reported a moderate intention to stay (mean ITS = 3.13, SD = .80). Regression analysis indicated that increased involvement in health policy was a significant positive predictor of intention to stay (β = 0.09, p < .007). More experienced nurses (β = .078, p < .044) and non-Omani nationality (β = 0.213, p < .001) were also positive predictors. Conversely, being single and facing numerous barriers were negative predictors of intention to stay (β = -0.071, p < .008; β = -0.165, p < .001). The study underscores the positive impact of nurses' involvement in healthcare policy on their intention to stay in their roles. It highlights the necessity for healthcare organizations to foster environments that enhance nurse engagement in policy-making, thereby potentially improving retention rates and sustaining their workforce.

Background: The adoption of 12‐h shifts in response to workforce shortages has raised questions about their impact on nurses’ well‐being and patient care quality. While international studies offer mixed findings, little is known about these effects in the Omani context. Aim: To compare the effects of 8‐h and 12‐h shifts on nurse fatigue, quality of life, satisfaction, turnover intention, and perceived patient care in a tertiary hospital in Oman. Methods: A comparative cross‐sectional study was conducted with 100 nurses from Sultan Qaboos University Hospital using self‐administered surveys. Descriptive statistics, t ‐tests, and chi‐square tests were performed to compare outcomes across shift types. A multiple regression analysis was also conducted to assess predictors of quality of life, controlling for shift type, age, gender, marital status, satisfaction, fatigue, and unit assignment. Results: Nurses working 12‐h shifts reported significantly higher levels of fatigue ( p < 0.001; Cohen’s d = 0.82) but also reported higher quality of life ( p < 0.001; d = 0.91) and greater satisfaction with their shift length ( p = 0.001; d = 0.72). No significant differences were found in turnover intention. Patient falls were more frequently reported among 12‐h shift nurses, while other safety incidents showed no significant variation. A multiple regression model predicting QOL was significant ( F (16, 83) = 9.64, p < 0.001, adjusted R ² = 0.583). Satisfaction with shift was the strongest positive predictor ( β = 0.432, p < 0.001, 95% CI [0.117, 0.287]), while working a 12‐h shift had a significant negative association with QOL ( β = −0.232, p = 0.004, 95% CI [−0.603, −0.117]). Marital status showed a marginally significant positive effect ( β = 0.180, p = 0.051, 95% CI [−0.001, 0.555]). Conclusion: Despite increased fatigue, nurses working 12‐h shifts reported higher quality of life, possibly due to more days off and enhanced work‐life balance. However, elevated fatigue and fall rates warrant caution. The findings underscore the importance of implementing flexible and individualized scheduling policies rather than universally adopting 12‐h shifts. Further longitudinal studies are needed to explore long‐term effects of shift length on nurse and patient outcomes.