Nurse practice environments and selected nurse outcomes (burnout, job satisfaction, turnover intention) in WHO-AFRO hospitals: a scoping review protocol.

The aim of this review is to map, describe, and explore the existing evidence base on nurse practice environments and selected nurse outcomes (burnout, job satisfaction, and turnover intention) within hospital settings across the World Health Organization African Region (WHO-AFRO). Nurses worldwide face persistent challenges with adverse nurse outcomes, particularly burnout, job dissatisfaction, and turnover intention. These outcomes pose significant threats to nurses' well-being, workforce stability, and the quality and safety of patient care. Evidence consistently identifies the nurse practice environment as a key determinant of these outcomes, positioning it as a key target for structured organisational interventions. International initiatives, such as the Magnet Recognition Program and the Pathway to Excellence, demonstrate the value of positive practice environments in improving nurse outcomes. However, these initiatives have primarily focused on high-income contexts, with comparatively limited attention to nurse practice environments in low- and middle-income countries, such as those in Africa, where nurses often work under resource constraints, inadequate equipment and severe staff shortages, frequently with limited structural support or standardised practices. Despite this, there remains a lack of consolidated evidence that comprehensively maps how nurse practice environments and nurse outcomes are conceptualised, measured, and addressed within African hospital settings. A scoping review was therefore deemed appropriate and will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The review will systematically identify, screen, and analyse published evidence on the selected nurse outcomes and the nurse practice environment among hospital-based nurses in the WHO-AFRO region. Evidence will be drawn from multiple electronic databases and will be limited to studies conducted in the 47 countries of the WHO-AFRO region and to full-text studies published in English within the last 10 years. The review will examine the evidence on the nurse practice environment and selected nurse outcomes among hospital-based nurses within the WHO-AFRO region. In addition, it will map the reported relationships between these variables and identify any frameworks, models, guidelines, or interventions to support them, as well as gaps in the existing evidence base. Data will be analysed using simple descriptive statistics and qualitative content analysis and presented in tabular and narrative form. This scoping review forms part of a multiphase research project aimed at developing a contextually relevant framework to strengthen nurse practice environments in South Africa. The findings of this review will provide a comprehensive overview of the current state of evidence in the WHO-AFRO region and serve as an empirical foundation for subsequent phases of framework development and validation.