The organizational culture of nursing staff in the hospital setting: A systematic literature review

Abstract

© 2015, Hellenic Nurses Association. All rights reserved. Introduction: Hospitals are characterized as multicultural entities, with their own culture, but also with embedded subcultures, which have a significant influence on the behaviour, beliefs and values of employees. Aim: Investigation of the organizational culture of nursing staff in the hospital setting. Method: Review of primary research studies referring to the measurement of the organizational culture of nursing staff at either the hospital level or the departmental/unit level. A search was conducted in May 2014 in the electronic databases PubMed, CINAHL, EBSCO (Academic Search Complete), Scopus and Embase for articles published from 1995 onwards, using the key-words “organizational culture”, “hospital personnel” and “nurse” in all combinations. Results: The search produced 32 relevant articles. It was observed that although there is difficulty in describing a common terminology or type of culture, analysis of the publications showed that the organizational culture that prevailed among nursing staff was mainly that of teamwork and human relations. This type of culture is positively associated with all the indicators of effectiveness that were studied, such as commitment, participation, satisfaction, change, quality of working life, low resignation rates, etc. It was found that other types, such as innovative culture, are also positively correlated with indicators of nursing effectiveness, while others, such as hierarchical or bureaucratic culture, have a negative impact on all the indicators of effectiveness that were studied. In some studies, the organizational culture appeared to be associated to some extent with specific variables, such as job position, leadership style, years of experience and level of education. Conclusions: The type of culture that dominates in the hospital nursing system has a significant impact on the indicators of effectiveness of nurses. It is therefore advisable that a balanced and constructive nursing culture is developed, depending on the situation and needs, which requires leadership ability.