Optimizing the quality of nursing care in public hospitals in low-and middle-income countries: an integrative literature review

Background: Quality nursing care is essential for positive patient outcomes and satisfaction. Understanding quality nursing care in public hospitals in low-and middle-income countries is invaluable for developing contextualised strategies aimed at optimizing the delivery of nursing care. Purpose: Summarize existing relevant literature on optimising quality nursing care in public hospitals of low- and middle-income countries. Methods: An integrative literature review according to Whittemore and Knafl's stages. An in-depth search of literature from January 1, 2014 to March 31, 2025 was conducted, including Web of Science, PubMed, Scopus, EBSCOhost (Academic Search Complete, CINAHL and MEDLINE), followed by a manual search on Google and citation search. The identified literature was critically appraised using the John Hopkins Nursing Evidence and Non-Research Evidence appraisal tools. Thematic analysis was used. Results: Nine strategies on optimising quality nursing care under two themes were identified from 17 articles: "Daily nursing care-related strategies" and "Organizational-related strategies". Five daily nursing care strategies relate to quality practice, interprofessional collaboration, cultural sensitivity, therapeutic communication, and family involvement. Five organizational strategies relate to culture and policy, work-life environment and technology, infrastructure and human resources, continuous education, and management support. Conclusion: This review identifies strategies to optimize nursing care quality and provides insights for public hospital management to improve programs and interventions. Effective implementation can enhance patient outcomes and strengthen healthcare systems in LMICs, but requires systemic reforms, targeted investments, context-specific solutions, and further research to address gaps and explore innovations.