What Is Needed to Create a Prosocial Classroom? The Effectiveness of the Dutch Meaningful Roles Program in Children: A Cluster Randomized Controlled Study.

The healthcare system is inherently complex and continuously evolving, making collaboration among nurses essential for ensuring patient safety and delivering high‐quality care [, ]. Nurses play a critical role not only in direct patient care but also in organizational and policy‐level processes that influence healthcare quality and outcomes [, ]. The World Health Organization (WHO) has recognized teamwork and team‐based care as key determinants of patient safety and quality of care []. Previous studies showed that appropriate attitudes toward teamwork among nurses may prevent turnover and shortages of nurses and other healthcare staff in hospitals [, ]. During and following the COVID‐19 pandemic, nurse turnover became a major challenge in healthcare organizations, particularly hospitals. Therefore, it is essential for nurse managers, hospital managers, and health policymakers to prioritize strengthening teamwork among nurses in clinical settings []. To better understand the importance of teamwork in healthcare, the integrative framework of teamwork, clinician occupational well‐being, and patient safety proposes mechanisms through which teamwork may influence clinician well‐being and patient safety, providing a comprehensive model for future empirical research. Nurse outcomes reflect nurses’ work‐related experiences and occupational well‐being and include indicators such as job satisfaction, burnout, and turnover intention []. Existing systematic reviews have identified several factors influencing nurse outcomes, such as nurse staffing levels [, ] and working hours []. Prolonged working hours are associated with adverse nurse outcomes, including increased fatigue and reduced job satisfaction []. In hospital settings, higher patient‐to‐nurse ratios have consistently been associated with adverse nurse outcomes, including increased burnout, lower job satisfaction, and greater turnover intention [, ]. Moreover, studies evaluating the implementation of mandated minimum nurse‐to‐patient ratios have found associations with more favorable nurse outcomes []. However, findings regarding the association between these staffing policies and patient outcomes remain unclear. Nurse‐sensitive patient outcomes are defined as patient outcomes that are directly influenced by nursing care and may include hospital‐acquired infections, falls, pressure ulcers, medication errors, and patient satisfaction [, ]. Systematic reviews have identified several influencing factors, including nurse staffing [, ], working conditions [], leadership styles [], and the overall work environment []. While relational leadership shows consistent positive associations with patient outcomes [], the relationship between nurse working conditions and patient outcomes remains inconclusive []. Evidence suggests that adequate staffing is associated with a lower risk of patient falls and mortality [], although the relationships between mandated nurse‐to‐patient ratios and patient outcomes remain mixed []. In addition, recent studies have emphasized the role of supportive work environments and an appropriate skill mix in improving the quality of care []. Multivariate analyses of Comprehensive Nursing Care Service Policy units show that nearly half of the associations with patient outcomes were positive and significant, despite methodological limitations []. Teamwork encompasses attitudes, behaviors, and cognitions. In this review, nurses′ attitudes toward teamwork were conceptualized broadly as nurses’ positive or negative evaluations, perceptions, and beliefs regarding teamwork within nursing units. Therefore, related constructs such as teamwork climate, perceived teamwork, nurse–nurse collaboration, team cohesion, and participative teamwork were considered conceptually aligned dimensions reflecting nurses’ perceptions and attitudes toward teamwork. Teamwork attitudes, defined as what team members feel or believe, can include concepts such as motivation and trust []. Healthcare researchers in various disciplines are increasingly interested in teamwork processes in healthcare settings. In this regard, previous studies have investigated the associations between teamwork and performance outcomes [, ]. The level of teamwork in different conditions depends on several factors, and the workplace in hospitals is one of these factors []. For example, within hospitals, nursing personnel working in intensive care units reported more positive perceptions of teamwork than those working in medical‐surgical units []. Several tools have been introduced to measure the level of teamwork, one of the most famous of which is the Teamwork Attitudes Questionnaire (TAQ) []. This instrument was developed and introduced under the auspices of the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) initiative, a program sponsored by the Agency for Healthcare Research and Quality [].