Team Cohesion Among Nursing; A Systematic Review

Abstract

This systematic review examines the role of team cohesion among nurses and its influence on professional, organizational, and patient‐related outcomes across healthcare settings. Drawing on evidence from quantitative, qualitative, and mixed-methods studies, the review synthesizes how team cohesion is formed, the conditions that strengthen or weaken it, and the consequences it produces within nursing teams. The findings show that cohesion among nurses is shaped by a combination of interpersonal relationships, leadership practices, psychological safety, work environment, and organizational stability. High levels of cohesion are associated with improved teamwork, stronger job satisfaction, lower burnout and turnover intentions, better communication, and enhanced patient safety and care quality. Conversely, fragmented teams characterized by poor communication, weak leadership, and high staff turnover demonstrate reduced collaboration, higher levels of missed care, and lower performance. The review further indicates that cohesive teams are more resilient during periods of crisis and change, allowing nurses to adapt, support one another, and maintain effective care delivery under pressure. Overall, the evidence positions team cohesion as a central mechanism through which nursing teams achieve both workforce wellbeing and high-quality patient outcomes, highlighting the importance of organizational strategies that foster trust, collaboration, and shared purpose in healthcare environments.