Global Research on Nursing Work Environment and Structural Empowerment: Trends and Thematic Evolution in Leadership and Workforce Outcomes-A Bibliometric Analysis.

BACKGROUND: Nursing work environment (NWE) and structural empowerment (SE) are closely related to nurse well-being, retention, leadership, care quality, and patient safety. However, their intellectual structure, thematic evolution, and policy relevance remain insufficiently synthesized amid global nursing workforce shortages. AIM: To map global research on NWE and SE and clarify its links with leadership development and nursing workforce outcomes. METHODS: A bibliometric analysis was conducted using English-language research articles retrieved from Web of Science Core Collection and Scopus. Publication trends, leading contributors, collaboration patterns, co-cited references, keyword clusters, thematic evolution, and emerging topics were examined. RESULTS: A total of 1470 publications from 2007 to 2026 were included. Annual output increased steadily, particularly after 2019. The United States, China, and Canada were leading contributors, and the University of Pennsylvania was the most productive institution. Influential scholarship connected practice environments, empowerment, leadership, burnout, retention, care quality, and patient safety. The field has shifted from describing adverse outcomes to explaining how organizational conditions and leadership support sustainable nursing workforces. DISCUSSION: The findings indicate a transition toward mechanism-oriented research explaining how SE and leadership connect organizational conditions with nurse well-being, retention, and care quality. This highlights the need to treat empowering practice environments as nursing management and health policy priorities. CONCLUSION: Research is moving toward understanding how empowering work environments and leadership practices sustain nurses and improve care. Stronger longitudinal and intervention evidence is needed. IMPLICATIONS FOR NURSING MANAGEMENT AND POLICY: Workforce policy should prioritize organizational reforms that create empowering practice environments, support leadership development, and sustain a stable nursing workforce alongside measures to increase nurse supply.