Rural Nursing Workforce Sustainability in Australia: A Scoping Review of Global Retention Strategies

The global nursing shortage significantly impacts healthcare sustainability, particularly in rural Australia, where geographic isolation, professional remoteness and resource constraints amplify challenges. To map and synthesise evidence on factors influencing rural nursing workforce sustainability across individual, organisational and systemic levels. A scoping review following PRISMA-ScR guidelines was conducted. Five databases and grey literature were searched for English-language publications (1995-2024) on rural nursing workforce sustainability. A micro-meso-macro conceptual framework guided the analysis of 33 publications, focusing on baccalaureate-prepared Registered Nurses. Key determinants were identified across three levels. Micro-level factors included personal characteristics, professional identity and safety considerations. Meso-level factors, addressed in 32 studies, encompassed health services programmes, organisational culture, management approaches and professional development opportunities. Macro-level factors included community engagement, educational pathways, scope of practice policies and government initiatives. Significant interconnections existed between factors across all levels. While targeted interventions show promise, programmes need systematic evaluation using standardised frameworks. Research priorities include longitudinal effectiveness studies, economic impact analyses and the development of practical implementation tools. A sustainable rural nursing workforce requires integrated approaches that simultaneously address individual, organisational and systemic factors. Success depends on evidence-based collaboration between healthcare organisations, educational institutions and government bodies to strengthen rural healthcare delivery through coordinated multilevel strategies.