Diversity, equity and inclusion in nursing professions in Germany: Systematic literature review on the current state of research and implementation

Status:

completed 03/2025

Aims:

Based on a systematic literature analysis, the aim is to clarify

a) the extent and form of diversity in the nursing professions in Germany,

b) the significance of diversity for the health and well-being of employees,

c) the development of diversity in the nursing professions and among patients that can be expected in Germany in the future,

d) the extent to which inclusion measures are planned or have already been introduced and what barriers may exist,

e) what further steps are necessary to contribute preventively to a better consideration of diversity, equal opportunities and inclusion in the interests of the health of carers in Germany.

Activities/Methods:

Research Design: This research was a narrative systematic literature review based on a descriptive analysis of multiple search engines, a standard in nursing research.

Studies’ Search Identification Approach

Studies were identified by searching the scientific databases PubMed, Psyndex, Web of Science, and Embase to identify primary articles reporting on diversity, equity, and inclusion in nursing professions in Germany.

Inclusion/Exclusion Criteria

The search strategy included studies that satisfied all the following criteria:

• Studies that focus on DE&I practices that relate to nursing in Germany.
• Studies in both German and English.
• The inclusion encompasses original research publications, reviews of any kind, comments, letters to the editor, editorials, and case reports, if applicable.
• All studies relevant to this systematic review are included regardless of the time or year.

The search strategy excluded papers where any of the following applied:

• Studies that describe diversity, equity, and inclusion from a patient perspective, as this research focuses on nursing professions in Germany.
• Articles in a language other than English and German.
• Studies focusing on other health professions other than nursing.

Search Strategy The search terminologies included specific keywords: divers* OR Equity OR Equality OR Inclusion OR Inclusive OR belonging AND nurs* AND German*.

Results:

144 of 1,881 publications (7.7%) met the initial inclusion criteria. After cleaning for exclusion criteria, k=24 (1.3%) relevant original papers remained for analysis. Regarding the diversity dimensions, the most addressed topics were culture k=11 (23.4%) and language (k=10; 21.3%). General nursing was the most addressed professional group (k=19; 79.2%). Publications identified were mostly qualitative studies (k=8; 33.3%). Discrimination was the main barrier (k=8; 44.4%) towards achieving equity and inclusion. Education (awareness-raising) played the most significant role (k=8; 32.0%) in the successful implementation and realisation of DE&I in nursing. The concept of DE&I was addressed respectively: diversity (k=19; 51.4%), inclusion (k=14; 37.8 %), and equity (k=4; 10.8%).

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