Topic: An intersectionality analysis of the task allocation to nurses (at a ward level) in healthcare settings: A systematic review protocol

Topic: An intersectionality analysis of the task allocation to nurses (at a ward level) in healthcare settings: A systematic review protocol | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Topic: An intersectionality analysis of the task allocation to nurses (at a ward level) in healthcare settings: A systematic review protocol Dusu Gyang Dung, Sadiq Bhanbhro, Carmel Bond, Anandi Ramamurthy This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6553825/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Assessing the nurses task allocation and workloads remains an area under researched. Clearly, there exist a limited amount of evidence in researching the division of labour in the nursing occupations. Several reports in the United Kingdom (UK), such as one from the Nursing Narratives: Racism and the Pandemic, has suspected the existence of inequality in the way task is allocated to nurses in healthcare settings. Using intersectionality lens this study aim to explore the role of different social identities (including ethnicity, race, gender, ability, class, etc.) in shaping nursing tasks allocation, responsibilities, and power dynamics in the UK healthcare settings. Methods and analysis: The following electronic databases will be searched from their inception to March 2025: CINHAL Complete, EMBASE, ASSIA, SCOPUS, MEDLINE, and PsycINFO. Grey sources include Google Scholar, and Open-Grey. Reference Lists and other relevant government and non-government websites will be searched using search combinations. All published primary research published in English and meets the inclusion criteria and are relevant to the topic will be selected. The primary investigator (PI) with at least two members of the supervisory team will involve in the article retrieval, removal of duplicates, screening, quality appraisal, and data analysis by the PI. Quality of the included literature using the Joanna Briggs institute (JBI) standardised tool for critical appraisal checklist. Final selected full-text articles will be qualitatively synthesised using both narrative pattern and thematic analysis and reported with the aid of inductive and deductive coding frameworks. We will present the findings with the aid of the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. Discussion: This systematic review will present a detailed synthesis of the evidence for inequality in nursing task allocation and power dynamics in the healthcare settings. We intended to leverage on identified gaps in the literatures for further investigation. Therefore, this systematic review is expected to provide requisite information required in designing the methodological phase of the study. Systematic review registration: PROSPERO CRD420251038899 Division of labour Tasks allocation Healthcare setting Intersectionality Nurses Figures Figure 1 Background The National Health Service (NHS) workforce has a higher proportion of members of racial and ethnic minority groups. This is especially true for staff groups, consisting of Asians (8.6%). Around 19% of NHS employees are foreign-born, with a high representation of Filipino, Irish immigrants, and Indians especially among nurses (Baker, 2023 ). The Workforce Race Equality Standard (WRES) report (2023) shows that 24.2% of staff working in NHS trusts in England are from ethnically minoritised backgrounds. However, immigrant and ethnically minoritised nursing groups are reported to disproportionately hold lower paid and junior positions when compared to their White counterparts (NHS Digital, 2021 ). Additionally, black and ethnically minoritised groups reported higher rates of racial harassment and discrimination (Likupe, 2015 ), are subject to more formal questions about their suitability to practice (West et al., 2017) and are exposed to unfavourable assumptions about their clinical abilities (Batnitzty& McDowell, 2011). This doctoral study builds on the findings from the Nursing Narratives: Racism and the Pandemic project. The project report found the level of discrimination and racism against nurses from ethnic minority backgrounds, regarding task allocation. Ethnically minoritised staff were forcefully redeployed to riskier wards/settings, assigned to riskier or more complex patients to manage, and allocated heavier workloads compared to their White colleagues. Migration status is often used as a weapon to coax this group of nurses into performing these tasks (Ramamurthy et al., 2022 ). Previous studies have also recorded unfair task allocation in the NHS (Archibong et al., 2019 ; Ross et al., 2020 ). This has resulted in job dissatisfaction and low staff retention, among other impacts. Furthermore, the findings from the American Community Survey data 2015 show that workers from disadvantaged socioeconomic groups face discriminatory workplace exclusion, which affects their access to jobs, ability to advance in their careers, the likelihood of facing disciplinary measures, and availability of support systems (Maroto, Pettinicchio, & Patterson, 2019 ). Heymann et al’s ( 2023 ) analysis of legal protections and gaps in all 193 UN countries report that there is the unwillingness of organisations to prohibit migration and racial and gender discrimination at the workplace, and where prohibited, employers tend not to take explicit measures to prevent workplace discrimination. Along this line, in a qualitative study involving 48 healthcare staff from London, Woodhead et al (2022) state that the experiences of those who identify as members of racial or ethnic minorities include being subjected to microaggressions, overtly unjust treatment, stereotyping, and prejudice. Furthermore, findings of the Talent Inclusion and Diversity Evaluation (TIDE) survey, in which 931 London-based healthcare practitioners participated, its findings suggest that these experiences are linked to increased mental health problems, adverse physical symptoms, low job satisfaction, and extended periods of sick leave in this workforce (Rhead et al., 2021 ). As a sociological and economic concept, the division of labour refers to the systematic allocation of specific tasks to individuals within a workplace context, thereby establishing a structured framework for productivity within a designated timeframe. In some environments, this process may be routine and predictable, while in others, task allocation can exhibit variability and spontaneity (Syed et al., 2016 ). When examining task allocation among nurses through an intersectional lens, the division of labour can be defined as a dynamic interplay of social identities, roles, and power relations that influence how tasks are distributed and executed within healthcare settings (Lavander et al., 2016 ). Healthcare activities require varying discipline, experience, and training to improve patients' health (Allen & Hughes, 2017 ). A healthcare setting thrives through the division of labour between and within different staffing hierarchies. However, a few studies into how this task and hierarchy are assigned have expounded an intersectional intention (Gkiouleka et al., 2018; Gkiouleka, 2019 ). Thus, structural inequities within healthcare institutions can be best understood through an intersectional lens (Mothupi et al., 2023 ), to understand the drivers of intersectionality, apportioning task, and, by implication, leadership in healthcare systems (Allen et al., 2002 ). The intersectionality lens can enable research to explore how healthcare systems are embedded within societal structures and further reflect the nuance of power dynamics within these systems (Bohren et al., 2024 ). Previous research concerning colonial legacy shows that contemporary systems of oppression and power are historically rooted. This is typically seen in the way black people were brutally treated occupation-wise during the apartheid regime in South Africa (Young et al., 2020). Similarly, a systematic review on COVID-19-related infections expounded that in the United States, the worst affected health workers are the low-wage workers who constitute the majority of black, Hispanic, and African Americans (Mackey et al., 2021 ). Additionally, most of these workers are from racially minoritised communities and constitute the front-line workers (Mackey et al., 2021 ). In Australia and the United Kingdom, there is the report of systemic disparity targeted at healthcare workers. Consequently, healthcare workers from black and minority ethnic (BAME) backgrounds disproportionately experienced a high COVID-19-related mortality rate. This is in addition to the growing concerns about the disproportionate representation of BAME healthcare workers in the decision-making processes, the senior management boards, and promotions (Bhaskar et al., 2020 ). Additionally, research in countries like Ghana uncovers the dynamic application of intersectionality in service delivery. Intersecting factors such as religion and spatial location were found to be associated with healthcare inequality (Amoah &Afoakwah, 2023 ). The available evidence shows that there is a clear indication of the selective/unequal positioning of marginalised groups within the systems (Musheno, Musheno, & Austin, 2021 ). Young et al (2020) recommend that future research should consider going beyond individual labels and tackling the power plays and negotiations that promote institutional inequality. Similarly, Sims & Alvarez ( 2022 ) argue that research should address indicators of disadvantages and privileges and push for data collection across all groups. Intersectionality acknowledges that social identities are not experienced in isolation but are interconnected and mutually constitutive (Hankivsky, 2014 ; Gender Economy, 2024 ). In the context of task allocation in healthcare, understanding the intersectional influences of different factors, including identity markers, would be helpful because different social identities intersect to create unique experiences, challenges, and opportunities for healthcare professionals (Hankivsky, 2014 ). When measured at the population level, inequities are often masked. It is hard to depict the root causes and/or address them. In the context of task allocation within healthcare settings, disadvantages and privileges are never dichotomous (Young et al., 2020). Previous literature reviews concerning nursing work have uncovered: 1) negligence of the contributions of nursing labour in healthcare setting (Afolabi et al., 2019 ). 2) several domains to what constitute the nursing labour (Jackson et al., 2021 ). That the emotional, physical, and organisational aspects of nursing labour are neither skilled nor complicated cognitive/mental workload. However, beyond looking at the nature of the nursing labour, evidence of how nursing labour is delegated, and factors that inform task/workload allocation remains to be explored. By reviewing the available relevant literature, we intend to identify key gaps in empirical knowledge on nursing task allocation (Collins, 2015 ). Subsequently, this review aims to systematically identify, thematically analyse, and narrate how different social identities intersect and shape the allocation of tasks, responsibilities, and power dynamics within healthcare settings. Review Question Do different social identities including ethnicity, race, gender, ability and class, intersect and shape the allocation of tasks, responsibilities, and power dynamics within healthcare settings in the UK? Objectives: To review sources that : Assess nurses’ tasks and time allocation in hospital/healthcare settings. Compare the task allocation of nurses from racialised backgrounds and white nurses. Explore the experiences and perspectives of nurses from ethnic minority backgrounds regarding the allocation of daily tasks in their wards. Seek to understand the impact of perceived inequitable task allocation on the career, motivation, and well-being of nurses from ethnic minority backgrounds and the impact on patient care. Document the views of managers, matrons, or sisters on methods of task allocation. Method The systematic review protocol is guided by the criteria set out in the Preferred Reporting Items for Systematic Reviews and Mata-analysis for Scoping Review (PRISMA-ScR) Checklist (Page, 2024 ). A systematic review of published articles related to task allocation in healthcare in the UK and beyond will be conducted through the Sheffield Hallam University (SHU) library gateway. All selected studies will be reviewed against the eligibility criteria. Eligible studies will be systematically presented using narrative synthesis or thematic analysis in accordance with a meta-aggregative approach (Munn et al., 2019 ). Search Strategy and Databases Language and time frame With the help of an experienced librarian, the search will include articles published in English from inception to May 2025. Searching for literatures from inception should yield thorough evidence and help focus on the past and most recently published article due to the possibility of policy changes in healthcare around the world before and after the COVID-19 pandemic. Eligibility criteria The PCC (Population [participants], Concept, and Context) framework will be used to decide the article’s eligibility for selection. Population refers to nurses (or midwives, matrons, sisters, and nurse managers) who are involved in direct care for patients in hospital/healthcare settings. Concept(s) (Position or banding, workload, social identities, and working conditions) are the work-related factors that determine how tasks are assigned in practices. Context (Hospital, Hospice, NHS Trust, Healthcare, Care homes) refers to study settings. Data sources Online databases include CINHAL Complete, EMBASE, ASSIA, SCOPUS, MEDLINE, and PsycINFO, Internurse.com, Nursing Times. Grey sources include Google Scholar, Undermind, and Open-Grey. Reference Lists and other relevant government and non-government websites will be searched using search combinations. The search process will be done iteratively building on the results of initial search. This systematic review will employ search terms and strategy summarised in Table 1 below: Table 1 Keywords and possible search combinations using Boolean (OR, AND, NOT) strings. Keywords Search Strategy Intersectionality Intersection* OR Gender OR Race OR Class OR Migration OR Band/Rank OR sexuality, OR Disability OR Ethnicity, OR Religion OR “Ethnically minoritised”OR etc. AND Division of labour “Division of labour” OR “Assign* Work” OR “Workload allocation” OR Redeployment OR “Task allocation” OR “Shift allocation” OR “Staffing and scheduling” OR “Nursing practice” OR Handover OR Paperwork OR “Ward round” OR “Nurses time allocation” OR Rota OR etc. AND Healthcare settings Healthcare OR Health* OR “National Health Service” OR NHS OR NHS Trust OR “Healthcare service” OR “Health institution” OR Hospital OR Hospice OR “Care Homes” OR “Mental healthcare” OR “Mental institution” OR Ward OR “Care homes” OR etc. AND Workers Nurs* OR Matron* OR Midwi* OR “Healthcare workers” OR “Healthcare workforce” OR “Front-line healthcare workers”, etc. Quality appraisal Two authors (DD and SB) will independently assess the quality of the included literature using the Joanna Briggs institute (JBI) standardised tool for critical appraisal checklist for qualitative data extraction (Munn, et al., 2014 ; McCann et al., 2019 ; Hadie et al., 2024). PRISMA-ScR guidelines will further ensure transparency in methodology and rigour in the review process. CB and AR are standby consults in the case there is a lack of consensus among the first two reviewers. Review management software (Covidence) will be employed to ensure records of our decisions are consistent, standardised, and excellent management of our data. Data extraction We will use a standardised data extraction (JBI) form to include the author(s), study title, objectives, study period, study design, sample size, method of data collection and analysis, context, study characteristics, key findings, journal, reviewer, outcomes, and conclusion (Peters et al., 2020; Pollock et al., 2023; Quan et al., 2023). Attention will be given to: Intersectional elements such as gender, race, migration, etc; Power dynamics; Workload allocation; Experience; Band OR Rank OR Level OR Promotion. Methodological rigour, sample size, and relevance to the research question, specifically regarding task allocation in healthcare settings. Study screening, selection, data management After searching the databases individually, abstracts and titles yielded from the search will be uploaded to Covidence software for conducting a systematic review and reviewed by the doctoral researcher and the supervisory team, and duplicates will be removed. Titles will be screened for eligibility criteria by the doctoral researcher and the supervisory team. Full-text articles will also be accessed and screened independently by the doctoral researcher and the director of study. We will keep a log of excluded studies, stating the reason for exclusion. In cases of disagreement and ambiguity, the doctoral student and the supervisory team will deliberate on inclusion. Should any study not match the inclusion criteria during the review, it will be removed. PRISMA-Protocol flowchart will be used to summarise article screening and selection steps (Alkhuzaimi et al., 2024 ; Hofman et al., 2023 ; 2024 ) (see Fig. 1 ). Full list of our inclusion criteria is in Table 2 below: Table 2 Study inclusion and exclusion criteria Inclusion criteria Exclusion criteria ● Population : Nurses, Matrons, Sisters, Nursing associates, Midwives, Nurse managers, and/or support workers with direct patient care. ● Focus of study : Nursing task allocation, Nursing responsibilities, Nursing handovers, Nursing Paperwork, Leadership style, Nursing workload, and Power dynamics involved. ● Timeline : Published from inception to May 2025. ● Geographical coverage : Studies undertaken in the United Kingdom and globally. ● Study type : Primary/empirical research published and grey literatures. ● Method : All methodological approaches. ● Language : Studies published in English. ● Studies that do not focus on task allocation in healthcare settings. ● Studies that lack well-defined theoretical approaches and/or Methodology (e.g., reports, essays, news articles, etc). ● Studies not involving nurses. ● Studies outside the healthcare. Data synthesis The information on the role of intersection in the task allocation in healthcare settings extracted from the final selected full-text articles will be qualitatively synthesised using a narrative pattern. The six steps in conducting thematic analysis by Braun and Clarck (2006) will be followed to identify codes, categories, themes, and patterns emerging from the articles (samples of superficial themes: Allocation of work; Role of social identities in task allocation; Intersectionality inform decisions in assigning task; Impact on patients and staff wellbeing; and social identities and Work hierarchy) and present the findings. The research question and the elements of intersectionality theory will guide the formulation of the coding framework (Barrios et al., 2021 ; DeBusschere & Maes, 2024). The processes of data coding will be constantly monitored and validated by the supervisory team to ensure consistency and rigour. The doctoral researcher and the supervisory team will meet fortnightly, to discuss emergent themes from the review and any discrepancies in the analysis. In the existing reviews, we will consider the implications of findings for research, policy, and practice and propose relevant recommendations. Discussion This systematic review will produce a holistic summary of the evidence for inequality in nursing task allocation and power dynamics in the (UK) healthcare settings. Previous findings have indicated negligence towards the contributions of nursing labour in the healthcare settings and the types and levels of the nursing labour (Afolabi et al., 2019; Jackson et al., 2021). Previous studies in the NHS have recorded unfair task allocation and an intersectional intention (Archibong et al., 2019; Ross et al., 2020). According to NHS Digital (2021) a data and information centre for health and social care in England, immigrant and ethnically minoritised nursing groups are reported to disproportionately hold salaries and lower ranks when compared to their White counterparts. Additionally, black and ethnically minoritised groups reported alarming rates of racial harassment and discrimination (Likupe, 2015), are subject to more formal questions about their suitability to practice (West et al., 2017) and are exposed to unfavourable assumptions about their clinical abilities (Batnitzty& McDowell, 2011). The review will provide clear information required in designing the data collection, data analysis, and the reporting tools for the UK nurses’ task allocation study. Abbreviations JBI Joanna Briggs Institute PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analysis CINAHL Cumulative Index to Nursing and Allied Health Literature MEDLINE Medical Literature Analysis and Retrieval Systemic Online EMBASE Excerpta Medica Database NHS National Health Service SHU Sheffield Hallam University GTA Graduate Teaching Assistant PROSPERO International Prospective Register of Systematic Reviews Declarations Ethics declaration: Not applicable. Authors Affiliation DD (MPH, MSc): PhD student and teaching assistant Centre for Applied Health and Social Care Research (CARe), Health Research Institute, Sheffield Hallam University, collegiate campus, Sheffield, S10 2BP. ORCiD: 0000-0002-1959-0229. SB (PhD): Director of study (DoS). Sheffield Hallam University, Centre for Applied Health and Social Care Research (CARe), S10 2BP. ORCiD: 0000-0003-0771-8130. AR (Professor Emeritus): First supervisor Sheffield Hallam University, Centre for Culture, Media & Society, S1 1WB. ORCiD: 0000-0002-4830-9029. CB (PhD): Second supervisor Sheffield Hallam University, School of Health and Social care, Health Research Institute, S10 2BP. ORCiD: 0000-0002-9945-8577. Research Team Doctoral Researcher: Dusu Dung Dusu conceptualised and drafted the review protocol, organised meetings with the supervisory team and pushed the work for publication. Supervisory Team: Dr Sadiq Bhanbhro (Director of Studies). Professor Anandi Ramamurthy (Emeritus) (First Supervisor). Dr Carmel Bond (Second Supervisor). DD and the supervisory team hold meetings at least twice a month during which they iteratively deliberate on what to include and/or exclude in the protocol. The team monitors, guides, and advises DD throughout the protocol design and systematic review writing processes. They ensure that due diligence is followed to resolve conflicts and make modifications where necessary. Authors’ Roles: DD will oversee the project, draft the protocol, select the study, extract the data, assess quality, interpret the results, and prepare the manuscript under the supervision of SB and CB. SB and CB will thoroughly review, provide feedback, and contribute to the intellectual content of this paper. All authors (DD, SB, CB, and AR) will make substantial contributions to the conception and contextualisation of the study protocol. All authors must read and approve the final manuscript. Corresponding authors: Dusu Dung (email: [email protected] ); and Sadiq Bhanbhro ( [email protected] ) are the corresponding authors. Consent to participate declaration: Not applicable Consent to publish declaration: Not applicable Dissemination: Work from this protocol will be published in a peer-reviewed journal and possibly presented in posters and/or conferences. Acknowledgement: We extend our heartfelt gratitude to the Health Research Institute (HRI) at Sheffield Hallam University (SHU) for funding DD’s doctoral study. Funding: DD’s doctoral study is fully funded by Sheffield Hallam University under its graduate teaching Assistantship (GTA) programme. Data and Materials: The systematic review article will include only data extracted from articles that meet the criteria set out in this review protocol. Competing Interest: Authors declare no competing interest Clinical trial number: Not applicable Open Access: This is an open-access article distributed based on a Creative Commons Attribution 4.0 International (CC BY-NC-ND 4.0) Licence, which allows the public to copy, remix, redistribute, build upon, and transform this work for any purpose. Original work must be appropriately credited. See the link to the licence: https://creativecommons.org/licenses/by/4.0/ References Afolabi O, Abboah-Offei M, Nkhoma K, Evans C. Task-shifting must recognise the professional role of nurses. Lancet Global Health. 2019;7(10):e1328–9. Alkhuzaimi F, Rainey D, Wilson CB, Bloomfield J. The impact of mobile health interventions on service users’ health outcomes and the role of health professions: a systematic review of systematic reviews—protocol. Syst Reviews. 2024;13(1):199. Allen D, Hughes D. Nursing and the Division of Labour in Healthcare. Bloomsbury Publishing; 2017. Allen D, Hughes D, Jordan S, Prowse M, Snelgrove S, Hughes D. Nursing and the division of labour: sociological perspectives. Nursing and the Division of Labour in Healthcare; 2002. pp. 1–21. Amoah JO, Afoakwah C. Unravelling the Health Inequalities in Ghana: An Intersectional Perspective. Soc Indic Res. 2023;170(3):987–1006. Archibong U, Kline R, Eshareturi C, McIntosh B. (2019). Disproportionality in NHS disciplinary proceedings. British Journal of Healthcare Management; 25(4):1–7. https://doi.org/10.12968/bjhc.2018.0062 Baker C. (2023). NHS staff from overseas: statistics. Retrieve March 13, 2024, from NHS staff from overseas: statistics - House of Commons Library (parliament.uk). Barrios VR, Khaw LBL, Bermea A, Hardesty JL. Future directions in intimate partner violence research: An intersectionality framework for analyzing women’s processes of leaving abusive relationships. J interpers Violence. 2021;36(23–24):NP12600–25. Batnitzky A, McDowell L. Migration, nursing, institutional discrimination and emotional/affective labour: ethnicity and labour stratification in the UK National Health Service. Social Cult Geogr. 2011;12(2):181–201. https://doi.org/10.1080/14649365.2011.545142 . Bhaskar S, Rastogi A, Menon KV, Kunheri B, Balakrishnan S, Howick J. Call for action to address equity and justice divide during COVID–19. Front Psychiatry. 2020;11:559905. Bohren MA, Iyer A, Barros AJ, Williams CR, Hazfiarini A, Arroyave L, Oladapo OT. (2024). Towards a better tomorrow: addressing intersectional gender power relations to eradicate inequities in maternal health. EClinicalMedicine, 67. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77–101. Braun V, Clarke V. Thematic analysis. American Psychological Association; 2012. Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qualitative Res sport Exerc health. 2019;11(4):589–97. Braun V, Clarke V. Conceptual and design thinking for thematic analysis. Qualitative Psychol. 2022;9(1):3. Collins PH. Intersectionality's definitional dilemmas. Ann Rev Sociol. 2015;41:1–20. Crenshaw KW. Mapping the margins: Intersectionality, identity politics, and violence against women of color. The public nature of private violence. Routledge; 2013. pp. 93–118. Debusscher P, Maes EL. (2024). The European Union-Intersectionality Framework: Unpacking Intersectionality in the ‘Union of Equality’Agenda. Political Stud Rev, 14789299241242343. Dominicé Dao M, Inglin S, Vilpert S, Hudelson P. The relevance of clinical ethnography: reflections on 10 years of a cultural consultation service. BMC Health Serv Res. 2018;18:1–11. Gender Economy. (2024). Intersectionality and the implication for workplace gender equity: Intersectionality and the implications for workplace gender equity | Gender and the Economy (gendereconomy.org). Gkiouleka A. (2019). An Intersectionality Informed Analytical Framework for Health Inequalities in Europe-The co-constituting roles of Socio-economic Position, Gender, and Migration (Doctoral dissertation, University of York). Hankivsky O. Rethinking care ethics: On the promise and potential of an intersectional analysis. Am Polit Sci Rev. 2014;108(2):252–64. Heymann J, Varvaro-Toney S, Raub A, Kabir F, Sprague A. (2023). Race, ethnicity, and discrimination at work: a new analysis of legal protections and gaps in all 193 UN countries. Equality, Diversity and Inclusion: An International Journal, 42(9), 16–34. Hofman H, Beeckman D, Duljic T, Al Gilani S, Johansson S, Kottner J, Eriksson M. (2023). Patients’ experiences with the application of medical adhesives to the skin: a qualitative systematic review protocol. BMJ open, 13(6), e073546. Hofman H, Duljic T, Johansson S, Kottner J, Kinnaer LM, Beeckman D, Eriksson M. (2024). Patients’ experiences with the application of medical adhesives to the skin: a qualitative systematic review. BMJ open, 14(10), e089773. Hadie SNH. (2024). ABC of a Scoping Review: A Simplified JBI Scoping Review Guideline. Educ Med J, 16(2). Jackson J, Anderson JE, Maben J. What is nursing work? A meta-narrative review and integrated framework. Int J Nurs Stud. 2021;122:103944. Lavander P, Meriläinen M, Turkki L. Working time use and division of labour among nurses and health-care workers in hospitals–a systematic review. J Nurs Adm Manag. 2016;24(8):1027–40. Leslie M, Paradis E, Gropper MA, Reeves S, Kitto S. Applying ethnography to the study of context in healthcare quality and safety. BMJ Qual Saf. 2014;23(2):99–105. Likupe G. Experiences of African nurses and the perception of their managers in the NHS. J Nurs Adm Manag. 2015;23(2):231–41. https://doi.org/10.1111/jonm.12119 . Likupe G, Archibong U. Black African Nurses’ experiences of equality, racism, and discrimination in the National. Health Service J Psychol Issues Organizational Cult. 2013;3(S1):227–46. https://doi.org/10.1002/jpoc.21071 . Mackey K, Ayers CK, Kondo KK, Saha S, Advani SM, Young S, Kansagara D. Racial and ethnic disparities in COVID–19–related infections, hospitalizations, and deaths: a systematic review. Ann Intern Med. 2021;174(3):362–73. Maroto M, Pettinicchio D, Patterson AC. Hierarchies of categorical disadvantage: Economic insecurity at the intersection of disability, gender, and race. Gend Soc. 2019;33(1):64–93. McCann E, Donohue G, de Jager J, Nugter A, Stewart J, Eustace-Cook J. Sexuality and intimacy among people with serious mental illness: a qualitative systematic review. JBI Database Syst Reviews Implement Rep. 2019;17(1):74–125. 10.11124/JBISRIR–2017–003824 . Mothupi M, Dasgupta J, Jebeli SSH, Stevenson J, Berdichevsky K, Vong S, George A. (2023). Gender Equality and Pandemic Response: Using an intersectionality approach to transform health services for overlooked healthcare users and workers after covid–19. The BMJ, 381. Munn Z, Moola S, Riitano D, Lisy K. The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J health policy Manage. 2014;3(3):123. Munn Z, Aromataris E, Tufanaru C, Stern C, Porritt K, Farrow J, Lockwood C, Stephenson M, Moola S, Lizarondo L, McArthur A, Peters M, Pearson A, Jordan Z. The development of software to support multiple systematic review types. Int J Evid Based Healthc. 2019;17(1):36–43. 10.1097/XEB.0000000000000152 . Musheno M, Musheno BV, Austin M. Exploring the prevalence and meaning of frontline work in the COVID–19 era: implications for policy analysis. J Comp Policy Analysis: Res Pract. 2021;23(1):30–40. Nguyen NT, Chia YT. Decolonizing research imagination: A journey of reshaping research epistemology and ontology. Asia Pac Educ Rev. 2023;24(2):213–26. NHS Digital. (2021). NHS workforce statistics – January 2021. Retrieved March 2024, from https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/january–2021 Nixon SA. The coin model of privilege and critical allyship: implications for health. BMC Public Health. 2019;19(1):1637. Norton MJ. Peer support working: a question of ontology and epistemology? Int J Mental Health Syst. 2023;17(1):1. Page ON. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Br J Sports Med. 2024;1001:58. Peel DK. 2010. Qualitative research methods. Criminological research and evaluation methods: Research themes, 55–57. Peters, M. D., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., …Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews.JBI evidence synthesis, 18(10), 2119–2126. Pollock, D., Peters, M. D., Khalil, H., McInerney, P., Alexander, L., Tricco, A. C.,… Munn, Z. (2023). Recommendations for the extraction, analysis, and presentation of results in scoping reviews.JBI evidence synthesis, 21(3), 520–532. Quan, C., Clark, N., Costigan, C. L., Murphy, J., Li, M., David, A., … Cross, B. (2023).JBI systematic review protocol of text/opinions on how to best collect race-based data in healthcare contexts.BMJ open, 13(5), e069753. Rahman MS. The advantages and disadvantages of using qualitative and quantitative approaches and methods in language testing and assessment research. A literature review; 2020. Ramamurthy A, Bhanbhro S, Bruce F, Gumber A, Fero K. Nursing narratives: Racism and the pandemic. The report was submitted to the UKRI-Covid Rapid Response Call Project. Sheffield, UK: Sheffield Hallam University; 2022. Rhead RD, Chui Z, Bakolis I, Gazard B, Harwood H, MacCrimmon S, Woodhead C, Hatch SL. Impact of workplace discrimination and harassment among National Health Service staff working in London trusts: results from the TIDES study. BJPsych Open. 2021;7(1):137. https://doi.org/10.1192/bjo.2020.137 . Ross S, Jabbal J, Chauhan K, Maguire D, Randhawa M, Dahir S. (2020). Workforce race inequalities and inclusion in NHS providers. King's Fund. https://www.nhsbmenetwork.org.uk/wp-content/uploads/2021/06/workforce-race-inequalities-inclusion-nhs-providers-july2020.pdf Sims H, Alvarez C. Frontline healthcare workers experiences and challenges with in-person and remote work during the COVID–19 pandemic: a qualitative study. Front public health. 2022;10:983414. Spinnewijn L, Aarts J, Verschuur S, Braat D, Gerrits T, Scheele F. (2020). Knowing what the patient wants: a hospital ethnography studying physician culture in shared decision making in the Netherlands. BMJ open, 10(3), e032921. Strudwick RM. Ethnographic research in healthcare–patients and service users as participants. Disabil Rehabil. 2021;43(22):3271–5. Syed I, Daly T, Armstrong P, Lowndes R, Chadoin M, Naidoo V. How do work hierarchies and strict divisions of labour impact care workers’ experiences of health and safety? case studies of long-term care in Toronto. J Nurs home Res Sci. 2016;2(1):41. West M, Dawson J, Kaur M. (2015). Making the difference: Diversity and inclusion in the NHS. Retrieved November 24, 2021, from https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Making-the-difference-summary-Kings-Fund-Dec–2015.pdf Woodhead, C., Stoll, N., Harwood, H., TIDES Study Team, Alexis, O., Hatch, S. L.,… Valmaggia, L. (2022). They created a team of almost entirely the people who work and are like them: A qualitative study of organisational culture and racialised inequalities among healthcare staff. Sociology of health & illness, 44(2), 267–289. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6553825","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":473247186,"identity":"78712ba2-5b7d-43e2-a21e-c4e9a1cf4c49","order_by":0,"name":"Dusu Gyang Dung","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuklEQVRIiWNgGAWjYBACewb+A0DKhsEAKmCARzEEGDbwJACpNBK0GBzgASk6TJoWM+mCX+ftzSUSGD/8YDhsTJyWmX23E3fOSGCW7GE4bEacFt6e2wkGNxIYpIEutCFWyzl7oBbm38Rr4flxgHHDjQQ2kC2EHWbYzJNszduQnLjhzMM2yx6DdMLet2fvP3ib54+dvcHx5MM3flRYGzYQ1MMMxIxtIBZjAzGxAgN/iFY5CkbBKBgFIxEAAHs2OOC/ZkzyAAAAAElFTkSuQmCC","orcid":"","institution":"Sheffield Hallam University","correspondingAuthor":true,"prefix":"","firstName":"Dusu","middleName":"Gyang","lastName":"Dung","suffix":""},{"id":473247187,"identity":"e6650874-0b90-40dd-8d92-9b6677064609","order_by":1,"name":"Sadiq Bhanbhro","email":"","orcid":"","institution":"Sheffield Hallam University","correspondingAuthor":false,"prefix":"","firstName":"Sadiq","middleName":"","lastName":"Bhanbhro","suffix":""},{"id":473247188,"identity":"9c68de7b-baa5-44e7-b15b-b1b74c8e775e","order_by":2,"name":"Carmel Bond","email":"","orcid":"","institution":"Sheffield Hallam University","correspondingAuthor":false,"prefix":"","firstName":"Carmel","middleName":"","lastName":"Bond","suffix":""},{"id":473247189,"identity":"d6951d82-1fc2-4d5f-8183-aa11b20f6a6b","order_by":3,"name":"Anandi Ramamurthy","email":"","orcid":"","institution":"Sheffield Hallam University","correspondingAuthor":false,"prefix":"","firstName":"Anandi","middleName":"","lastName":"Ramamurthy","suffix":""}],"badges":[],"createdAt":"2025-04-29 07:53:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6553825/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6553825/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84976007,"identity":"886a8d6c-4924-4114-a42d-fdeef5528605","added_by":"auto","created_at":"2025-06-19 12:15:41","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":56070,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003ePRISMA diagram\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6553825/v1/74d9cfd359c8875422395f00.png"},{"id":88045762,"identity":"6ca5107c-c052-4ce1-8c82-39a9092b85dd","added_by":"auto","created_at":"2025-07-31 18:16:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":746578,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6553825/v1/8bc1642a-57f7-42ec-bac4-c44e89baaabd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Topic: An intersectionality analysis of the task allocation to nurses (at a ward level) in healthcare settings: A systematic review protocol","fulltext":[{"header":"Background","content":"\u003cp\u003eThe National Health Service (NHS) workforce has a higher proportion of members of racial and ethnic minority groups. This is especially true for staff groups, consisting of Asians (8.6%). Around 19% of NHS employees are foreign-born, with a high representation of Filipino, Irish immigrants, and Indians especially among nurses (Baker, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The Workforce Race Equality Standard (WRES) report (2023) shows that 24.2% of staff working in NHS trusts in England are from ethnically minoritised backgrounds. However, immigrant and ethnically minoritised nursing groups are reported to disproportionately hold lower paid and junior positions when compared to their White counterparts (NHS Digital, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Additionally, black and ethnically minoritised groups reported higher rates of racial harassment and discrimination (Likupe, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2015\u003c/span\u003e), are subject to more formal questions about their suitability to practice (West et al., 2017) and are exposed to unfavourable assumptions about their clinical abilities (Batnitzty\u0026amp; McDowell, 2011).\u003c/p\u003e \u003cp\u003eThis doctoral study builds on the findings from the Nursing Narratives: Racism and the Pandemic project. The project report found the level of discrimination and racism against nurses from ethnic minority backgrounds, regarding task allocation. Ethnically minoritised staff were forcefully redeployed to riskier wards/settings, assigned to riskier or more complex patients to manage, and allocated heavier workloads compared to their White colleagues. Migration status is often used as a weapon to coax this group of nurses into performing these tasks (Ramamurthy et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Previous studies have also recorded unfair task allocation in the NHS (Archibong et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Ross et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This has resulted in job dissatisfaction and low staff retention, among other impacts. Furthermore, the findings from the American Community Survey data 2015 show that workers from disadvantaged socioeconomic groups face discriminatory workplace exclusion, which affects their access to jobs, ability to advance in their careers, the likelihood of facing disciplinary measures, and availability of support systems (Maroto, Pettinicchio, \u0026amp; Patterson, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHeymann et al\u0026rsquo;s (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) analysis of legal protections and gaps in all 193 UN countries report that there is the unwillingness of organisations to prohibit migration and racial and gender discrimination at the workplace, and where prohibited, employers tend not to take explicit measures to prevent workplace discrimination. Along this line, in a qualitative study involving 48 healthcare staff from London, Woodhead et al (2022) state that the experiences of those who identify as members of racial or ethnic minorities include being subjected to microaggressions, overtly unjust treatment, stereotyping, and prejudice. Furthermore, findings of the Talent Inclusion and Diversity Evaluation (TIDE) survey, in which 931 London-based healthcare practitioners participated, its findings suggest that these experiences are linked to increased mental health problems, adverse physical symptoms, low job satisfaction, and extended periods of sick leave in this workforce (Rhead et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs a sociological and economic concept, the division of labour refers to the systematic allocation of specific tasks to individuals within a workplace context, thereby establishing a structured framework for productivity within a designated timeframe. In some environments, this process may be routine and predictable, while in others, task allocation can exhibit variability and spontaneity (Syed et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). When examining task allocation among nurses through an intersectional lens, the division of labour can be defined as a dynamic interplay of social identities, roles, and power relations that influence how tasks are distributed and executed within healthcare settings (Lavander et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHealthcare activities require varying discipline, experience, and training to improve patients' health (Allen \u0026amp; Hughes, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). A healthcare setting thrives through the division of labour between and within different staffing hierarchies. However, a few studies into how this task and hierarchy are assigned have expounded an intersectional intention (Gkiouleka et al., 2018; Gkiouleka, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Thus, structural inequities within healthcare institutions can be best understood through an intersectional lens (Mothupi et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), to understand the drivers of intersectionality, apportioning task, and, by implication, leadership in healthcare systems (Allen et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). The intersectionality lens can enable research to explore how healthcare systems are embedded within societal structures and further reflect the nuance of power dynamics within these systems (Bohren et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePrevious research concerning colonial legacy shows that contemporary systems of oppression and power are historically rooted. This is typically seen in the way black people were brutally treated occupation-wise during the apartheid regime in South Africa (Young et al., 2020). Similarly, a systematic review on COVID-19-related infections expounded that in the United States, the worst affected health workers are the low-wage workers who constitute the majority of black, Hispanic, and African Americans (Mackey et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Additionally, most of these workers are from racially minoritised communities and constitute the front-line workers (Mackey et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). In Australia and the United Kingdom, there is the report of systemic disparity targeted at healthcare workers. Consequently, healthcare workers from black and minority ethnic (BAME) backgrounds disproportionately experienced a high COVID-19-related mortality rate. This is in addition to the growing concerns about the disproportionate representation of BAME healthcare workers in the decision-making processes, the senior management boards, and promotions (Bhaskar et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Additionally, research in countries like Ghana uncovers the dynamic application of intersectionality in service delivery. Intersecting factors such as religion and spatial location were found to be associated with healthcare inequality (Amoah \u0026amp;Afoakwah, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The available evidence shows that there is a clear indication of the selective/unequal positioning of marginalised groups within the systems (Musheno, Musheno, \u0026amp; Austin, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eYoung et al (2020) recommend that future research should consider going beyond individual labels and tackling the power plays and negotiations that promote institutional inequality. Similarly, Sims \u0026amp; Alvarez (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) argue that research should address indicators of disadvantages and privileges and push for data collection across all groups.\u003c/p\u003e \u003cp\u003eIntersectionality acknowledges that social identities are not experienced in isolation but are interconnected and mutually constitutive (Hankivsky, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Gender Economy, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). In the context of task allocation in healthcare, understanding the intersectional influences of different factors, including identity markers, would be helpful because different social identities intersect to create unique experiences, challenges, and opportunities for healthcare professionals (Hankivsky, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). When measured at the population level, inequities are often masked. It is hard to depict the root causes and/or address them. In the context of task allocation within healthcare settings, disadvantages and privileges are never dichotomous (Young et al., 2020).\u003c/p\u003e \u003cp\u003ePrevious literature reviews concerning nursing work have uncovered: 1) negligence of the contributions of nursing labour in healthcare setting (Afolabi et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). 2) several domains to what constitute the nursing labour (Jackson et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). That the emotional, physical, and organisational aspects of nursing labour are neither skilled nor complicated cognitive/mental workload. However, beyond looking at the nature of the nursing labour, evidence of how nursing labour is delegated, and factors that inform task/workload allocation remains to be explored.\u003c/p\u003e \u003cp\u003eBy reviewing the available relevant literature, we intend to identify key gaps in empirical knowledge on nursing task allocation (Collins, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Subsequently, this review aims to systematically identify, thematically analyse, and narrate how different social identities intersect and shape the allocation of tasks, responsibilities, and power dynamics within healthcare settings.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eReview Question\u003c/strong\u003e \u003cp\u003eDo different social identities including ethnicity, race, gender, ability and class, intersect and shape the allocation of tasks, responsibilities, and power dynamics within healthcare settings in the UK?\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eObjectives: To review sources that\u003c/b\u003e:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAssess nurses\u0026rsquo; tasks and time allocation in hospital/healthcare settings.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eCompare the task allocation of nurses from racialised backgrounds and white nurses.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eExplore the experiences and perspectives of nurses from ethnic minority backgrounds regarding the allocation of daily tasks in their wards.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSeek to understand the impact of perceived inequitable task allocation on the career, motivation, and well-being of nurses from ethnic minority backgrounds and the impact on patient care.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eDocument the views of managers, matrons, or sisters on methods of task allocation.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003eThe systematic review protocol is guided by the criteria set out in the Preferred Reporting Items for Systematic Reviews and Mata-analysis for Scoping Review (PRISMA-ScR) Checklist (Page, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). A systematic review of published articles related to task allocation in healthcare in the UK and beyond will be conducted through the Sheffield Hallam University (SHU) library gateway. All selected studies will be reviewed against the eligibility criteria. Eligible studies will be systematically presented using narrative synthesis or thematic analysis in accordance with a meta-aggregative approach (Munn et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSearch Strategy and Databases\u003c/h2\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003eLanguage and time frame\u003c/h2\u003e \u003cp\u003eWith the help of an experienced librarian, the search will include articles published in English from inception to May 2025. Searching for literatures from inception should yield thorough evidence and help focus on the past and most recently published article due to the possibility of policy changes in healthcare around the world before and after the COVID-19 pandemic.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eEligibility criteria\u003c/h3\u003e\n\u003cp\u003eThe PCC (Population [participants], Concept, and Context) framework will be used to decide the article\u0026rsquo;s eligibility for selection.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePopulation\u003c/b\u003e refers to nurses (or midwives, matrons, sisters, and nurse managers) who are involved in direct care for patients in hospital/healthcare settings.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConcept(s)\u003c/b\u003e (Position or banding, workload, social identities, and working conditions) are the work-related factors that determine how tasks are assigned in practices.\u003c/p\u003e \u003cp\u003e \u003cb\u003eContext\u003c/b\u003e (Hospital, Hospice, NHS Trust, Healthcare, Care homes) refers to study settings.\u003c/p\u003e\n\u003ch3\u003eData sources\u003c/h3\u003e\n\u003cp\u003eOnline databases include CINHAL Complete, EMBASE, ASSIA, SCOPUS, MEDLINE, and PsycINFO, Internurse.com, Nursing Times. Grey sources include Google Scholar, Undermind, and Open-Grey. Reference Lists and other relevant government and non-government websites will be searched using search combinations. The search process will be done iteratively building on the results of initial search.\u003c/p\u003e \u003cp\u003eThis systematic review will employ search terms and strategy summarised in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below:\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKeywords and possible search combinations using Boolean (OR, AND, NOT) strings.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeywords\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSearch Strategy\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntersectionality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntersection* OR Gender OR Race OR Class OR Migration OR Band/Rank OR sexuality, OR Disability OR Ethnicity, OR Religion OR \u0026ldquo;Ethnically minoritised\u0026rdquo;OR etc. AND\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivision of labour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Division of labour\u0026rdquo; OR \u0026ldquo;Assign* Work\u0026rdquo; OR \u0026ldquo;Workload allocation\u0026rdquo; OR Redeployment OR \u0026ldquo;Task allocation\u0026rdquo; OR \u0026ldquo;Shift allocation\u0026rdquo; OR \u0026ldquo;Staffing and scheduling\u0026rdquo; OR \u0026ldquo;Nursing practice\u0026rdquo; OR Handover OR Paperwork OR \u0026ldquo;Ward round\u0026rdquo; OR \u0026ldquo;Nurses time allocation\u0026rdquo; OR Rota OR etc. AND\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthcare settings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealthcare OR Health* OR \u0026ldquo;National Health Service\u0026rdquo; OR NHS OR NHS Trust OR \u0026ldquo;Healthcare service\u0026rdquo; OR \u0026ldquo;Health institution\u0026rdquo; OR Hospital OR Hospice OR \u0026ldquo;Care Homes\u0026rdquo; OR \u0026ldquo;Mental healthcare\u0026rdquo; OR \u0026ldquo;Mental institution\u0026rdquo; OR Ward OR \u0026ldquo;Care homes\u0026rdquo; OR etc. AND\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorkers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNurs* OR Matron* OR Midwi* OR \u0026ldquo;Healthcare workers\u0026rdquo; OR \u0026ldquo;Healthcare workforce\u0026rdquo; OR \u0026ldquo;Front-line healthcare workers\u0026rdquo;, etc.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eQuality appraisal\u003c/h3\u003e\n\u003cp\u003eTwo authors (DD and SB) will independently assess the quality of the included literature using the Joanna Briggs institute (JBI) standardised tool for critical appraisal checklist for qualitative data extraction (Munn, et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; McCann et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Hadie et al., 2024). PRISMA-ScR guidelines will further ensure transparency in methodology and rigour in the review process. CB and AR are standby consults in the case there is a lack of consensus among the first two reviewers. Review management software (Covidence) will be employed to ensure records of our decisions are consistent, standardised, and excellent management of our data.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData extraction\u003c/h2\u003e \u003cp\u003eWe will use a standardised data extraction (JBI) form to include the author(s), study title, objectives, study period, study design, sample size, method of data collection and analysis, context, study characteristics, key findings, journal, reviewer, outcomes, and conclusion (Peters et al., 2020; Pollock et al., 2023; Quan et al., 2023).\u003c/p\u003e \u003cp\u003eAttention will be given to:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eIntersectional elements such as gender, race, migration, etc; Power dynamics; Workload allocation; Experience; Band OR Rank OR Level OR Promotion.\u003c/span\u003e \u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eMethodological rigour, sample size, and relevance to the research question, specifically regarding task allocation in healthcare settings.\u003c/span\u003e \u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy screening, selection, data management\u003c/h3\u003e\n\u003cp\u003eAfter searching the databases individually, abstracts and titles yielded from the search will be uploaded to Covidence software for conducting a systematic review and reviewed by the doctoral researcher and the supervisory team, and duplicates will be removed. Titles will be screened for eligibility criteria by the doctoral researcher and the supervisory team. Full-text articles will also be accessed and screened independently by the doctoral researcher and the director of study. We will keep a log of excluded studies, stating the reason for exclusion. In cases of disagreement and ambiguity, the doctoral student and the supervisory team will deliberate on inclusion. Should any study not match the inclusion criteria during the review, it will be removed. PRISMA-Protocol flowchart will be used to summarise article screening and selection steps (Alkhuzaimi et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Hofman et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Full list of our inclusion criteria is in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e below:\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStudy inclusion and exclusion criteria\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInclusion criteria\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExclusion criteria\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e● \u003cspan type=\"BoldSmallCaps\" class=\"BoldSmallCaps\" name=\"Emphasis\"\u003ePopulation\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eNurses, Matrons, Sisters, Nursing associates, Midwives, Nurse managers, and/or support workers with direct patient care.\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"BoldSmallCaps\" class=\"BoldSmallCaps\" name=\"Emphasis\"\u003eFocus of study\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eNursing task allocation, Nursing responsibilities, Nursing handovers, Nursing Paperwork, Leadership style, Nursing workload, and Power dynamics involved.\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"BoldSmallCaps\" class=\"BoldSmallCaps\" name=\"Emphasis\"\u003eTimeline\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003ePublished from inception to May 2025.\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"BoldSmallCaps\" class=\"BoldSmallCaps\" name=\"Emphasis\"\u003eGeographical coverage\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eStudies undertaken in the United Kingdom and globally.\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"BoldSmallCaps\" class=\"BoldSmallCaps\" name=\"Emphasis\"\u003eStudy type\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003ePrimary/empirical research published and grey literatures.\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"BoldSmallCaps\" class=\"BoldSmallCaps\" name=\"Emphasis\"\u003eMethod\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eAll methodological approaches.\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"BoldSmallCaps\" class=\"BoldSmallCaps\" name=\"Emphasis\"\u003eLanguage\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eStudies published in English.\u003c/span\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e● \u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eStudies that do not focus on task allocation in healthcare settings.\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eStudies that lack well-defined theoretical approaches and/or Methodology (e.g., reports, essays, news articles, etc).\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eStudies not involving nurses.\u003c/span\u003e\u003c/p\u003e \u003cp\u003e● \u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eStudies outside the healthcare.\u003c/span\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eData synthesis\u003c/h3\u003e\n\u003cp\u003eThe information on the role of intersection in the task allocation in healthcare settings extracted from the final selected full-text articles will be qualitatively synthesised using a narrative pattern. The six steps in conducting thematic analysis by Braun and Clarck (2006) will be followed to identify codes, categories, themes, and patterns emerging from the articles (samples of superficial themes: Allocation of work; Role of social identities in task allocation; Intersectionality inform decisions in assigning task; Impact on patients and staff wellbeing; and social identities and Work hierarchy) and present the findings.\u003c/p\u003e \u003cp\u003eThe research question and the elements of intersectionality theory will guide the formulation of the coding framework (Barrios et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; DeBusschere \u0026amp; Maes, 2024). The processes of data coding will be constantly monitored and validated by the supervisory team to ensure consistency and rigour. The doctoral researcher and the supervisory team will meet fortnightly, to discuss emergent themes from the review and any discrepancies in the analysis. In the existing reviews, we will consider the implications of findings for research, policy, and practice and propose relevant recommendations.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis systematic review will produce a holistic summary of the evidence for inequality in nursing task allocation and power dynamics in the (UK) healthcare settings. \u0026nbsp;Previous findings have indicated negligence towards the contributions of nursing labour in the healthcare settings and the types and levels of the nursing labour (Afolabi et al., 2019; Jackson et al., 2021). Previous studies in the NHS have recorded unfair task allocation and an intersectional intention (Archibong et al., 2019; Ross et al., 2020).\u003c/p\u003e\n\u003cp\u003eAccording to NHS Digital (2021) a data and information centre for health and social care in England, immigrant and ethnically minoritised nursing groups are reported to disproportionately hold salaries and lower ranks when compared to their White counterparts. Additionally, black and ethnically minoritised groups reported alarming rates of racial harassment and discrimination (Likupe, 2015), are subject to more formal questions about their suitability to practice (West et al., 2017) and are exposed to unfavourable assumptions about their clinical abilities (Batnitzty\u0026amp; McDowell, 2011). The review will provide clear information required in designing the data collection, data analysis, and the reporting tools for the UK nurses’ task allocation study.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eJBI\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eJoanna Briggs Institute\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003ePRISMA\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePreferred Reporting Items for Systematic Reviews and Meta-Analysis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eCINAHL\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCumulative Index to Nursing and Allied Health Literature\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eMEDLINE\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMedical Literature Analysis and Retrieval Systemic Online\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eEMBASE\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eExcerpta Medica Database\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eNHS\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNational Health Service\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eSHU\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSheffield Hallam University\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eGTA\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGraduate Teaching Assistant\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003ePROSPERO\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInternational Prospective Register of Systematic Reviews\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics declaration:\u003c/strong\u003e Not applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Affiliation\u003c/strong\u003e\u003c/p\u003e\n\u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003eDD (MPH, MSc): PhD student and teaching assistant\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eCentre for Applied Health and Social Care Research (CARe), Health Research Institute, Sheffield Hallam University, collegiate campus, Sheffield, S10 2BP.\u003c/p\u003e\n\u003cp\u003eORCiD: 0000-0002-1959-0229.\u003c/p\u003e\n\u003col start=\"2\" type=\"1\"\u003e\n \u003cli\u003eSB (PhD): \u0026nbsp;Director of study (DoS).\u0026nbsp;\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eSheffield Hallam University, Centre for Applied Health and Social Care Research (CARe), S10 2BP.\u003c/p\u003e\n\u003cp\u003eORCiD: 0000-0003-0771-8130.\u003c/p\u003e\n\u003col start=\"3\" type=\"1\"\u003e\n \u003cli\u003eAR (Professor Emeritus): First supervisor\u0026nbsp;\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eSheffield Hallam University, Centre for Culture, Media \u0026amp; Society, S1 1WB.\u003c/p\u003e\n\u003cp\u003eORCiD: 0000-0002-4830-9029.\u003c/p\u003e\n\u003col start=\"4\" type=\"1\"\u003e\n \u003cli\u003eCB (PhD): Second supervisor\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eSheffield Hallam University, School of Health and Social care, Health Research Institute, S10 2BP.\u003c/p\u003e\n\u003cp\u003eORCiD: 0000-0002-9945-8577.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch Team\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDoctoral Researcher:\u003c/strong\u003e Dusu Dung\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDusu conceptualised and drafted the review protocol, organised meetings with the supervisory team and pushed the work for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSupervisory Team:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDr Sadiq Bhanbhro (Director of Studies).\u003c/p\u003e\n\u003cp\u003eProfessor Anandi Ramamurthy (Emeritus) (First Supervisor).\u003c/p\u003e\n\u003cp\u003eDr Carmel Bond (Second Supervisor).\u003c/p\u003e\n\u003cp\u003eDD and the supervisory team hold meetings at least twice a month during which they iteratively deliberate on what to include and/or exclude in the protocol. The team monitors, guides, and advises DD throughout the protocol design and systematic review writing processes. They ensure that due diligence is followed to resolve conflicts and make modifications where necessary.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Roles:\u0026nbsp;\u003c/strong\u003eDD will oversee the project, draft the protocol, select the study, extract the data, assess quality, interpret the results, and prepare the manuscript under the supervision of SB and CB. SB and CB will thoroughly review, provide feedback, and contribute to the intellectual content of this paper. All authors (DD, SB, CB, and AR) will make substantial contributions to the conception and contextualisation of the study protocol. All authors must read and approve the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding authors:\u003c/strong\u003e Dusu Dung (email: [email protected]); and\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSadiq Bhanbhro ([email protected]) are the corresponding authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate declaration:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish declaration:\u003c/strong\u003e Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDissemination:\u0026nbsp;\u003c/strong\u003eWork from this protocol will be published in a peer-reviewed journal and possibly presented in posters and/or conferences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement:\u003c/strong\u003e We extend our heartfelt gratitude to the Health Research Institute (HRI) at Sheffield Hallam University (SHU) for funding DD\u0026rsquo;s doctoral study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e DD\u0026rsquo;s doctoral study is fully funded by Sheffield Hallam University under its graduate teaching Assistantship (GTA) programme.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData and Materials:\u0026nbsp;\u003c/strong\u003eThe systematic review article will include only data extracted from articles that meet the criteria set out in this review protocol.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest:\u003c/strong\u003e Authors declare no competing interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOpen Access:\u003c/strong\u003e This is an open-access article distributed based on a Creative Commons Attribution 4.0 International (CC BY-NC-ND 4.0) Licence, which allows the public to copy, remix, redistribute, build upon, and transform this work for any purpose. Original work must be appropriately credited. See the link to the licence: \u0026nbsp;https://creativecommons.org/licenses/by/4.0/\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAfolabi O, Abboah-Offei M, Nkhoma K, Evans C. Task-shifting must recognise the professional role of nurses. Lancet Global Health. 2019;7(10):e1328\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlkhuzaimi F, Rainey D, Wilson CB, Bloomfield J. The impact of mobile health interventions on service users\u0026rsquo; health outcomes and the role of health professions: a systematic review of systematic reviews\u0026mdash;protocol. Syst Reviews. 2024;13(1):199.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAllen D, Hughes D. Nursing and the Division of Labour in Healthcare. Bloomsbury Publishing; 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAllen D, Hughes D, Jordan S, Prowse M, Snelgrove S, Hughes D. Nursing and the division of labour: sociological perspectives. Nursing and the Division of Labour in Healthcare; 2002. pp. 1\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmoah JO, Afoakwah C. Unravelling the Health Inequalities in Ghana: An Intersectional Perspective. Soc Indic Res. 2023;170(3):987\u0026ndash;1006.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArchibong U, Kline R, Eshareturi C, McIntosh B. (2019). Disproportionality in NHS disciplinary proceedings. British Journal of Healthcare Management; 25(4):1\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.12968/bjhc.2018.0062\u003c/span\u003e\u003cspan address=\"10.12968/bjhc.2018.0062\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBaker C. (2023). NHS staff from overseas: statistics. Retrieve March 13, 2024, from NHS staff from overseas: statistics - House of Commons Library (parliament.uk).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarrios VR, Khaw LBL, Bermea A, Hardesty JL. Future directions in intimate partner violence research: An intersectionality framework for analyzing women\u0026rsquo;s processes of leaving abusive relationships. J interpers Violence. 2021;36(23\u0026ndash;24):NP12600\u0026ndash;25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBatnitzky A, McDowell L. Migration, nursing, institutional discrimination and emotional/affective labour: ethnicity and labour stratification in the UK National Health Service. Social Cult Geogr. 2011;12(2):181\u0026ndash;201. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/14649365.2011.545142\u003c/span\u003e\u003cspan address=\"10.1080/14649365.2011.545142\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhaskar S, Rastogi A, Menon KV, Kunheri B, Balakrishnan S, Howick J. Call for action to address equity and justice divide during COVID\u0026ndash;19. Front Psychiatry. 2020;11:559905.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBohren MA, Iyer A, Barros AJ, Williams CR, Hazfiarini A, Arroyave L, Oladapo OT. (2024). Towards a better tomorrow: addressing intersectional gender power relations to eradicate inequities in maternal health. EClinicalMedicine, 67.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77\u0026ndash;101.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraun V, Clarke V. Thematic analysis. American Psychological Association; 2012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraun V, Clarke V. Reflecting on reflexive thematic analysis. Qualitative Res sport Exerc health. 2019;11(4):589\u0026ndash;97.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraun V, Clarke V. Conceptual and design thinking for thematic analysis. Qualitative Psychol. 2022;9(1):3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCollins PH. Intersectionality's definitional dilemmas. Ann Rev Sociol. 2015;41:1\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCrenshaw KW. Mapping the margins: Intersectionality, identity politics, and violence against women of color. The public nature of private violence. Routledge; 2013. pp. 93\u0026ndash;118.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDebusscher P, Maes EL. (2024). The European Union-Intersectionality Framework: Unpacking Intersectionality in the \u0026lsquo;Union of Equality\u0026rsquo;Agenda. Political Stud Rev, 14789299241242343.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDominic\u0026eacute; Dao M, Inglin S, Vilpert S, Hudelson P. The relevance of clinical ethnography: reflections on 10 years of a cultural consultation service. BMC Health Serv Res. 2018;18:1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGender Economy. (2024). Intersectionality and the implication for workplace gender equity: Intersectionality and the implications for workplace gender equity | Gender and the Economy (gendereconomy.org).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGkiouleka A. (2019). An Intersectionality Informed Analytical Framework for Health Inequalities in Europe-The co-constituting roles of Socio-economic Position, Gender, and Migration (Doctoral dissertation, University of York).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHankivsky O. Rethinking care ethics: On the promise and potential of an intersectional analysis. Am Polit Sci Rev. 2014;108(2):252\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeymann J, Varvaro-Toney S, Raub A, Kabir F, Sprague A. (2023). Race, ethnicity, and discrimination at work: a new analysis of legal protections and gaps in all 193 UN countries. Equality, Diversity and Inclusion: An International Journal, 42(9), 16\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHofman H, Beeckman D, Duljic T, Al Gilani S, Johansson S, Kottner J, Eriksson M. (2023). Patients\u0026rsquo; experiences with the application of medical adhesives to the skin: a qualitative systematic review protocol. BMJ open, 13(6), e073546.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHofman H, Duljic T, Johansson S, Kottner J, Kinnaer LM, Beeckman D, Eriksson M. (2024). Patients\u0026rsquo; experiences with the application of medical adhesives to the skin: a qualitative systematic review. BMJ open, 14(10), e089773.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHadie SNH. (2024). ABC of a Scoping Review: A Simplified JBI Scoping Review Guideline. Educ Med J, 16(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJackson J, Anderson JE, Maben J. What is nursing work? A meta-narrative review and integrated framework. Int J Nurs Stud. 2021;122:103944.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLavander P, Meril\u0026auml;inen M, Turkki L. Working time use and division of labour among nurses and health-care workers in hospitals\u0026ndash;a systematic review. J Nurs Adm Manag. 2016;24(8):1027\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeslie M, Paradis E, Gropper MA, Reeves S, Kitto S. Applying ethnography to the study of context in healthcare quality and safety. BMJ Qual Saf. 2014;23(2):99\u0026ndash;105.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLikupe G. Experiences of African nurses and the perception of their managers in the NHS. J Nurs Adm Manag. 2015;23(2):231\u0026ndash;41. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/jonm.12119\u003c/span\u003e\u003cspan address=\"10.1111/jonm.12119\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLikupe G, Archibong U. Black African Nurses\u0026rsquo; experiences of equality, racism, and discrimination in the National. Health Service J Psychol Issues Organizational Cult. 2013;3(S1):227\u0026ndash;46. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/jpoc.21071\u003c/span\u003e\u003cspan address=\"10.1002/jpoc.21071\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMackey K, Ayers CK, Kondo KK, Saha S, Advani SM, Young S, Kansagara D. Racial and ethnic disparities in COVID\u0026ndash;19\u0026ndash;related infections, hospitalizations, and deaths: a systematic review. Ann Intern Med. 2021;174(3):362\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaroto M, Pettinicchio D, Patterson AC. Hierarchies of categorical disadvantage: Economic insecurity at the intersection of disability, gender, and race. Gend Soc. 2019;33(1):64\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcCann E, Donohue G, de Jager J, Nugter A, Stewart J, Eustace-Cook J. Sexuality and intimacy among people with serious mental illness: a qualitative systematic review. JBI Database Syst Reviews Implement Rep. 2019;17(1):74\u0026ndash;125. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.11124/JBISRIR\u0026ndash;2017\u0026ndash;003824\u003c/span\u003e\u003cspan address=\"10.11124/JBISRIR\u0026ndash;2017\u0026ndash;003824\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMothupi M, Dasgupta J, Jebeli SSH, Stevenson J, Berdichevsky K, Vong S, George A. (2023). Gender Equality and Pandemic Response: Using an intersectionality approach to transform health services for overlooked healthcare users and workers after covid\u0026ndash;19. The BMJ, 381.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMunn Z, Moola S, Riitano D, Lisy K. The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J health policy Manage. 2014;3(3):123.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMunn Z, Aromataris E, Tufanaru C, Stern C, Porritt K, Farrow J, Lockwood C, Stephenson M, Moola S, Lizarondo L, McArthur A, Peters M, Pearson A, Jordan Z. The development of software to support multiple systematic review types. Int J Evid Based Healthc. 2019;17(1):36\u0026ndash;43. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/XEB.0000000000000152\u003c/span\u003e\u003cspan address=\"10.1097/XEB.0000000000000152\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMusheno M, Musheno BV, Austin M. Exploring the prevalence and meaning of frontline work in the COVID\u0026ndash;19 era: implications for policy analysis. J Comp Policy Analysis: Res Pract. 2021;23(1):30\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNguyen NT, Chia YT. Decolonizing research imagination: A journey of reshaping research epistemology and ontology. Asia Pac Educ Rev. 2023;24(2):213\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNHS Digital. (2021). NHS workforce statistics \u0026ndash; January 2021. Retrieved March 2024, from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/january\u0026ndash;2021\u003c/span\u003e\u003cspan address=\"https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/january\u0026ndash;2021\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNixon SA. The coin model of privilege and critical allyship: implications for health. BMC Public Health. 2019;19(1):1637.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNorton MJ. Peer support working: a question of ontology and epistemology? Int J Mental Health Syst. 2023;17(1):1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePage ON. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Br J Sports Med. 2024;1001:58.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeel DK. 2010. Qualitative research methods. Criminological research and evaluation methods: Research themes, 55\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeters, M. D., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., \u0026hellip;Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews.JBI evidence synthesis, 18(10), 2119\u0026ndash;2126.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePollock, D., Peters, M. D., Khalil, H., McInerney, P., Alexander, L., Tricco, A. C.,\u0026hellip; Munn, Z. (2023). Recommendations for the extraction, analysis, and presentation of results in scoping reviews.JBI evidence synthesis, 21(3), 520\u0026ndash;532.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQuan, C., Clark, N., Costigan, C. L., Murphy, J., Li, M., David, A., \u0026hellip; Cross, B. (2023).JBI systematic review protocol of text/opinions on how to best collect race-based data in healthcare contexts.BMJ open, 13(5), e069753.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRahman MS. The advantages and disadvantages of using qualitative and quantitative approaches and methods in language testing and assessment research. A literature review; 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRamamurthy A, Bhanbhro S, Bruce F, Gumber A, Fero K. Nursing narratives: Racism and the pandemic. The report was submitted to the UKRI-Covid Rapid Response Call Project. Sheffield, UK: Sheffield Hallam University; 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRhead RD, Chui Z, Bakolis I, Gazard B, Harwood H, MacCrimmon S, Woodhead C, Hatch SL. Impact of workplace discrimination and harassment among National Health Service staff working in London trusts: results from the TIDES study. BJPsych Open. 2021;7(1):137. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1192/bjo.2020.137\u003c/span\u003e\u003cspan address=\"10.1192/bjo.2020.137\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoss S, Jabbal J, Chauhan K, Maguire D, Randhawa M, Dahir S. (2020). Workforce race inequalities and inclusion in NHS providers. King's Fund. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.nhsbmenetwork.org.uk/wp-content/uploads/2021/06/workforce-race-inequalities-inclusion-nhs-providers-july2020.pdf\u003c/span\u003e\u003cspan address=\"https://www.nhsbmenetwork.org.uk/wp-content/uploads/2021/06/workforce-race-inequalities-inclusion-nhs-providers-july2020.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSims H, Alvarez C. Frontline healthcare workers experiences and challenges with in-person and remote work during the COVID\u0026ndash;19 pandemic: a qualitative study. Front public health. 2022;10:983414.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSpinnewijn L, Aarts J, Verschuur S, Braat D, Gerrits T, Scheele F. (2020). Knowing what the patient wants: a hospital ethnography studying physician culture in shared decision making in the Netherlands. BMJ open, 10(3), e032921.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStrudwick RM. Ethnographic research in healthcare\u0026ndash;patients and service users as participants. Disabil Rehabil. 2021;43(22):3271\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSyed I, Daly T, Armstrong P, Lowndes R, Chadoin M, Naidoo V. How do work hierarchies and strict divisions of labour impact care workers\u0026rsquo; experiences of health and safety? case studies of long-term care in Toronto. J Nurs home Res Sci. 2016;2(1):41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWest M, Dawson J, Kaur M. (2015). Making the difference: Diversity and inclusion in the NHS. Retrieved November 24, 2021, from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Making-the-difference-summary-Kings-Fund-Dec\u0026ndash;2015.pdf\u003c/span\u003e\u003cspan address=\"https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Making-the-difference-summary-Kings-Fund-Dec\u0026ndash;2015.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWoodhead, C., Stoll, N., Harwood, H., TIDES Study Team, Alexis, O., Hatch, S. L.,\u0026hellip; Valmaggia, L. (2022). They created a team of almost entirely the people who work and are like them: A qualitative study of organisational culture and racialised inequalities among healthcare staff. Sociology of health \u0026amp; illness, 44(2), 267\u0026ndash;289.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Division of labour, Tasks allocation, Healthcare setting, Intersectionality, Nurses","lastPublishedDoi":"10.21203/rs.3.rs-6553825/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6553825/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003eAssessing the nurses task allocation and workloads remains an area under researched. Clearly, there exist a limited amount of evidence in researching the division of labour in the nursing occupations. Several reports in the United Kingdom (UK), such as one from the Nursing Narratives: Racism and the Pandemic, has suspected the existence of inequality in the way task is allocated to nurses in healthcare settings. Using intersectionality lens this study aim to explore the role of different social identities (including ethnicity, race, gender, ability, class, etc.) in shaping nursing tasks allocation, responsibilities, and power dynamics in the UK healthcare settings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods and analysis:\u003c/strong\u003e The following electronic databases will be searched from their inception to March 2025: CINHAL Complete, EMBASE, ASSIA, SCOPUS, MEDLINE, and PsycINFO. Grey sources include Google Scholar, and Open-Grey. Reference Lists and other relevant government and non-government websites will be searched using search combinations. All published primary research published in English and meets the inclusion criteria and are relevant to the topic will be selected. The primary investigator (PI) with at least two members of the supervisory team will involve in the article retrieval, removal of duplicates, screening, quality appraisal, and data analysis by the PI. Quality of the included literature using the Joanna Briggs institute (JBI) standardised tool for critical appraisal checklist. Final selected full-text articles will be qualitatively synthesised using both narrative pattern and thematic analysis and reported with the aid of inductive and deductive coding frameworks. We will present the findings with the aid of the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion:\u003c/strong\u003e This systematic review will present a detailed synthesis of the evidence for inequality in nursing task allocation and power dynamics in the healthcare settings. We intended to leverage on identified gaps in the literatures for further investigation. Therefore, this systematic review is expected to provide requisite information required in designing the methodological phase of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSystematic review registration: \u003c/strong\u003ePROSPERO CRD420251038899\u003c/p\u003e","manuscriptTitle":"Topic: An intersectionality analysis of the task allocation to nurses (at a ward level) in healthcare settings: A systematic review protocol","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-19 12:07:37","doi":"10.21203/rs.3.rs-6553825/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"05f131ac-0d84-4a9b-b0b1-9b289226d956","owner":[],"postedDate":"June 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-31T18:08:38+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-19 12:07:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6553825","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6553825","identity":"rs-6553825","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}