Today, healthcare organizations are not only determined with respect to well-established structures like offices and hierarchies; similar to the people, organizations have their personalities and lives beyond their parts (Yeop & Rashid, 2020). The workplace dynamics, in their turn, are significantly influenced by organizational culture, which consists of common beliefs, values, and behaviors of staff members (Aydogdu, 2023). In addition, it significantly regulates the work of employees, the quality of healthcare, collaboration within the institution, the desire to reach the organizational aims, and the adherence to the main mission of the healthcare institution (Goyal & Kaur, 2023). An ideal of a positive organizational culture can be the one that is characterized by shared values, mutual respect, good communication, and leadership support that will increase job satisfaction, engagement, and commitment of nurses. This atmosphere creates the sense of quality care and boosts the desire to remain in the profession (Choi et al., 2023; Zhai et al., 2023). On the other hand, unsupportive or toxic cultures result in dissatisfaction, disengagement, and high turnover, all of which have a negative effect on patient outcomes and the effectiveness of healthcare delivery in general (Al Yahyaei et al., 2022).

Nurses play an important role in fulfilling the changing healthcare demands and organizational objectives. Healthcare managers should focus on their trust in healthcare institutions and their desire to have long-term employment (Kleemola et al., 2020). The quality of the healthcare services is also based on the organizational culture that underlies the clinical skills of the nurses. An organizational culture of cooperation and support empowers nurses, improves the quality of patient care, and results in improved health outcomes (Al-Surimi et al., 2022; Asfour et al., 2025). Conversely, lack of effective communication, insufficient support, and work-related stress affect the quality of provided services and the well-being of the personnel (Al-Balas et al., 2024).

The intention to stay is the phenomenon that signifies the conscious and intentional decision of an employee to remain in an institution and is preconditioned by a variety of factors including the managerial support, working conditions, organizational factor, and the personal demographics (Assi et al., 2024; Al-Hamdan et al., 2020). It has been also found that meaningful work and fewer illegitimate tasks can help motivate nurses and keep them at work longer (Ahlstedt, 2024). Job satisfaction, leadership, workload, and work-life balance are some of the numerous factors that influence the intention to stay and quality of care among nurses (Muchlis et al., 2022; Rodríguez-García et al., 2023). Nursing staff are more likely to stay when they work in favorable work environments that promote their safety culture (Rodríguez-García et al., 2023). Turnover prediction models highlight the value of cooperative behaviour and respect in accelerating the intentions of nurses to remain (Muchlis et al., 2022).

Organizational culture has a deep impact on the quality of the healthcare services. There are cultures that encourage teamwork, accountability, learning, and patient-centeredness, and this is related to positive patient outcomes (Slåtten et al., 2022). The empirical data confirms that the organization culture, career development, and job satisfaction have a direct and indirect impact on nursing performance and quality of services (Pedrosa, Sousa et al., 2021). Leadership style, work environment, moral distress, and professional support are some of the factors that mediate the relationship between intention to stay and quality of care (Tan Jr et al., 2024).

The common situations of missed and delayed medication administration and staffing shortages in Jordanian public hospitals reveal serious problems in the quality of care indicating the necessity of positive organizational cultures that foster effective nursing practice (Al-Faouri et al., 2021). The healthcare organizations are urgently required to enhance the service quality and retention of nurses, particularly in resource-limited situations in public hospitals where the organizational dynamics are complicated (Tan Jr et al., 2024). Although much has been studied, the exact impact of different types of organizational culture on the perceptions and intention of nurses to remain in Jordanian public hospitals is poorly researched. This research fills this gap by establishing the relationship between various dimensions of culture and healthcare quality perceptions and retention intentions. This gap is critical to the hospital administrators and policymakers who wish to improve the quality of healthcare services as well as intention to stay.

The Competing Values Framework is the theoretical framework based on which the organizational culture is conceptualized in four types (Clan, Adhocracy, Market, Hierarchy) and, therefore, offers the foundation on which the influence of each of them on the nursing outcome should be investigated (Cameron and Quinn, 1999). The hypothesis, as the literature suggests, is that the intention to stay among nurses can be promoted in the presence of the clan and hierarchy organizational cultures, as they offer supportive, cohesive, and stable work environments that adhocracy and market cultures may diminish (Braithwaite et al., 2017; Harhash et al., 2020; Tietschert et al., 2024). The focus on innovation or competitiveness in both adhocracy and market cultures may cause uncertainty or stress and decrease intention to stay. However, it is also suggested that each of the four types of cultures, including clan, hierarchy, adhocracy, and market, will probably improve the perceived quality of healthcare by promoting more effective communication, coordination, and common shared values among the staff (Braithwaite et al., 2017; Harhash et al., 2020; Tietschert et al., 2024). See Fig. 1.

This study aims to examine how organizational culture affects the nursing perceptions on the quality of healthcare services and the intention to stay in nurses working in government hospitals in Jordan. The study has three primary objectives: (1) To assess how nurses perceive the organizational culture and perceive healthcare quality in their workplace; (2) To examine the correlations between types of culture, perception of quality of healthcare and intention to stay; and (3) To identify what predicts the perceived quality of healthcare.