Background:
Moral sensitivity is crucial in nursing ethics, significantly impacting patient care and decision-making. By recognizing ethical dilemmas, nurses provide compassionate, patient-centered care that improves outcomes. This review explores the levels of moral sensitivity among nurses and factors influencing its role, aiming to enhance ethical decision-making and standards in nursing.

Methods:
This systematic review will follow the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search will be conducted across multiple databases, including PubMed, Web of Science, Scopus, PsycINFO, Embase, and CINAHL, from January 1995 to April 2025. The search will not be restricted by study design or language. Studies on moral sensitivity scores in nursing practice, their levels, and the factors influencing them will be considered. The evidence synthesis will incorporate qualitative and quantitative analyses, with the results examined using descriptive statistics and thematic synthesis. The Theoretical Domains Framework will be utilised to categorise the factors influencing moral sensitivity.

Discussion:
This study highlights the significance of moral sensitivity in nurses for ethical decision-making and patient care. Findings will reveal factors influencing moral sensitivity in nursing and showcase strengths and gaps in practices and education. Ultimately, the data will inform targeted interventions and educational strategies aimed at enhancing moral sensitivity and improving patient outcomes.

Systematic review registration:
PROSPERO CRD420251010641. This protocol follows the PRISMA-P guidelines for reporting systematic reviews.