<![CDATA[This study examines the relationship between performance-based compensation (PBC) and employee sustainable performance (ESP) among hospital nurses, focusing on the roles of intrinsic motivation, workplace health, and innovative safety climate. Although performance-based compensation is intended to improve productivity and organizational efficiency, excessive performance targets may increase work-related stress, undermine nurses’ intrinsic motivation, and negatively affect their physical and mental well-being. Therefore, this study aims to systematically review the effects of performance-based compensation on nurses’ sustainable performance and identify the psychological and organizational factors that influence this relationship. A Systematic Literature Review (SLR) was conducted using the PRISMA guidelines. Relevant empirical articles were searched in Scopus, Web of Science, and PubMed and assessed using the PICOS framework and Critical Appraisal Skills Programme (CASP). The literature selection process identified 480 records, from which 14 empirical studies met the inclusion criteria for qualitative thematic synthesis. The findings indicate that performance-based compensation does not automatically improve sustainable performance. Aggressive financial targets may contribute to psychological distress, physical strain, reduced intrinsic motivation, and increased turnover intentions. However, procedural fairness and transparent bonus allocation can help maintain nurses’ intrinsic motivation. Furthermore, an innovative safety climate, supported by modern safety facilities and a non-punitive reporting culture, can reduce the negative effects of performance pressure on workplace health. In conclusion, sustainable nursing performance requires a balanced compensation system that integrates fair financial incentives, intrinsic motivation, employee well-being, and a supportive safety climate.]]>
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