Nursing workload and patient safety--a mixed method study with an ecological restorative approach

Area of Science:

• Healthcare Management
• Nursing Research
• Patient Safety Science

Background:

• Nursing workload is a critical factor influencing patient safety outcomes.
• Understanding the complex relationship between nurse staffing levels and patient care quality is essential for healthcare institutions.

Purpose of the Study:

• To investigate the association between nursing workload and patient safety within medical and surgical inpatient units.
• To identify specific care activities that contribute significantly to nursing workload and patient safety risks.

Main Methods:

• A sequential explanatory mixed-methods research design was employed.
• Quantitative data on patient safety indicators were collected and analyzed.
• Qualitative data were gathered through nursing staff to explore their perspectives on workload and safety.

Main Results:

• Increased patient assignments per nurse correlated with higher rates of patient falls and central line-associated bloodstream infections.
• Higher nursing workload was linked to increased nursing staff turnover and absenteeism.
• Medication administration, patient transport, and bed baths were identified as high-impact workload activities posing safety hazards.

Conclusions:

• Significant associations exist between nursing workload and patient safety indicators.
• Lower patient assignments for nursing staff correlated with improved care-related and management-related patient safety.
• Ecological and restorative thinking frameworks offered valuable insights into the nurse-patient safety relationship, promoting participatory research.