Differentiating the importance of workplace barriers for ICU nurse well-being and patient safety using AHP and FAHP...

High quality nursing in intensive care units (ICU) depends on supportive and efficient work systems. Using a sequential exploratory design, and the systems engineering initiative for patient safety (SEIPS) model as a framework, interviews were conducted with fourteen experienced ICU nurses working in Fars, Iran to identify workplace barriers. The transcribed codes were collated into eighteen barriers which were categorized into the five components of the SEIPS model. Two decision-making methods (the analytic hierarchical process (AHP) and the fuzzy analytic hierarchical process (FAHP)) were then applied to rank the workplace barriers by importance. These yielded the same order at the SEIPS component and the within-component levels. There were differences in overall ranking of workplace barriers that reflected differences in the underlying weightings of the two methods. The most important barrier using AHP was organisational culture, and using FAHP was task demand, difficulty and complexity. These outcomes are discussed in terms of tailoring interventions that address the complexities of the ICU work environment for nurses.