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

• Published in: Revista latino-americana de enfermagem Vol. 21 Spec No; no. spe; pp. 146 - 154
• Main Authors: de Magalhães, Ana Maria Müller, Dall'Agnol, Clarice Maria, Marck, Patricia Beryl
• Format: Journal Article
• Language: English
• Published: Brazil Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo 01.01.2013
• Subjects: Cross-Sectional Studies; Humans; NURSING; Nursing - statistics & numerical data; Patient Safety - statistics & numerical data; Retrospective Studies; Workload - statistics & numerical data; Nursing Staff, Hospital; Seguridad del Paciente; Safety Management; Segurança do Paciente; Recursos Humanos de Enfermagem no Hospital; Nursing Service, Hospital; Workload; Serviço Hospitalar de Enfermagem; Servicio Hospitalario de Enfermería; Patient Safety; Carga de Trabalho; Carga de Trabajo; Gerenciamento de Segurança; Recursos Humanos de Enfermería en el Hospital; Gerenciamiento de Seguridad
• ISSN: 0104-1169; 1518-8345; 1518-8345; 0104-1169
• DOI: 10.1590/S0104-11692013000700019

The aim of this study was to analyze the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching hospital. a mixed method strategy (sequential explanatory design). the initial quantitative stage of the study suggest that increases in the number of patients assigned to each nursing team lead to increased rates of bed-related falls, central line-associated bloodstream infections, nursing staff turnover, and absenteeism. During the subsequent qualitative stage of the research, the nursing team stressed medication administration, bed baths, and patient transport as the aspects of care that have the greatest impact on workload and pose the greatest hazards to patient, provider, and environment safety. The findings demonstrated significant associations between nursing workload and patient safety. We observed that nursing staff with fewer patients presented best results of care-related and management-related patient safety indicators. In addition, the tenets of ecological and restorative thinking contributed to the understanding of some of the aspects in this intricate relationship from the standpoint of nursing providers. They also promoted a participatory approach in this study.