Association between workload of the nursing staff and patient safety outcomes

Abstract

Objective:To describe the workload of the nursing team and relate it with patient safety outcomes in clinical and surgical inpatient units of a university hospital. Method: Crosssectional study, carried out from October 2013 to September 2015. The factor under study was the workload, expressed as the ratio between the mean number of patients and the number of nursing professionals in 24 hours and in the day shifts. Results: The sample consisted of 157,481 patients, 502 nursing professionals and 264 observations of safety outcomes. The ratios of patients per nurse and per nursing technician in day shifts indicate a mean estimate of 14-15 and 5-6 patients per professional, respectively. There was a significant association between the workloads in the inpatient units and average length of stay, urinary infection related to invasive procedure and the satisfaction of patients with nursing care. Conclusion: The increase in the workload of the nursing team had an impact on quality of care and safety for patients. An adequate staffing promotes a safer care environment.

Disparities in the delivery of pediatric oncology nursing care by country income classification: International survey results

“…A robust body of scientific evidence linking nursing care and patient outcomes has emerged over the past two decades. Factors such as nurses’ workload, educational preparation, and work environments are associated with a decrease in mortality, infection rates, and cost of care in hospitalized patients . Although studies specific to the pediatric population are limited, evidence indicates that nursing resources vary significantly across institutions caring for children and that inadequate nursing resources in pediatric wards are associated with surveillance left undone and missed changes in patients’ condition …”

“…Factors such as nurses' workload, educational preparation, and work environments are Abbreviations: BMT, bone marrow transplant; CIC, country income classification; HIC, high-income countries; IV, intravenous; LIC, low-income countries; LMIC, lower-middle income countries; L/LMIC, low-and lower-middle income countries; PICU, pediatric intensive care unit; PODC, Paediatric Oncology in Developing Countries; UMIC, upper-middle income countries; WHO, World Health Organization associated with a decrease in mortality, infection rates, and cost of care in hospitalized patients. [1][2][3][4][5] Although studies specific to the pediatric population are limited, evidence indicates that nursing resources vary significantly across institutions caring for children and that inadequate nursing resources in pediatric wards are associated with surveillance left undone and missed changes in patients' condition. 6 Approximately 300 000 children aged 0-19 are diagnosed with cancer per year.…”

The association of patients' daily summarized self‐rated “real‐time” pain scores with physical recovery after major surgery – A repeated measurement design

“…The idea of monitoring patients' postoperative recovery by using patients' pain scores is to simplify something that is complex and multifaceted. With limited resources in health care, there is a need to balance workload (e.g., collection of data) with other care duties to maintain the quality of care (Magalhaes et al, ). Furthermore, experiences from different contexts show that most patients, including the elderly and patients with a diminished cognitive ability, can score their symptoms with the NRS in “real‐time” (Hjermstad et al, ; van Dijk, Kappen, Wijck, Kalkman, & Schuurmans, ;).…”

Sizing of the Nursing Staff in Adult Intensive Therapy

“…1,2,3 A exemplo disso, estudo recente associou a carga de trabalho a indicadores de segurança do paciente em unidades de internação de um hospital universitário de grande porte, em análise retrospectiva de 157.481 pacientes e 502 profissionais de enfermagem. 19 Na investigação, apurou-se que o aumento da proporção de pacientes por trabalhador de enfermagem, traduzida como a elevação da carga de trabalho, foi responsável por piores resultados entre a média de permanência hospitalar, infecção urinária relacionada a procedimentos invasivos e também a própria satisfação do paciente sobre a assistência de enfermagem. 19 Com base no construto deste estudo e da literatura correlata, considera-se o alerta aos gestores para que se promova o dimensionamento adequado dos profissionais de enfermagem nas instituições de saúde.…”