Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province

Abstract

BackgroundRecording of information on multiple documents increases professional nurses’ responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient’s information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-To-Child Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care.ObjectivesThe objective of this study was to investigate and describe the effects of increased nurses’ workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province.MethodsThe study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses’ workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who work at PHC facilities in Vhembe District. Purposive sampling was used to select nurses and three professional nurses were sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide.ResultsPHC facilities encountered several effects due to increased nurses’ workload where incomplete patient information is documented. Unavailability of patient information was observed, whilst some documented information was found to be illegible, inaccurate and incomplete.ConclusionDocumentation of information at PHC facilities is an evidence of effective communication amongst professional nurses. There should always be active follow-up and mentoring of the nurses’ documentation to ensure that information is accurately and fully documented in their respective facilities. Nurses find it difficult to cope with the increased workload associated with documenting patient information on the multiple records that are utilized at PHC facilities, leading to incomplete information. The number of nurse...

The Effects of Anxiety Levels on Burnout Syndrome in Nurses

“…Working conditions in hospitals have been of great concern to health care personnel worldwide (1). Nurses experience heavy workloads in health care systems worldwide (2). In addition to the high level of stress, the pressure of the patients or their relatives frequently encountered by hospital employees or administrative pressures increases the level of anxiety and leads to the development of work-related psychological disorders such as burnout symptoms.…”

Influence of Workload on Primary Care Nurses’ Health and Burnout, Patients’ Safety, and Quality of Care: Integrative Review

“…Within the profession, there are mechanisms that help soften the effects of this situation [16][17][18][19][20]. However, professional exhaustion [21] appears, whereby primary care variables related to overload, such as the deterioration of the staff's health status [22][23][24][25], decreased the quality of care [26], and a negative effect on the patient's safety [27,28] emerged. This has been declared of great importance in the national health system [29] and the nursing profession [30].…”

“…The definition of work overload varies depending on the study and different criteria and tools are used, so it is a matter that depends on the individual perception of the researchers in each case. Some of the criteria used have been a lower ratio of nurses [6,8], subjective perception of overload [12,26,30], or several questionnaires [6,8,[10][11][12]23].Regarding the deterioration of nurses' health, burnout and professional exhaustion [31] have become more important, as well as their relationship with job satisfaction [32][33][34], quality of life at work [35], and suicidal risk [36], in addition to quality of care and patient safety and satisfaction [37]. The scope of the problem is global, as there are studies in different labour contexts at the international level [38][39][40][41][42].…”

“…Health services have primary care as a gateway, and this has been suffering a decrease in the quality of the service provided with less resources [10], a high working pace [12], and insecurity in patients [22] in recent years. The effects of professional burnout [37] and work overload [26,27] are behind this phenomenon. Regarding the quality of care, the main aspects affected are the increase in costs and the decrease in productivity of professionals [4], the increase in hospital stays [4,7,8], demoralized [11] and sick [17,24,25,32] personnel, outdated knowledge [25], lower quality of services provided [16] and worsening of records [26].…”

“…The effects of professional burnout [37] and work overload [26,27] are behind this phenomenon. Regarding the quality of care, the main aspects affected are the increase in costs and the decrease in productivity of professionals [4], the increase in hospital stays [4,7,8], demoralized [11] and sick [17,24,25,32] personnel, outdated knowledge [25], lower quality of services provided [16] and worsening of records [26]. Regarding patient safety, an increase of the adverse effects derived from patient care [5][6][7]16], mortality [4][5][6][7], and preventable errors [27] are observed.Therefore, the objective of this review is to identify relationships between overload, nurses' diseases, burnout, quality, and safety during the services.…”