Workplace Predictors of Quality and Safe Patient Care Delivery Among Nurses Using Machine Learning Techniques

Abstract

Background: Working in unhealthy environments is associated with negative nurse and patient outcomes. Previous body of evidence in this area is limited as it investigated only a few factors within nurses' workplaces. Purpose: The purpose of this study was to identify the most important workplace factors predicting nurses' provision of quality and safe patient care using a 13-factor measure of workplace conditions. Methods: A cross-sectional correlational survey study involving 4029 direct care nurses in British Columbia was conducted using random forest data analytics methods. Results: Nurses' reports of healthier workplaces, particularly workload management, psychological protection, physical safety and engagement, were associated with higher ratings of quality and safe patient care. Conclusion: These workplace conditions are perceived to impact patient care through influencing nurses' mental health. To ensure a high standard of patient care, data-driven policies and interventions promoting overall nurse mental health and well-being are urgently required.

The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses

“…The ISO provides a framework for identifying and addressing workplace risk factors to employee psychological health and safety across a wide range of industries and sectors including healthcare. In Canada, studies of the Canadian Standard identified workplace risk factors most predictive of nurses’ mental ill health and their quality and safety of care delivery [ 19 , 32 ]. Despite this progress, the implementation of ISO is yet to be mandated in healthcare by governments internationally.…”

“…Similarly, even the samples’ representativeness of the provincial nursing workforce may be questionable due to low response rates. Although comparative analyses revealed no large differences in samples’ demographics and the provincial and national nursing workforce [ 19 , 27 ], we still believe generalizing the results beyond the study sample should be conducted cautiously. Second, differences in nurses’ mental health symptoms and quality and safety ratings across the two surveys could potentially be a result of small differences in sample demographics (2–4%).…”

“…Quality and safety of patient care delivery was measured using 3 questions from the international RN4CAST, a 12-country study of nurses’ work environment conditions and their impact on quality and safety [ 16 , 17 , 18 , 19 ]. Questions asked nurses to: give their primary unit an overall safety grade on a five-point scale ranging from ‘failing’ to ‘excellent’; rate the general quality of nursing care they delivered to patients on their unit using a four-point response scale with options ranging from ‘poor’ to ‘excellent’; and indicate their likelihood of recommending their unit to friends and family for care on a four-point scale ranging from ‘definitely no’ to ‘definitely yes’.…”

Workplace Predictors of Violence against Nurses Using Machine Learning Techniques: A Cross-Sectional Study Utilizing the National Standard of Psychological Workplace Health and Safety

“…The findings of this work identified 13 psychosocial risk factors that were integrated into the National Standard of Workplace Psychological Health and Safety (“the Standard”). The Standard and its measurement tool were recently validated among Canadian nurses [ 19 , 20 ]. According to these studies, ineffective workload management and lack of or limited psychological protection in the workplace were consistently among the strongest predictors of five mental health and three care delivery outcomes.…”