+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life

A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life

Bmj Quality and Safety 20(1): 15-24

Nursing workload is increasingly thought to contribute to both nurses' quality of working life and quality/safety of care. Prior studies lack a coherent model for conceptualising and measuring the effects of workload in healthcare. In contrast, we conceptualised a human factors model for workload specifying workload at three distinct levels of analysis and having multiple nurse and patient outcomes. To test this model, we analysed results from a cross-sectional survey of a volunteer sample of nurses in six units of two academic tertiary care paediatric hospitals. Workload measures were generally correlated with outcomes of interest. A multivariate structural model revealed that: the unit-level measure of staffing adequacy was significantly related to job dissatisfaction (path loading=0.31) and burnout (path loading=0.45); the task-level measure of mental workload related to interruptions, divided attention, and being rushed was associated with burnout (path loading=0.25) and medication error likelihood (path loading=1.04). Job-level workload was not uniquely and significantly associated with any outcomes. The human factors engineering model of nursing workload was supported by data from two paediatric hospitals. The findings provided a novel insight into specific ways that different types of workload could affect nurse and patient outcomes. These findings suggest further research and yield a number of human factors design suggestions.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 051147647

Download citation: RISBibTeXText

PMID: 21228071

DOI: 10.1136/bmjqs.2008.028381

Related references

A human factors engineering conceptual framework of nursing workload and patient safety in intensive care units. Intensive and Critical Care Nursing 21(5): 284-301, 2005

Impact of performance obstacles on intensive care nurses' workload, perceived quality and safety of care, and quality of working life. Health Services Research 44(2 Pt 1): 422-443, 2009

Patient Safety Incidents and Nursing Workload. RevistaLatino-AmericanadeEnfermagem25:E2841, 2017

Does Employee Safety Matter for Patients Too? Employee Safety Climate and Patient Safety Culture in Health Care. Journal of Patient Safety 14(3): 181-185, 2018

Quality of the Execution of Corporate Safety Policies and Employee Safety Outcomes: Assessing the Moderating Role of Supervisor Safety Support and the Mediating Role of Employee Safety Control. Journal of Business and Psychology 18(4): 483-506, 2004

Do perceived working conditions and patient safety culture correlate with objective workload and patient outcomes: A cross-sectional explorative study from a German university hospital. Plos one 14(1): E0209487, 2019

Association between workload of the nursing staff and patient safety outcomes. Revista Da Escola de Enfermagem Da U S P 51: E03255, 2017

Application of a human factors classification framework for patient safety to identify precursor and contributing factors to adverse clinical incidents in hospital. Applied Ergonomics 52: 185-195, 2016

Employee fitness and recreation: towards a quality of working life. Employee fitness and recreation: towards a quality of working life: 6, 1982

Medication administration - nursing workload and patient safety in clinical wards. Revista Brasileira de Enfermagem 72(1): 183-189, 2019

The Effects of Quality of Working Life (Qwl) on Employee Behavioral Responses. Social Indicators Research 22(1): 31-47, 1990

Quality of working life: an antecedent to employee turnover intention. International Journal of Health Policy and Management 1(1): 43-50, 2013

Workload and quality of life of medical doctors in the field of oncology in Germany--a survey of the working group quality of life of the AIO for the study group of internal oncology. Oncology Research and Treatment 38(4): 154-159, 2015

Community Pharmacists Working Practices: Interruptions, Distractions and Potential Implications for Workload Management and Patient Safety. Research in Social and Administrative Pharmacy 10(5): E12-E13, 2014

Nursing workload, patient safety incidents and mortality: an observational study from Finland. Bmj Open 8(4): E016367, 2018