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mary lualhati

on 5 August 2014

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Main Objective:
“ Is there a significant relationship between nurses’ workload and patient safety?”
Research Questions
1. “What are the factors that increase the nurses’ workload?”

2. “ Is there a relationship between nurses’ workload and patient safety in terms of:

2.1 Falls
2.2 Medication errors
2.3 Nosocomial infection

Patient response on the nurses
Bedside care
Strategies that can help the nurse manage workload stress
Mortality and morbidity rates due to unacceptable nursing care
Direct admission conducted in wards

Significance of Study
• staff nurses

• nursing/hospital administrators

• clinical instructors

• nursing students

• UP-Philippine general hospital, a National training hospital, equipped with more than 1000 beds where first aid or emergent care, medical care and surgical care services are provided.
• Cover the workload of staff nurses and sentinel events such as falls, medication error, and Nosocomial infection at the Medicine wards.

1. Fall
- unintentional event wherein the patient imbeds in the ground or floor
2. Medication Error
- medications were administered inappropriately
3. Nosocomial Infection
- acquired infection in the hospital
4. Nurse-Patient Ratio
- how many patients and nurse on duty is required to handle
Patient’s Safety
- ensuring that the patient is free from accidental injury
6. Sentinel Events
- unexpected event that may result to serious injury
7. Workload -
amount of work expected to be done by the nurse-on-duty

 few researches have been conducted locally to investigate the association between nurses’ workload and patient safety

 to have a better grasp of the effects of increased nurses’ workload on patient safety

 to come up with approaches that will enhance patients’ safety

 more research conducted = more recognition of the importance of this study
Nursing Workload

The Mersey Regional Health Authority defined nursing workload as ‘the totality of the need for nursing time from all work that must be carried out over a defined period of time’ (Mersey Regional Health Authority 1991; page 84). Needham (1997) came up with a more specific definition which is “the time taken to carry out ‘direct’ and ‘indirect’ care, and other activities including ward and organization management”.

Workload can be a factor contributing to errors, thus workload and time pressure may reduce the care provided by a nurse to a safety-critical task resulting to more errors and unsafe patient care.

A study conducted by Aiken, Needleman (2002) showed that patient' outcomes (eg. Safety, well being) is greatly affected by nurse workload. An increase in nurse staff decreases odds of hospital acquired pneumonia, unplanned extubation, respiratory failure and cardiac arrest due to decrease in nurses workload (Kane, Shamliyan, Mueller, Duval and Wilt, 2007) Moreover, Penover (2010) came up with a result in his study that decrease staffing greatly increases nurses' workload and this leads to increase adverse events with regards to patient safety during their stay.

Patient Safety
The safety of the patient is the major concern when it comes to nursing care. When safety is compromised nurses experience moral distress (Rodney P.2009).

IOM defines patient safety as “The Prevention of Harm to Patients."

Sentinel Events
“An unexpected occurrence that results in death or serious physical or psychological injury to a patient”.

“Unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof”. Serious injury specifically includes loss of limb or function.

Nishizaki and colleagues concluded that the greater nursing workloads may be related to the higher patient safety incidents in inpatient wards of hospitals.
Studies showed significant evidence indicating that improved nurse staffing and hours of work reduce medication errors.
Drug administration is part of nurse’s job that is achieved through four stages (prescription, transcription dispensing, and administration). Therefore, medication error is defined as any type of error in the prescription, transcription, dispensing and administration process which could bring about serious consequences.
The result was the higher the staffing in unit had the lower incidence of healthcare associated infections (HAI) like central line associated bloodstream infection (CLBSI), ventilator-associated pneumonia (VAP). The increased in overtime resulted in higher incidence of other healthcare associated infection like catheter-associated urinary tract infections (CAUTI).
Conceptual Framework

Descriptive Correlational

Purposive sampling

Staff nurses of
Philippine General Hospital

Medicine Ward 1 and
Medicine Ward 3 of
Philippine General Hospital
Survey type of instrument consisting of the following:

Part 1: Number of Patients Handled, Classification of Patients
Part 2: 10 Nursing Care Indicators


-researchers will gather information regarding the recent reports of sentinel events (falls, medication error, nosocomial infection)
-researchers will give each respondents a tool to fill out
-researchers will explain the objectives of the study
-consent will be obtained
-instructions will be given on how to complete the survey
-confidentiality will be observed
-researchers will validate the completeness of the tool answered by the respondents
Patient Safety
Sentinel Events
 Falls
 Medication Errors
 Nosocomial Infection

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