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“EFFECTS OF NURSES’ WORKLOAD

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mary lualhati

on 8 August 2014

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Transcript of “EFFECTS OF NURSES’ WORKLOAD

“RELATIONSHIP OF NURSES’ WORKLOAD AND PATIENT SAFETY”
CHAPTER I
BACKGROUND
The researchers wanted to widen their knowledge regarding the different workload of nurses and how it affects patients' safety in terms of sentinel events.
The researchers are interested in this study for the reason that they are members of the healthcare team and their line of work is to ensure the patients safety.
The researchers believe that the more research is conducted, the more professionals will recognize the importance of this matter in relation to the nursing profession as a whole.
Main Objective:

“ Is there a significant relationship between nurses’ workload and patient safety?”

Research Questions:

The current analysis seeks answer to the following question:
1. “What are the factors that increases 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
Significance of Study
• staff nurses
• nursing/hospital administrators
• clinical instructors
• nursing students
CHAPTER II

REVIEW OF RELATED LITERATURE
Magalhaes et al, 2013 conducted a study about the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching hospital. The researchers observed that fewer patient assigned by a nurse on duty, the lesser of chance a nurse commit any harm to the patients and maintain patient safety throughout the shift.
SENTINEL EVENTS
A retrospective data analysis study of Nishizaki, et al., in 2010, was conducted concerning the medicine wards in a hospital in Japan. The study sample was fifty five nurses working on the wards with 105 beds. The study resulted that the presence of transfers of patients from ICU to wards is a risk factor and may be associated to accidental falls. Nishizaki and colleagues concluded that the greater nursing workloads may be related to the higher patient safety incidents in inpatient wards of hospitals.
Nurses
Workload
Patient Safety
Sentinel Events
 Falls
 Medication Errors
 Nosocomial Infection

Nursing Quality Indicators
 Monitoring
 Comfort measures and hygiene
 Nutrition
 Ventilatory support
 Safety
 IV therapy
 Medication
 Tube care
 Wound care
 Terminal cleaning
Conceptual Framework
Descriptive Correlational
Quantitative Research
RESEARCH DESIGN
Medicine Ward 1 and Medicine Ward 3
of Philippine General Hospital
RESEARCH LOCALE
Survey type of instrument consisting of the following:

Part 1: Number of Patients Handled, Classification of Patients
Part 2: 10 Nursing Care Indicators
RESEARCH INSTRUMENT
Approval from the Ethics committee for the review of reports.
Use of Retrospective data analysis (January – June 2014) regarding the
Nursing Quality Indicators
Reports of sentinel events (falls, medication error and nosocomial infection)
Measurement Analysis Improvement report
Nurse Performance Review Board
Monthly reports
Modifications the tool’s congruence with the study.
Tallying
Recording Nursing Quality Indicators data
Analysis and interpretation with the help of statistician or/and research experts
Data Gathering Procedure
CHAPTER III
METHODOLOGY
Chi square
Statistical Analysis
PART I:
Total number of patients handled per 8- hour shift:_____
Classification of Patients:
From the total number of patients handled, classify them in the following categories
Category I- Minimal Care
Category II- Moderate Care
Category III- Maximum Care
Category IV- Intensive Care
Part II
Nursing quality indicators
INSTRUMENTS/TOOL
Definition of Terms
1. Fall- unintentional event wherein the patient imbeds in the ground or floor.

2. Medication Error - reported case of any type of error in the prescription, transcription, dispensing and administration of medication.

3. Nosocomial Infection - acquired infection in the hospital.

4. Nursing Quality Indicators - a quantitative/qualitative tool used to measure the nurses’ workload.
• Covers the workload of staff nurses based on the nursing quality indicators such as monitoring, safety, medications etc., and
• Sentinel events such as falls, medication error, and Nosocomial infection at the Medicine wards.
Scope and Limitation
Olds & Clarke, 2010 reported that for every additional hour of overtime worked each week, the likelihood that a nurse reported occasional/frequent wrong medication or dose administration increased by 2%.
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)
Patient Safety
NuRSING WORKLOAD
According to the study of Rogers et al. in 2004, the increased in nursing workload is understaffing that will result to extended working hours of nurses. When the shifts are longer than 12 hours it will cause 3x higher increased in the adverse events on the patient.
Thank you for Listening in our presentation.
APCN Batch 36th - Research Group
5. 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 - work done by the nurse-on-duty on the patients being handled at a specified time or shift based on the nursing quality indicators (monitoring, comfort measures, safety etc.)
The study of Bailit and Blanchard in 2004 that when there is insufficient manpower or so called understaffing there will be decreased to the quality of care and patient safety.
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.
The study of Stone, et. al. in 2007, 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).
Al-shara conducted a study in 2010, demonstrated that medication errors result from interrelated factors concerning the types of errors (wrong patient and wrong dose), stages of errors (introduction of medication to the patient, ordering the medication and transcribing and dispensing) and causes of errors (heavy workload, new staff and personal neglect).
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