RT Journal Article
SR Electronic
T1 A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life
JF BMJ Quality & Safety
JO BMJ Qual Saf
FD BMJ Publishing Group Ltd
SP 15
OP 24
DO 10.1136/bmjqs.2008.028381
VO 20
IS 1
A1 Richard J Holden
A1 Matthew C Scanlon
A1 Neal R Patel
A1 Rainu Kaushal
A1 Kamisha Hamilton Escoto
A1 Roger L Brown
A1 Samuel J Alper
A1 Judi M Arnold
A1 Theresa M Shalaby
A1 Kathleen Murkowski
A1 Ben-Tzion Karsh
YR 2011
UL http://qualitysafety.bmj.com/content/20/1/15.abstract
AB Background 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.Methods 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.Results 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.Discussion 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.