A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life. BMJ Qual Saf 2011 Jan;20(1):15-24
Date
01/14/2011Pubmed ID
21228071Pubmed Central ID
PMC3058823DOI
10.1136/bmjqs.2008.028381Scopus ID
2-s2.0-79953803462 (requires institutional sign-in at Scopus site) 169 CitationsAbstract
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.
Author List
Holden RJ, Scanlon MC, Patel NR, Kaushal R, Escoto KH, Brown RL, Alper SJ, Arnold JM, Shalaby TM, Murkowski K, Karsh BTAuthor
Matthew C. Scanlon MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Cross-Sectional StudiesFemale
Humans
Male
Medication Errors
Nurses
Patient Safety
Quality of Life
Work Schedule Tolerance
Workload
