The association between self‐reported workload and perceptions of patient safety culture: A study of intensive care unit nurses

Abstract

Aim and Objective This study aimed to examine the association between workload and patient safety culture (PSC) among intensive care unit (ICU) nurses. Background ICU nurses play a vital role in promoting patient safety and are essential indicators in any healthcare system including ICUs. Research studies focusing on the relationship between nursing workload and PSC among ICU nurses are limited. Design Descriptive correlational design. Methods The study participants involved 380 ICU nurses at two hospitals in Riyadh, Saudi Arabia. Data were collected between February 2019–April 2019 and were analysed using SPSS v.22 statistical software. This study was guided by the STROBE checklist. Results The results showed that ICU nurses have high positive perceptions in the following PSC subscales: teamwork within units, organisational learning–continuous improvement, frequency of events reported, feedback and communication about error, management support for patient safety, teamwork across units, supervisor/manager expectations and actions promoting patient safety, handoffs and transitions, nonpunitive response to errors, staffing and overall perceptions of patient safety. However, the participants collectively considered the overall grade on patient safety as poor. The participants had high mean scores in physical demand, effort, mental demand and overall workload. A statistically significant variability existed in the mean scores of the PSC subscales and workload of ICU nurses. The overall workload was significantly and negatively associated with the PSC perceptions of ICU nurses. Conclusion The ICU nurses experienced high overall workload, physical demand, effort and mental demand which influenced the poor grade of their overall perceived PSC. Relevance to Clinical Practice Identifying differences and associations with the perceptions of ICU nurses regarding workload and PSC is important because such perceptions may affect their delivery of nursing care. Hospital and nursing administrators must use the study results to find strategies that address workload issues and enhance patient safety.

Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis

“…However, there is some contradictory research from intensive care units specific to general versus dimension-level perceptions. For example, intensive care nurses (n = 380) reported high positive perceptions about teamwork within units and organizational learning: continuous improvement, despite having an overall low perception of patient safety culture due to physical and mental demand and overall workload [ 128 ]. Importantly, general perceptions need to be carefully interpreted across time within the context, culture, and conditions of the health sector.…”

The relationship between practice environment, job satisfaction and intention to leave in critical care nurses

“…The data collection occurred (coincidentally) in the early stages of the COVID‐19 pandemic in KSA. COVID‐19‐related medical emergencies have significantly changed the CCU NPE due to strict infection control measures (eg, isolation room, comprehensive PPE, limited visitation) resulting in increased workload and high stress 39,50,51 . However, the pandemic has also promoted interprofessional collaboration and a high sense of responsibility in these times 50,52 .…”

“…resulting in increased workload and high stress. 39,50,51 However, the pandemic has also promoted interprofessional collaboration and a high sense of responsibility in these times. 50,52 Similar highstress circumstances have previously been associated with burnout, moral distress and compassion fatigue in CCU nurses.…”

Nursing workload assessment in an intensive care unit: A retrospective observational study using the Nursing Activities Score

“…Nursing activities in ICUs are dynamic and variable over the 24‐h period 3 and the management of nursing workload is becoming a challenge 1,4–9 . In fact, increased nursing workload is associated with increased incidence of adverse events 10,11 that could compromise the patient safety culture 12–14 and the quality of care 6,15,16 …”