Exploring the Impact of Nurse Workload on Patient Safety Outcomes in Intensive Care Units: A Multicenter Study
DOI:
https://doi.org/10.63278/jicrcr.vi.773Keywords:
Nurse workload, patient safety, Intensive Care Units, Nurse-to-patient ratio, Nursing Activities Score, Adverse events, healthcare-associated infections, mortality rates, Burnout, and Staffing policies.Abstract
Background
Intensive Care Units (ICUs) are among the most expensive and resource-intensive healthcare environments.Workloads are correlated with an increase in adverse events, healthcare-associated infections (HAIs), and elevated mortality rates.Notwithstanding the risks of staff shortages, it is clear that there is still great variability in nurse-to-patient ratios (NPRs) and staffing policies across hospitals, which emphasizes the necessity for comprehensive, multicenter research.
Objectives
In this study, patient safety outcomes, such as adverse events, HAIs, and mortality rate, in ICUs were studied in the context of the impact of nurse workload, as measured by the NPRs and NAS.It also investigated ICU nurses' perceptions of the effects of workload challenges on care quality.
Methods
This multicenter observational study was conducted in 15 ICUs in the India. For 1,500 patients, quantitative data on NPRs, NAS, and patient safety indicators (adverse events, HAIs, and mortality rates) were collected. Semi-structured interviews were conducted with 60 ICU nurses to collect qualitative data.The relationships between workload metrics and patient outcomes were examined using descriptive and inferential statistical analyses, and thematic analysis was conducted to understand the key qualitative insights.
Results
Facilities with higher NPRs (≥1: as compared to lower workload ICUs, 3) and NAS (>80%) reported 28% more adverse events (p < 0.01), 40% more HAIs (p < 0.05), and twice as many mortalities (12% vs. 8%, p < 0.01).Regarding qualitative findings, potential cognitive overload, emotional burnout, and coordination were the key issues.
Conclusion
Poor patient safety outcomes are strongly associated with high nurse workload in ICUs.To improve patient care quality and nurse well-being, nurses' workload must be decreased by optimizing the staffing ratios, equitable task dispensation among nurses, and supportive policies.
