Veille documentaire MTPH

Médecine du travail du personnel hospitalier

A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life

Auteur     Richard J Holden
Auteur     Matthew C Scanlon
Auteur     Neal R Patel
Auteur     Rainu Kaushal
Auteur     Kamisha Hamilton Escoto
Auteur     Roger L Brown
Auteur     Samuel J Alper
Auteur     Judi M Arnold
Auteur     Theresa M Shalaby
Auteur     Kathleen Murkowski
Auteur     Ben-Tzion Karsh
Résumé     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.
Publication     BMJ quality & safety
Volume     20
Numéro     1
Pages     15-24
Date     Jan 2011

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