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.
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.
Authors: Anne Marie Rafferty; Sean P Clarke; James Coles; Jane Ball; Philip James; Martin McKee; Linda H Aiken Journal: Int J Nurs Stud Date: 2006-10-24 Impact factor: 5.837
Authors: Richard J Holden; Rupa S Valdez; Christiane C Schubert; Morgan J Thompson; Ann S Hundt Journal: Ergonomics Date: 2016-05-10 Impact factor: 2.778
Authors: Richard J Holden; Neal R Patel; Matthew C Scanlon; Theresa M Shalaby; Judi M Arnold; Ben-Tzion Karsh Journal: Res Social Adm Pharm Date: 2010-02-11
Authors: Gail E Armstrong; Mary Dietrich; Linda Norman; Jane Barnsteiner; Lorraine Mion Journal: J Nurs Care Qual Date: 2017 Jul/Sep Impact factor: 1.597
Authors: Pascale Carayon; Ben-Tzion Karsh; Ayse P Gurses; Richard Holden; Peter Hoonakker; Ann Schoofs Hundt; Enid Montague; Joy Rodriguez; Tosha B Wetterneck Journal: Rev Hum Factors Ergon Date: 2013-09-01