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

被引：150

作者：

Holden, Richard J. ^{[1
]}

Scanlon, Matthew C. ^{[2
]}

Patel, Neal R. ^{[3
]}

Kaushal, Rainu ^{[4
]}

Escoto, Kamisha Hamilton ^{[5
]}

Brown, Roger L. ^{[1
]}

Alper, Samuel J. ^{[1
]}

Arnold, Judi M. ^{[6
]}

Shalaby, Theresa M. ^{[6
]}

Murkowski, Kathleen ^{[7
]}

Karsh, Ben-Tzion ^{[1
]}

机构：

[1] Univ Wisconsin, Madison, WI 53706 USA

[2] Med Coll Wisconsin, Milwaukee, WI 53226 USA

[3] Vanderbilt Univ, Nashville, TN USA

[4] Weill Cornell Med Coll, New York, NY USA

[5] Ingenix, Analyt & Res Unit, Eden Prairie, MN USA

[6] Vanderbilt Childrens Hosp, Nashville, TN USA

[7] Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA

来源：

BMJ QUALITY & SAFETY | 2011年 / 20卷 / 01期

基金：

美国医疗保健研究与质量局; 美国国家卫生研究院;

关键词：

FALSE DISCOVERY RATE; MENTAL WORKLOAD; JOB-SATISFACTION; INTENSIVE-CARE; HUMAN ERROR; NURSES; USABILITY; MORTALITY; WORKPLACE; TURNOVER;

D O I：

10.1136/bmjqs.2008.028381

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

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.

引用

页码：15 / 24

页数：10

共 107 条

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