Al-Kandari Fatimah, Thomas Deepa
College of Nursing, Public Authority for Applied Education & Training, Kuwait.
J Clin Nurs. 2009 Feb;18(4):581-90. doi: 10.1111/j.1365-2702.2008.02369.x.
This study was carried out to identify the perceived adverse patient outcomes as related to nurses' workload. It also assessed nurses' perception of variables contributing to the workload and adverse patient outcomes.
Several studies have been published on adverse patient outcomes in which a correlation was found between nurses' workload and some adverse patient outcomes.
A cross-sectional survey was conducted between registered nurses (n = 780) working in medical and surgical wards of five general governmental hospitals in Kuwait. DATA COLLECTION INSTRUMENTS: Data were collected using a self-administered questionnaire consisting of three sections to elicit information about the sample characteristics, perception of workload and perceived adverse patient outcomes during the last shift and last working week.
The three major perceived adverse outcomes reported by the nurses while on duty during their last shift were: complaints from patients and families (2%), patients received a late dose or missed a dose of medication (1.8%) and occurrences of pressure ulcer (1.5%). Similarly, the reported adverse outcomes over the past week were complaints from patients and families (5%), patients received a late dose or missed a dose of medication (5.3%) and discovery of a urinary tract infection (3.7%). Increases in nurse-patient load, bed occupancy rate, unstable patients' condition, extra ordinary life support efforts and non-nursing tasks; all correlated positively with perceived adverse patient outcomes.
This study sheds light on an important issue affecting patient safety and quality of care as perceived by the nurses themselves as caregivers.
Nurses' perception of variables contributing to adverse patient outcomes and their workload could significantly affect the provided nursing care and nursing care recipients. The findings could help in policy formulation and planning strategies to decrease adverse patient outcomes in many countries with a health care structure similar to that of Kuwait.
本研究旨在确定与护士工作量相关的患者不良结局。同时评估护士对导致工作量和患者不良结局的变量的认知。
已有多项关于患者不良结局的研究发表，其中发现护士工作量与一些患者不良结局之间存在关联。
对科威特五家政府综合医院内科和外科病房的注册护士（n = 780）进行了横断面调查。
使用一份自填式问卷收集数据，问卷包括三个部分，以获取有关样本特征、上一班次和上一周工作期间的工作量认知以及感知到的患者不良结局的信息。
护士在上一班次值班期间报告的三大主要不良结局是：患者及家属投诉（2%）、患者用药延迟或漏服（1.8%）和发生压疮（1.5%）。同样，过去一周报告的不良结局是患者及家属投诉（5%）、患者用药延迟或漏服（5.3%）和发现尿路感染（3.7%）。护士与患者的比例增加、床位占用率、患者病情不稳定、特殊生命支持工作和非护理任务；所有这些都与感知到的患者不良结局呈正相关。
本研究揭示了一个影响患者安全和护理质量的重要问题，这是护士作为护理人员自身所感知到的。
护士对导致患者不良结局的变量及其工作量的认知可能会显著影响所提供的护理及护理对象。这些研究结果有助于在许多医疗保健结构与科威特类似的国家制定政策和规划策略，以减少患者不良结局。
