The impact of heavy nurse workload and patient/family complaints on workplace violence: An application of human factors framework.

AIM

To examine the relationships between workload factors at different systems levels (unit level, job level and task level), patients/family complaints and nurse reports of patient violence towards them using a human factors framework.

DESIGN

This is a secondary analysis of cross-sectional data.

METHODS

Data from 528 nurses working in medical-surgical settings in British Columbia, Canada, were analysed. At the unit-level workload factors included patient-RN ratios, patient acuity and dependency; at the job-level perceptions of heavy workload, undone nursing tasks and compromised professional standards due to workload; and at the task-level interruptions to workflow.

RESULTS

Workload factors at multiple levels were directly related to workplace violence. Nurses' increased reports of compromised standards (job level) and interruptions (task level) were related to increased reports of physical and emotional violence, and higher patient acuity (unit level) was related to increased reports of emotional violence. Patient/family complaints mediated the relationship between almost all the workload factors and workplace violence.