Nursing Turbulence in Critical Care: Relationships With Nursing Workload and Patient Safety.
Journal
American journal of critical care : an official publication, American Association of Critical-Care Nurses
ISSN: 1937-710X
Titre abrégé: Am J Crit Care
Pays: United States
ID NLM: 9211547
Informations de publication
Date de publication:
01 05 2020
01 05 2020
Historique:
entrez:
2
5
2020
pubmed:
2
5
2020
medline:
16
6
2021
Statut:
ppublish
Résumé
Increased nursing workload can be associated with decreased patient safety and quality of care. The associations between nursing workload, quality of care, and patient safety are not well understood. The concept of workload and its associated measures do not capture all nursing work activities, and tools used to assess healthy work environments do not identify these activities. The variable turbulence was created to capture nursing activities not represented by workload. The purpose of this research was to specify a definition and preliminary measure for turbulence. A 2-phase exploratory sequential mixed-methods design was used to translate the proposed construct of turbulence into an operational definition and begin preliminary testing of a turbulence scale. A member survey of the American Association of Critical-Care Nurses resulted in the identification of 12 turbulence types. Turbulence was defined, and reliability of the turbulence scale was acceptable (α = .75). Turbulence was most strongly correlated with patient safety risk (r = 0.41, n = 293, P < .001). Workload had the weakest association with patient safety risk (r = 0.16, n = 294, P = .005). Acknowledging the concepts of turbulence and workload separately best describes the full range of nursing demands. Improved measurement of nursing work is important to advance the science. A clearer understanding of nurses' work will enhance our ability to target resources and improve patients' outcomes.
Sections du résumé
BACKGROUND
Increased nursing workload can be associated with decreased patient safety and quality of care. The associations between nursing workload, quality of care, and patient safety are not well understood.
OBJECTIVES
The concept of workload and its associated measures do not capture all nursing work activities, and tools used to assess healthy work environments do not identify these activities. The variable turbulence was created to capture nursing activities not represented by workload. The purpose of this research was to specify a definition and preliminary measure for turbulence.
METHODS
A 2-phase exploratory sequential mixed-methods design was used to translate the proposed construct of turbulence into an operational definition and begin preliminary testing of a turbulence scale.
RESULTS
A member survey of the American Association of Critical-Care Nurses resulted in the identification of 12 turbulence types. Turbulence was defined, and reliability of the turbulence scale was acceptable (α = .75). Turbulence was most strongly correlated with patient safety risk (r = 0.41, n = 293, P < .001). Workload had the weakest association with patient safety risk (r = 0.16, n = 294, P = .005).
CONCLUSIONS
Acknowledging the concepts of turbulence and workload separately best describes the full range of nursing demands. Improved measurement of nursing work is important to advance the science. A clearer understanding of nurses' work will enhance our ability to target resources and improve patients' outcomes.
Identifiants
pubmed: 32355966
pii: 30933
doi: 10.4037/ajcc2020180
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
182-191Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright© 2020 American Association of Critical-Care Nurses.