Description of the National Healthcare Issue
The high workload for nurses is a huge issue in healthcare. Nurses are experiencing higher workloads primarily as a result of a shortage of nurses, which forces the few available nurses to deal with the high workload in the healthcare sector ( Magalhães et al., 2017; Amin, 2011 ). Aside from the inadequate supply of nurses and reduced staffing, which results in the shortage of nurses, the higher demand for registered nurses, the reduction in patients’ duration of stay, and increased overtime also increases the workload for nurses. Nurses agree with the fact that errors in psychomotor skills, documentation, and medication administration occur due to heavy workload. 70% of the nurses believe that heavy workload affects them mentally, with the remaining 30% linking heavy workload to the high levels of physical fatigue (Dechavez, 2016). The heavy workload increases the level of dissatisfaction among the nurses. In addition, the heavy workload has a negative effect on the standard of care offered by nursing personnel, and thus negatively affecting patient safety in healthcare institutions. In sum, the high workload leads to the impairment of nursing vigilance leading to an increased risk of detrimental events such as falls, UTI, errors in the administration of medications, and central catheter infections, among others.
Summary of Articles
Dechavez (2016) identifies the factors that contribute to the high nursing workload and explores the impact of staff reduction on care quality in Shalamar hospital. According to the study, which involved 60 registered nurses, reduced staff, increased number of patients, and the outbreak of disease were the primary causes of heavy workload. Dechavez (2016) links the heavy workload to both mental and physical fatigue, which results in the reduction of nursing vigilance, causing errors in psychomotor skills, documentation, and the administration of medicine. Hospital nursing management can help reduce the heavy workload by balancing the nurse-patient ratio, along with allocating assistants to nurses (Dechavez, 2016). Contrary to popular opinion, asking for help from other departments cannot solve the problem of high workload for nurses.
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Elsewhere, Berry et al. (2013) discuss how Canadian nurses are demoralized by the inaction of decision-makers despite the massive evidence that correlates a safe level of nurse staffing with improved levels of patient safety. Based on the report, there is an international shortage of nurses, which leads to nurses being burned out, stressed, and overwhelmed by their working environment. To address the health issues, there is a need to improve nurses’ workload and work-life through various measures, such as proper staffing, minimizing levels of absenteeism, and nurse fatigue, among other measures (Berry et al., 2013). According to the report, there is a need to change the current nurse staffing models. For these new models to be effective, there is a need to incorporate nurses in the decision-making process, both at the individual patient level and on how the healthcare system is run.
Carayon et al. (2008) analyze nursing workload from the human factor engineering point of view. According to the article, the nursing workload can be categorized into workload at the unit level, the workload at the job level, situation-level workload, and workload at the patient level. At the unit level, a high workload is associated with a negative effect on patient care. The workload at the job level, on the other hand, is linked to multiple nursing outcomes, including stress and job dissatisfaction, situation-level workload is associated with poor work surrounding, inadequate stocking of supplies, and ineffective communication, among other factors. Carayon et al. (2008) also discuss the effect of nursing workload on patient safety. To help eradicate the negative effect of nursing workload on patient safety, the article proposes the use of the human factor engineering approach in conjunction with the Systems Engineering Initiative for Patient Safety (SEIPS) model of work, which can help in the process of identification of the factors contributing to nursing workload and the redesign of a system that will eradicate the heavy workload.
Summary of Strategies for Addressing the Organizational Impact of High Workload for Nurses
The high workload for nurses can be solved through the application of the human engineering factor approach, along with the increased involvement of nurses in the decision-making process to facilitate adequate staffing. The human factor engineering approach, which depends on the SIEPS model of work system and patient safety, helps in the analysis of the causal factors associated with nursing workload (Carayon et al., 2008). The process facilitates a better conceptualization of how the nurses’ working system contribute to a heavy workload. The outcome of the analysis will help the decision-makers to better understand the elements and characteristics of the work system and how they translate to a high workload for nurses (Carayon et al., 2008). With the outcome of the analysis, the human factor engineers can propose a new design for the nurses’ work system to help eliminate the bottleneck in the system. However, to effectively implement the necessary measures to adequately staff nurses as recommended by the workload measurement tools, there is a need to incorporate nurses’ input in how the health care system will be run. Moreover, these nurses need to be given authority and autonomy to be able to implement the necessary measures to staff the units to the recommended level (Berry et al., 2013). In addition to increasing nurse staffing, these nurses can be provided with assistants to help ease their workload. The redesign of the nurses’ working system may require nurses to be accustomed to the new system and thus interrupting the quality of work in the short-term. However, in the long-term, the redesigned system will help eliminate the high workload and thus improve the working environment. In addition, increasing nurse staffing will cost additional money in the form of salary expenditures. However, eventually, the organization will reap the financial benefits of improved nurse staffing, such as the reduced likelihood of post-discharge ER visits, which offsets the nurse staffing costs.
References
Amin, S. G. (2011). A study to determine the influence of workload on nursing personnel.
Berry, L., & Curry, P. (2013). Nursing workload and patient care: Understanding the value of nurses, the effects of excessive workload, and how nurse-patient ratios and dynamic staffing models can help . Canadian Federation of Nurses Unions.
Carayon, P., & Gurses, A. P. (2008). Nursing workload and patient safety—a human factors engineering perspective. In Patient safety and quality: An evidence-based handbook for nurses . Agency for Healthcare Research and Quality (US).
Dechavez, S. (2016). The increased nursing workload and its impact on nursing care. Texila International Journal of Nursing, 2 (2): 1-2
Magalhães, A. M. M. D., Costa, D. G. D., Riboldi, C. D. O., Mergen, T., Barbosa, A. D. S., & Moura, G. M. S. S. D. (2017). Association between workload of the nursing staff and patient safety outcomes. Revista da Escola de Enfermagem da USP , 51 .
