Patient Safety Incidents and Nursing Workload.
Katya Cuadros Carlesi, Kátia Grillo Padilha, Maria Cecília Toffoletto and 2 others
PMID 28403334WHAT IT FOUND
Falls were the only patient safety incident that correlated with nursing workload across hospital services.
Medication errors, self-removal and restraint incidents did not correlate with workload, so staffing alone does not explain them.
Key findings
01The fall rate was highly positively correlated with workload variables (r = 0.8770).
02Self-removal of invasive devices and mechanical restraint incidents correlated with each other (r = 0.7744 and r = 0.7748), but not with workload variables.
03Medication error rate showed a high correlation index (r = 0.9124) only in its own component and no correlation with the other studied variables.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study analysed 11 clinical services as the unit of observation, not individual patients or nurses, so it could not use usual regression methods. It was done in one hospital, and the authors state the results are valid only for that hospital. Workload estimates for most services did not consider patient risk or degree of dependence, except in intensive care units. The study was cross-sectional and used correlations, so it cannot show that workload caused incidents. Different incident formulas and methods make comparison with other studies difficult.
The easy way to misread this
Do not read this as proof that adding nurses prevents patient safety incidents. The study found only a correlation between workload variables and fall rates at service level, and medication errors, self-removal and restraint incidents did not correlate with workload.