Relationship between nursing workloads and patient safety incidents

Abstract

Yuji Nishizaki1, Yasuharu Tokuda2, Ekiko Sato1, Keiko Kato1, Akiko Matsumoto1, Miwako Takekata1, Mineko Terai1, Chitose Watanabe3, Yang Ya Lim1, Sachiko Ohde1, Ryoichi Ishikawa11St. Luke’s International Hospital, Tokyo, Japan; 2Mito Medical Center, University of Tsukuba, Ibaraki, Japan; 3Saitama City Hospital, Saitama, JapanObjective: To evaluate the relationship between nursing workloads and patient safety incidents in inpatient wards of a general hospital.Methods: A retrospective data analysis was conducted involving the internal medicine wards in a teaching hospital in Japan between July 1st and December 31st, 2006. To assess associations between nursing workloads and patient safety incidents, we analyzed the following: the relationships between the level of patients’ dependency and the number of incident reports; and the relationships between the presence of accidental falls and the presence of patients transferred from the intensive care unit to the wards.Results: Fifty-five nurses worked on the wards (105 beds). The total number of incidents was 142 over the 184 days of this study. There was a positive trend between the number of incidents and the total patient dependency score. The presence of accidental falls in the wards was associated with the presence of transfers from the intensive care unit to the wards (odds ratio 3.14, 95% confidence interval: 1.48, 6.65).Conclusion: Greater nursing workloads may be related to the higher number of patient safety incidents in inpatient wards of hospitals. Keywords: risk management, bed control, incident report, patient dependency, nursing care, diagnosis and procedure combination