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08-11-2011 | Legal medicine | Article

Quality of working environment for nurses impacts patient health


Free abstract

MedWire News: A poor quality working environment for nurses can adversely impact on patient health, say US researchers.

"Our findings suggest that patient safety and occupational safety for nurses may be related by common causes, and should be considered together in future studies," said study author Jennifer Taylor from Drexel University, Philadelphia, Pennsylvania, in a press statement.

As reported in the journal BMJ Quality and Safety, the team conducted a cross-sectional study of 723 nurses working in 29 nursing units in the USA and 28,876 patients discharged from the units.

The researchers assessed the safety climate of the nursing units in 2004 using the validated Safety Attitudes Questionnaire (SAQ). Registered nursing hours per patient day (RNHPPD) and unit staff turnover were also taken into account when evaluating working conditions. Working conditions and outcomes were measured in 2005. Outcomes included patient injury/adverse outcome and nurse injury.

Patient injuries/adverse outcomes included 105 decubitus ulcers, 167 pulmonary embolism/deep vein thrombosis, and 290 falls, whereas nurse injury (n=78) included reported needle-sticks, trips, falls, splashes, or slips.

According to the results of the SAQ, there were significant negative associations between the Safety and Teamwork domain scores and the rate of nurse injury and frequency of patient decubitus ulcers.

For example, each 10-point increase in SAQ Safety domain score for a nursing unit was associated with a 48% decrease in risk for patient decubitus ulcer and a 45% reduction in risk for nurse injury on that unit. Similar results were observed for the Teamwork domain of the SAQ.

RNHPPD was negatively associated with patient falls and decubitus ulcers, notes the team. In addition, higher unit staff turnover increased the risk for nurse injury and patient pulmonary embolism/deep vein thrombosis, but reduced the risk for falls and decubitus ulcers.

"This is one of few studies that have identified predictors of both nurse and patient injury in the hospital setting," said Taylor. "We need to look deeper into hospital organizations to understand the cause and effect relationship."

The authors conclude: "Future healthcare safety research and intervention efforts should consider a new paradigm integrating lessons learnt from both disciplines to more comprehensively and efficiently reduce preventable injuries to both workers and patients."

By Helen Albert

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