Professional Accountability and Patient Safety: Impact of Nursing Workloads on Nursing Practice and Patient Safety

This article discusses the impact of nursing workloads on nursing practice and patient safety. It covers the definition of nursing workloads, its significance to nursing, and strategies to minimize its impact. The article also includes statistics and figures that show the effects of nursing workload on the quality of nursing care, patient outcome, and nursing job dissatisfaction.

Running head: Professional Accountability and Patient Safety 1
PROFESSIONAL ACCOUNTABILITY AND PATIENT SAFETY
Student Name
Institution

Professional Accountability and Patient Safety 2
Nursing Workloads
Introduction
The nursing workload is a professional nursing issue that needs a throughput
understanding. Nursing workload refers to the magnitude of work and professional setting that
practicing nursing professionals are subjected to given the professional standards of practice
(Alghamdi 2016, pp 449-57). Throughput definition of nursing workloads encompasses five
dimensions that include the amount of time, nursing competency, work setting, nursing intensity,
and professional development. Firstly, the amount of time is the nursing professionals spend
offering both direct and indirect care to patients. The nursing setting is characterized by a huge
amount of time that is stressful and this affects the health safety.
Secondly, nursing competency is another aspect of nursing practice that clearly describes
or explains the nursing workloads (Abbas & Hassan 2017, pp 37-47). Nursing competency can
be used to describe the skill, knowledge, and behavior that nursing professional has and use for
to care for patients. The nursing workplace requires high professional competency yet nursing
practitioners have limited competency that does not match the current complex healthcare
situation. Thirdly, nursing intensity also defines nursing workloads since it touches on the
amount of care offered to the patient within healthcare. Nursing practitioners offer a wide variety
of patient care that is really demanding and this has left many nursing professionals struggling to
care beyond their ability. Fourthly, the professional development includes physical activities,
mental and emotional developments that help the nurse to be fully developed in the line of the
profession (Hunter & Giardino 2007, Issue 13).

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Significant of nursing workload to nursing
Nursing workloads are highly significant in the nursing practice and play role in the
nursing profession. Firstly, nursing workloads have a high impact on nursing profession since the
workload determines the quality of nursing care. Nursing workloads reduce the quality of care
the nursing professional offers to the patient since nursing workload makes the profession
stressful. High nursing workload makes number of nursing professionals few as compared to the
number of patients (Carayon & Gurses 2005, pp 284–301).
Secondly, the nursing workload is a professional issue since the nursing workload highly
affects the nursing profession. Nursing workloads are seen as making many nursing
professionals consider leaving the profession for other jobs. This is due to the high workload that
makes the whole profession very stressful and uncalled for. In addition, the nursing workload is
lowering the quality of the practice offered by nursing practitioners. As a professional issue
nursing workload has an effect on the ethical standards that are applied on the practice. For
instance, nursing workload makes the quality of healthcare services lower that contradict the
ethical requirement of nursing practice (Mellor 2014).
Nursing workload has an impact on individual nurse since the issue is making the nursing
workplace unsafe for the individual nurse. Nursing workload reduces an individual nurse
competency due to the low quality of care offered to the patient. The high amount of time that
nurse practitioner spent caring for the patient has a huge impact on the individual nurse and the
nursing profession as a whole. The magnitude of nursing workload has an impact on the
physical, emotional and mental development of an individual nurse hence increasing exhaustion.

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Several activities a nurse does at the healthcare increase the fatigue and reducing the
performance of individual nurse. Furthermore, workload makes nurse work under intense
pressure that is so compelling and this increases the number of nursing practitioner leaving the
nursing profession for other jobs. Nursing workloads also make the healthcare environment
worse and unattractive for new entrants. Another impact of the negative nursing workload is the
negative nursing outcome that so much affects an individual nursing practitioner. The negative
nursing care that results from huge nursing workload has a negative impact on the competency of
the nursing practitioner (Stanton & Rutherford 2004).
There are statistics and figures that show the effects of nursing workload on the quality of
nursing care, patient outcome, and nursing job dissatisfaction. Firstly, one of the issues of
concern is the nursing job dissatisfaction that shows more nurses are not satisfied with their
nursing profession due to poor working conditions. These poor working conditions is a resultant
from high nursing workloads experience at healthcare. Many nurses are on the verge of leaving
the nursing profession and the number is worrying. For instance, according to Mellor (2014), 23
% of nurses and midwives were likely to leave the nursing profession in Australia. In addition,
more than 33 % of nursing practitioners frequently thought about leaving the profession in
Australia (Rogers, Hwang & Scott et al, 2004, pp 202-12).
Impact of nursing workloads on patient safety
The impact of the nursing workload on the nursing profession is directly related to
patient safety. Nursing workload reduces the patient length of stay since the workload increases
the number of nurses required at a particular time. A high number of the patient cannot match the

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minimal number of nursing practitioners. This has reduced the number of hours spend with
patients, a low number of caregivers and inability to rescue patients from complications (Hunter
& Giardino 2007, Issue 13). Low staffing ration between nursing practitioners and patients
corresponds to a high number of patients stay in the healthcare. Violation of policies, protocols,
and standards is another impact of workload on the patient's safety. Nursing workloads bring
more pressure on nurse leading to the low observance of general standards of practice thereby
risking the life of patients under their care. For instance, compliance with a clinical protocol or
violation of clinical protocol has an immense impact on the clinical patient's outcome. Violation
of clinical protocol is associated with worse clinical outcome and this can be attributed to
nursing workload. Most protocol violations are due to the workload pressures experienced during
emergency situations that are normally demanding for nursing practitioners (Baethge & Rigotti,
2013, pp 43–63).
There are statistics that are showing the adverse effect of nursing workloads on patient’s
safety. Firstly, a study conducted in Australia on causing factor for death due to cancer include
the nursing workload that has a direct effect on patient care hence death due low nursing care.
According to the study, 73% nursing practitioners felt they had inadequate time to incorporate
strategies into their existing nursing workload (Carayon & Gurses 2005, pp 284–301). Another
study suggests that an increase of 1 hour worked by practicing nurse (PNs) per patient day is
directly related to an 8.9 percent chronic decrease outcomes. A retrospective cohort study within
neonatal ICU indicates that the incidence of E cloacae infection within the unit was at least
higher when there was limited number of nurses. Another example includes a study that used 168

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patients and revealed that there is 7% increase in death within 30 days of medication due
understaffing of nursing practitioners (Baernholdt et al 2010, pp229-34).
The nursing workloads as an issue of patient safety concern have an adverse consequence
on the patient. Firstly, the nursing workload affects the patient outcome and particularly results
in the negative patient's outcomes. The negative patient outcome results in the lower quality of
nursing care offered due to huge nursing workloads (Cho et al 2003, pp 71–9). Secondly, another
adverse effect of nursing workload on a patient includes high mortality rate that is part of the
limited time spent on patient care by nursing professional. Studies show that more mortality
results from failure to rescue a patient who develops complications due to a limited number of
nursing practitioners within high workloads. In addition, using health data obtained from 799
hospitals within 11 States indicates that a higher number of hours of Registered Nursing
practitioners care daily were related to lower failure to rescue rates (Aiken, Clarke & Sloane et
al. 2002, pp 1987–93).
Strategies that can be utilized to minimize the impact of nursing workloads on
nursing practice and patient safety
There are various strategies that can be used to minimize the impact of nursing workloads
on nursing practice and patient’s safety. Firstly, interdisciplinary approach to patient cares in one
of the strategies to minimize the impact of workload. The interdisciplinary approach reduces the
impact of huge workload that nursing practitioners experience while working. Moreover, the
interdisciplinary approach increases the staffing capacity to deal with the patient care. The

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interdisciplinary approach also helps reduce the amount of time that is required for the nursing
office to work in patient care (Gurses 2005).
Secondly, nursing staffing is another strategy that can assist to minimize the impact of
workload on nursing practice. Statistics indicate that there are few nursing practitioners in
Australia that take care of patients as compared to the number of patients that need the nursing
care. This magnitude of work has raised the amount of work left in the hand of these nursing
practitioners. Increasing the number of nursing staffs in various health care throughout Australia
would reduce the nursing workload and reduce the impact of nursing workload on patients safety
(Kondro 2004, p2059).
Nursing education framework is another important strategy as it seeks to improve the
nursing skills and knowledge. Nursing education has been an issue of concern particularly when
it comes to the nursing workloads. One of the aspects of nursing workload includes lack of skills
and knowledge that can match the current health care requirement. This can be rectified through
the development of nursing education framework that provides an avenue for nursing
practitioners to further their education with updates on development in the nursing profession.
Nursing education moreover, has the capability of changing current nursing challenges that are
contributing to nursing workloads (Duffield 2006, Pp 16-22).
Application of modern information technology is another strategy that can be used to
reduce the impact of nursing workload on patient safety and nursing practice. According to
Ferguson-Pare and Bandurchin (2010, pp20-32), patient records can be computerized as a way to
maintain the amount of work nursing practitioners required to perform. This also helps in

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monitoring the patient's progress and outcomes from any place through electronic means. The
current information technologies make monitoring of patient care easy provided that all the
information is registered into the system. For instance, the Royal Australian College of General
Practitioners indicates that the use of Practicing Nurse system to monitor health records
projecting to have an impact on the nursing workload (The Royal Australian College of General
Practitioners, 2018).
Conclusion
In conclusion, the nursing workload is an important nursing professional issue that affects
many nursing practitioners and healthcare facilities in Australia. The nursing workload can be
defined in terms of intensity of nursing, amount of time spent on patient care and physical,
emotional and mental development. Understaffing which is part of nursing workload is
correlated to patient safety concerns as it results in low patient care. In addition, the nursing
workload has an adverse effect on both nursing profession and patient safety.

Professional Accountability and Patient Safety 9
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