• Health services research · Apr 2009

    Impact of performance obstacles on intensive care nurses' workload, perceived quality and safety of care, and quality of working life.

    • Ayse P Gurses, Pascale Carayon, and Melanie Wall.
    • Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA. agurses1@jhmi.edu
    • Health Serv Res. 2009 Apr 1;44(2 Pt 1):422-43.

    ObjectivesTo study the impact of performance obstacles on intensive care nurses' workload, quality and safety of care, and quality of working life (QWL). Performance obstacles are factors that hinder nurses' capacity to perform their job and that are closely associated with their immediate work system.Data Sources/Study SettingData were collected from 265 nurses in 17 intensive care units (ICUs) between February and August 2004 via a structured questionnaire, yielding a response rate of 80 percent.Study DesignA cross-sectional study design was used. Data were analyzed by correlation analyses and structural equation modeling.Principal FindingsPerformance obstacles were found to affect perceived quality and safety of care and QWL of ICU nurses. Workload mediated the impact of performance obstacles with the exception of equipment-related issues on perceived quality and safety of care as well as QWL.ConclusionsPerformance obstacles in ICUs are a major determinant of nursing workload, perceived quality and safety of care, and QWL. In general, performance obstacles increase nursing workload, which in turn negatively affect perceived quality and safety of care and QWL. Redesigning the ICU work system to reduce performance obstacles may improve nurses' work.

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