TY - JOUR
T1 - Nursing turbulence in critical care
T2 - Relationships with nursing workload and patient safety
AU - Browne, Jennifer
AU - Braden, Carrie Jo
N1 - Publisher Copyright:
© 2020 American Association of Critical-Care Nurses.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Background Increased nursing workload can be associated with decreased patient safety and quality of care. The associations between nursing workload, quality of care, and patient safety are not well understood. Objectives The concept of workload and its associated measures do not capture all nursing work activities, and tools used to assess healthy work environments do not identify these activities. The variable turbulence was created to capture nursing activities not represented by workload. The purpose of this research was to spec-ify a definition and preliminary measure for turbulence. Methods A 2-phase exploratory sequential mixed-methods design was used to translate the proposed construct of turbulence into an operational definition and begin preliminary testing of a turbulence scale. Results A member survey of the American Association of Critical-Care Nurses resulted in the identification of 12 turbulence types. Turbulence was defined, and reliability of the turbulence scale was acceptable (α =.75). Turbulence was most strongly correlated with patient safety risk (r = 0.41, n = 293, P <.001). Workload had the weakest association with patient safety risk (r = 0.16, n = 294, P =.005). Conclusions Acknowledging the concepts of turbulence and workload separately best describes the full range of nursing demands. Improved measurement of nursing work is important to advance the science. A clearer understanding of nurses’ work will enhance our ability to target resources and improve patients’ outcomes.
AB - Background Increased nursing workload can be associated with decreased patient safety and quality of care. The associations between nursing workload, quality of care, and patient safety are not well understood. Objectives The concept of workload and its associated measures do not capture all nursing work activities, and tools used to assess healthy work environments do not identify these activities. The variable turbulence was created to capture nursing activities not represented by workload. The purpose of this research was to spec-ify a definition and preliminary measure for turbulence. Methods A 2-phase exploratory sequential mixed-methods design was used to translate the proposed construct of turbulence into an operational definition and begin preliminary testing of a turbulence scale. Results A member survey of the American Association of Critical-Care Nurses resulted in the identification of 12 turbulence types. Turbulence was defined, and reliability of the turbulence scale was acceptable (α =.75). Turbulence was most strongly correlated with patient safety risk (r = 0.41, n = 293, P <.001). Workload had the weakest association with patient safety risk (r = 0.16, n = 294, P =.005). Conclusions Acknowledging the concepts of turbulence and workload separately best describes the full range of nursing demands. Improved measurement of nursing work is important to advance the science. A clearer understanding of nurses’ work will enhance our ability to target resources and improve patients’ outcomes.
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U2 - 10.4037/ajcc2020180
DO - 10.4037/ajcc2020180
M3 - Article
C2 - 32355966
AN - SCOPUS:85084198050
SN - 1062-3264
VL - 29
SP - 182
EP - 191
JO - American Journal of Critical Care
JF - American Journal of Critical Care
IS - 3
ER -