Effects of nursing work loads on patients safety in the selected public hospitals in Vhembe District of Limpopo Province, South Africa

Abstract

Background: The heavy workload of hospital nurses is a major problem globally. Nurses are experiencing higher workloads than ever before due to four main reasons, increased demand for nurses, inadequate appointment of new nurses, reduced staffing and increased overtime and reduction in patient length of stay. It is necessary for South Africa to find ways to reduce nursing workload and improve patient safety particularly in rural areas, to understand these effects of nursing workload on patient safety, the study was conducted with professional nurses from selected hospitals in Vhembe district, Limpopo Province. Purpose: The purpose of this study was to determine and to assess the effects of nurses‘ workloads on patient safety in the selected public hospitals, Vhembe District, Limpopo Province, South Africa. Methodology: Quantitative, exploratory descriptive design was adopted. Self-administered questionnaires were used for data collection from the sampled hospitals in Vhembe district. Hospitals were sampled based on the statistics of admitted patients in medical and surgical wards. Target population were professional nurses with at least two years working in the sampled wards. Ethical considerations were maintained. Results: There are several important consequences of high nursing workload. Findings show that a heavy nursing workload adversely affects patient safety. The study also shows that majority 80 (79.0%) of the respondents were overloaded by nursing responsibilities and this negatively affects nursing job satisfaction. As many as 55 (54.4%) indicated that such v workload contributes to high turnover and the nursing shortage. In addition to the higher patient acuity, work system factors and expectations also contribute to the nurses‘ workload: nurses are expected to perform non-professional tasks such as delivering and retrieving food trays; housekeeping duties; transporting patients; and ordering, coordinating, or performing ancillary services Conclusion: Nursing workload is affected by staffing levels and the patients‘ conditions, but also by the design of the nurses‘ work system. The study showed that a work situation above the assumed optimal level increases the risk for adverse events and patient mortality. However, the resources for nursing staff are limited in all public hospitals where the study focused. Professional nurses, therefore, must use available resources in the most optimal way. The study also recommended that there should be a creation of the nursing posts and the filling of all vacant positions in South Africa. Continuity of in-service training to empower professional nurses on patient safety was emphasised.