Nurse Working Conditions & Patient Safety Outcomes

Nurses' working conditions have been found to play an important role in patient outcomes.
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Nurses play an integral role in patient care that is hard to underestimate. It is not surprising, then, that the relationship between nurses' working conditions and patient safety outcomes is an important one. When working conditions are difficult for nurses, it is not just nurses who suffer -- patients often bear the brunt of the problem, and with undesirable effects.

Nurse-Patient Connection

    The relationship between nurses' working conditions and patient safety is one that provokes continual debate and research in the health care field. It's an issue the Agency for Healthcare Research and Quality has studied in-depth, leading the AHRQ to state in its "Nursing and Patient Safety Primer" that nurses "play a critically important role in ensuring patient safety by monitoring patients for clinical deterioration, detecting errors and near misses, understanding care processes and weaknesses inherent in some systems, and performing countless other tasks to ensure patients receive high-quality care."

    This critically important role can be compromised by working conditions that make it difficult for nurses to monitor patients and provide a level of care optimal to patient safety.

Working Conditions That Contribute to Poor Outcomes

    One nurse's poor working conditions may be another nurse's status quo, but research conducted by the AHRQ states that several job-related factors can create nursing work conditions that increase the incidence of poor patient outcomes. Unfortunately, many of these factors are common enough to the nursing field to be considered standard to the job, such as high nurse-to-patient ratios, longer shifts and overtime and responsibility for additional non-nursing tasks. Despite the prevalence of these conditions in the nursing field, all have been identified in multiple research studies as factors that contribute to adverse patient outcomes.

Adverse Patient Safety Outcomes

    Understaffing, overtime and increased workload decrease the amount of time and energy nurses have to spend with patients, and the research compiled by the AHRQ has linked these poor working conditions to adverse conditions that can affect patient care, safety and even mortality. Everything from insufficient hand washing and gloving techniques to increased instance of nosocomial infections and pneumonia to medication errors and failures to rescue patients in life-threatening situations have been linked to nursing work conditions where nurses are strapped for time and expected to work long hours.


    Defining factors that contribute to poor nursing conditions and poor patient safety has become a popular research topic, but the AHRQ's conclusion relates poor patient outcomes to a less definable problem -- burnout. Understanding what contributes to nurse burnout, however, is even more difficult. According to the AHRQ, some studies suggest that higher patient ratios contribute to the problem, while others suggest that the high-risk nature of the job is to blame. Workloads and work conditions vary so drastically from employer to employer that burnout may explain this relationship between work conditions and patient safety, though it make tackling the problem more difficult.

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