title: Performance obstacles of intensive care nurses.
abstract: BACKGROUND
  The work environment of intensive care nurses may have substantial impact on both nursing outcomes and patient safety. The factors in a nurse's immediate work environment, in the local work context, have not been studied in detail to provide useful, specific information for work redesign efforts to improve nurse's work and patient safety. Performance obstacles are the factors that hinder intensive care nurses' capacity to perform their jobs and that are associated closely with their immediate work environment.
  
  
  OBJECTIVE
  To identify the performance obstacles experienced by intensive care nurses in their work environment.
  
  
  METHODS
  A multisite, cross-sectional study was conducted. Data were collected using a 36-item questionnaire and analyzed using univariate statistical analysis. The frequencies of performance obstacles reported by intensive care nurses were computed.
  
  
  RESULTS
  Nurses (n = 272) from 17 intensive care units (ICUs) of seven hospitals in Wisconsin participated in the study. The most frequently experienced performance obstacles included noisy work environment (46%), distractions from families (42%), hectic (40%) and crowded work environments (37%), delay in getting medications from pharmacy (36%), spending considerable amount of time teaching families (34%), equipment not being available-someone else using it (32%), patient rooms not well-stocked (32%), insufficient workspace for completing paperwork (26%), seeking for supplies (24%) or patients' charts (23%), receiving many phone calls from families (23%), delay in seeing new medical orders (21%), and misplaced equipment (20%).
  
  
  CONCLUSIONS
  Intensive care nurses experience a variety of performance obstacles in their work environment. Future research should investigate the impact of various performance obstacles on nursing workload, nursing quality of working life, and quality and safety of care, as well as the impact of interventions aimed at redesigning the work system of ICU nurses to remove performance obstacles.
authors.affiliation: Division of Health Policy on Management, School of Public Health, University of Minnesota, Minneapolis 55455, USA. gurse001@umn.edu
authors.forename: Ayse P
authors.initials: AP
authors.lastname: Gurses
authors.forename: Pascale
authors.initials: P
authors.lastname: Carayon
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000458:organization & administration / Q000523:psychology; D003430:Cross-Sectional Studies; D003441:Crowding; D017598:Efficiency, Organizational; D005260:Female; D006272:Health Facility Environment / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D024802:Nurse's Role / Q000523:psychology; D015401:Nursing Administration Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D011787:Quality of Health Care / Q000458:organization & administration; D017751:Safety Management / Q000458:organization & administration; D011795:Surveys and Questionnaires; D013597:Systems Analysis; D013996:Time and Motion Studies; D017749:Total Quality Management / Q000458:organization & administration*; D014922:Wisconsin; D016526:Workload; D017132:Workplace / Q000458:organization & administration / Q000523:psychology