title: Nursing workload and patient safety--a mixed method study with an ecological restorative approach.
abstract: OBJECTIVE
  The aim of this study was to analyze the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching hospital.
  
  
  METHODS
  a mixed method strategy (sequential explanatory design).
  
  
  RESULTS
  the initial quantitative stage of the study suggest that increases in the number of patients assigned to each nursing team lead to increased rates of bed-related falls, central line-associated bloodstream infections, nursing staff turnover, and absenteeism. During the subsequent qualitative stage of the research, the nursing team stressed medication administration, bed baths, and patient transport as the aspects of care that have the greatest impact on workload and pose the greatest hazards to patient, provider, and environment safety.
  
  
  CONCLUSIONS
  The findings demonstrated significant associations between nursing workload and patient safety. We observed that nursing staff with fewer patients presented best results of care-related and management-related patient safety indicators. In addition, the tenets of ecological and restorative thinking contributed to the understanding of some of the aspects in this intricate relationship from the standpoint of nursing providers. They also promoted a participatory approach in this study.
authors: Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Brazil. amagalhaes@hcpa.ufrgs.br
authors: Ana Maria Müller
authors: AM
authors: de Magalhães
authors: Clarice Maria
authors: CM
authors: Dall'Agnol
authors: Patricia Beryl
authors: PB
authors: Marck
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D009729:Nursing / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016526:Workload / Q000706:statistics & numerical data*