• nurses;
  • nursing;
  • nurse-patient load;
  • perceived adverse patient outcomes;
  • workload

Aim.  This study was carried out to identify the perceived adverse patient outcomes as related to nurses’ workload. It also assessed nurses’ perception of variables contributing to the workload and adverse patient outcomes.

Background.  Several studies have been published on adverse patient outcomes in which a correlation was found between nurses’ workload and some adverse patient outcomes.

Design.  A cross-sectional survey was conducted between registered nurses (n = 780) working in medical and surgical wards of five general governmental hospitals in Kuwait.

Data collection instruments.  Data were collected using a self-administered questionnaire consisting of three sections to elicit information about the sample characteristics, perception of workload and perceived adverse patient outcomes during the last shift and last working week.

Results.  The three major perceived adverse outcomes reported by the nurses while on duty during their last shift were: complaints from patients and families (2%), patients received a late dose or missed a dose of medication (1·8%) and occurrences of pressure ulcer (1·5%). Similarly, the reported adverse outcomes over the past week were complaints from patients and families (5%), patients received a late dose or missed a dose of medication (5·3%) and discovery of a urinary tract infection (3·7%). Increases in nurse-patient load, bed occupancy rate, unstable patients’ condition, extra ordinary life support efforts and non-nursing tasks; all correlated positively with perceived adverse patient outcomes.

Conclusion.  This study sheds light on an important issue affecting patient safety and quality of care as perceived by the nurses themselves as caregivers.

Relevance to clinical practice.  Nurses’ perception of variables contributing to adverse patient outcomes and their workload could significantly affect the provided nursing care and nursing care recipients. The findings could help in policy formulation and planning strategies to decrease adverse patient outcomes in many countries with a health care structure similar to that of Kuwait.