The Impact of Short-Term Solutions of Nursing Shortage on Nursing Outcome, Nurse Perceived Quality of Care, and Patient Safety

Abstract

BACKGROUND: Nurses represent a significant proportion of the entire healthcare workforce. Unfortunately, the world is plagued with the shortage of qualified nurses to deliver safe, dignified, compassionate care. OBJECTIVE: The objective of the study was to determine the relationships between overtime and floating as short-term solutions and nursing outcomes, nurse-perceived quality of care and patient safety among registered nurses in Saudi Arabia. SETTING/DESIGN: A cross-sectional study was conducted at King Abdullah Medical City (KAMC) located in Makkah, Saudi Arabia. SUBJECTS AND METHODS: The study was conducted for two months (from July 20, 2020 to August 20, 2020), including both inpatient and outpatient registered nurses who had worked for, at least, one year at KAMC either as part-time or full-time. Nurses who had worked for less than one year, nurse educators, nurse managers and clinical nurse specialists were excluded. Measuring Variables included demographic characteristics, job satisfaction, intention to leave, nursing perceived quality of care, perceived patient safety, patient safety, patient acuity and dependency, workload and floating. A pre-designed questionnaire was distributed to willing nurses. Data were non-normally distributed and Scatter plots were also generated. T-test was used to find the relation of floating and overtime with sample characteristics. RESULTS: A total of 337 registered nurses completed the questionnaire. Majority of the participants were from 41-50 years of age group (60.5%), and non-Saudi nationals (90.5%). Statistically significant relation of age groups with development of pressure ulcers (p = 0.030) was found. Nationality showed significant relation with job satisfaction (p = 0.008), quality of care (p = 0.006) and patient safety (p <0.05). Specialist nursing category showed significant association with quality of care (p = 0.008) and pressure ulcers development (p = 0.050). Education level, overtime floating showed significant association with intention to leave (p <0.05). Nationality, extended shifts and mandatory overtime had significant association with job satisfaction. Hospital data showed significant association of overtime with medication error. CONCLUSION: Unmarried Saudi nurses have potential to provide quality of care to the patient with satisfied patient safety, especially in the days of overtime and increased workload.