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Fatigue, burnout, work environment, workload and perceived patient safety culture among critical care nurses

09 January 2020
16 min read
Volume 29 · Issue 1


A study was conducted to explore whether fatigue, workload, burnout and the work environment can predict the perceptions of patient safety among critical care nurses in Oman. A cross-sectional predictive design was used. A sample of 270 critical care nurses from the two main hospitals in the country's capital participated, with a response rate of 90%. The negative correlation between fatigue and patient safety culture (r= -0.240) indicates that fatigue has a detrimental effect on nurses' perceptions of safety. There was also a significant relationship between work environment, emotional exhaustion, depersonalisation, personal accomplishment and organisational patient safety culture. Regression analysis showed that fatigue, work environment, emotional exhaustion, depersonalisation and personal accomplishment were predictors for overall patient safety among critical care nurses (R2=0.322, F=6.117, P<0.0001). Working to correct these predictors and identifying other factors that affect the patient safety culture are important for improving and upgrading the patient safety culture in Omani hospitals.

Patient safety is considered to be one of the most important health issues across the world (World Health Organization (WHO), 2016) and has been defined as the ‘absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum’ (WHO, 2017). It has an impact on both patient outcomes and the healthcare system itself; it is deemed to be one of the credible measures of a hospital's performance (Welp et al, 2015), and is an important factor in ensuring the delivery of high-quality health care (Rajalatchumi et al, 2018).

WHO (2017) has stressed the importance of identifying factors that affect patient safety and monitoring improvements in patient safety. About 43 million patient safety events occur worldwide every year, with the estimated cost of medication errors amounting to US $42 billion. This is considered the third patient safety challenge, after healthcare-associated infection and safe surgery (WHO, 2017).

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