Nurses' perceptions regarding risk management strategies in overcrowded clinical areas

Abstract

This study used an exploratory descriptive research design to explore nurses' perceptions regarding risk management issues in overcrowded clinical areas. Particular aspects explored were nurses' views on cross infection, medication error, and pressure ulcers. Nurses' perceptions regarding how the overcrowding is influencing their nursing care were also examined. Data was collected from the whole population of nurses (n=60) and a random sample of managers (n=8) from the medical wards. A self-administered questionnaire formulated by the researcher was used to collect data from the nurses. An interview schedule based on the same questionnaire was used for the eight managers. Qualitative data was analyzed through content analysis. Findings revealed that nurses in medical wards strongly feel that the overcrowding is affecting their nursing care. The main reasons given were that due to lack of time and shortage of staff, nurses are sometimes resorting to shortcuts in their care. Moreover, the nurses perceived difficulties such as lack of space and lack of privacy as hindering during their daily work. Most nurses believe that in: overcrowded settings, close bed proximity and lack of hand washing are the main contributors to cross infection where measures to be adapted included reinforcing and creating awareness to hand washing. In addition, nurses revealed that overcrowded settings give rise to a high workload where lack of time could possibly lead to pressure sores resulting from lack of mobilization. Furthermore, frequent interruptions during the preparation and administration of treatment may possibly lead to medication error where making better use of patient ID would help minimize errors. The results highlighted several management implications and a number of recommendations were identified. Literature shows that an increased workload gives rise to potential errors and higher stress levels consequently it is being recommended sufficient staffing be provided and where ever possible overcrowding be kept to a minimum thus leading to better patient outcomes. Moreover, it is recommended that managers provide support to nurses and wherever appropriate, a non-punitive approach should be adopted.