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Globally, patients pay the price for insufficient nursing staff, large workloads

Nurses believe that heavy workloads and insufficient staff are impacting patient care and health outcomes around the world, according to research presented at the International Council of Nurses' 24th Quadrennial Congress.

The results are part of an extensive global attitudinal survey, which asked more than 2,000 nurses about the challenges and opportunities nurses face.
 
“Nurses represent the largest group of healthcare providers in the world,” said ICN Chief Executive Officer David Benton. “We are keen to better understand nurses’ views of their work and the environments in which they practice across the world. These results will inform the Positive Practice Environment campaign ICN and partners are implementing to improve the practice environment and with it the quality of care.”
 
An estimated 13 million nurses form the backbone of healthcare systems, working in hospitals, clinics, communities and other settings. ICN and Pfizer External Medical Affairs collaborated on this global representative survey of 2,203 nurses in eleven countries, including Brazil, Canada, Colombia, Japan, Kenya, Portugal, South Africa,Taiwan, Uganda, the UK, and the U.S.

“Nurses are key patient advocates and have always been patient-focused. The research shows that for nurses, the most favourable aspect of their profession is indeed patient contact,” said Paula DeCola, RN, from the office of the chief medical officer at Pfizer External Medical Affairs. “This survey supports the research of Dr. Linda Aiken at the University of Pennsylvania - nurses perceive that inadequate staffing and high workloads are having a negative impact on the quality of care patients receive.”

The survey finds that 92 percent of nurses face time constraints that prevent them from spending enough time with individual patients as they think necessary. Nearly all nurses surveyed (96 percent) say that spending more time with individual patients would have a significant impact on patient health.
 
“Nurses globally are thinking about leaving the profession, which will further impact already burdened healthcare systems, including in countries such as Kenya, Uganda and South Africa,” said Benton. “It is urgent to respond to their needs with adequate staffing, greater independence and greater involvement in decision-making. Nurses must be involved in crucial policy conversations as healthcare systems are growing, developing and changing.”

Other key findings from the research provide a glimpse at the challenges nurses face, and opportunities for improvements:
 

  • Nearly half of nurses (46  percent) say their workload is currently worse compared to five years ago, potentially impacting the quality of patient care;
  • Nurses are most concerned with heavy workloads (42 percent), insufficient pay and benefits (22 percent), a lack of recognition for their work (15 percent) and too much bureaucracy (13 percent);
  • Nurses are most likely to say that patient contact (37 percent) is the most favorable aspect of their work experience;
  • Nursing as a career is viewed as worse than it was five years ago in Canada (52 percent), the U.S. (46 percent), Taiwan (45 percent), and the UK (39 percent); however nurses in Kenya (71 percent), Brazil (64 percent) and South Africa (63 percent) are more likely to see their roles improving over this time;
  • When asked to rate the likelihood they will still be practicing nursing in five years, 53 percent say it is ‘very likely.’ However, the commitment varies significantly by country. Nurses in Portugal (77 percent), Brazil (75 percent), Canada (71 percent), and the U.S. (68 percent) say they are very likely to stay in nursing for the next five years, while nurses in countries with severe health human resource shortages and heavy disease burdens such as Kenya (38 percent), South Africa (33 percent), Taiwan (33 percent), and Uganda (32 percent), say they are less likely to do so;
  • Nurses favor expanding their healthcare responsibilities, including the authority to prescribe medicines to patients. Eight in ten (83 percent) nurses surveyed say they currently do not have the authority to prescribe medicines to patients. Nevertheless, seven in ten (70 percent) say they favour nurses having this authority. Nurses in Colombia (61 percent), the U.S. (59 percent) and Taiwan (57 percent) are most likely to oppose nurses having this authority, while those in Kenya (94 percent), the UK (87 percent), Canada (87 percent), Uganda (84 percent) and South Africa (83 percent) are most in favour of it;
  • The research shows that having greater independence and control over their practice area, sufficient staff, greater involvement in decisions impacting their work and patient care, and improved work-life balance have a significant impact on nurses’ likelihood to remain in nursing.

 

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