Effects of Nurse’s Work Environment and Practice on Patient’s Safety


Background: When a patient with an acute medical illness is admitted to a hospital, their safety is a prime concern for healthcare professionals. Ongoing nursing assessment is a type of nursing assessment that commences at the beginning of every shift and is completed on every patient. This information is used to develop a plan of care. The aim of this study was to assess the application of ongoing nursing assessment approaches in intensive care units. 

Methods: This cross-sectional hospital-based study included a total of 135 nurses, of which 23 (17%) were from Khartoum hospital, 62 (46%) from Alshaab hospital, 15 (11%) from Soba University Hospital, and 35 (26%) from the National Center for Neurological Science.

Results: The ongoing nursing assessment approaches were available in most intensive care units of the study area with the domination of the ABCDE approach. Factors that can impact the thoroughness of the ongoing nursing assessment performance suggested by the studied participants were nurses' knowledge and competency, followed by insufficient time and resources to carry out the assessment.

Conclusion: Most participants did not complete the assessment suggesting a poor performance. The knowledge base of the participants was not reflected in their practice with a wide difference between them.

Key words: Nursing assessment approach, intensive care unit, assessment performance, Sudan

[1] Marie, P. N. (2011). Effects of work environments on nursing and patient outcomes. Journal of Nursing Management, vol. 18, pp. 1–2.
[2] Claudia, S. and Marlene, K. (2008). Essentials of a productive nurse work environment. Nursing Center E-news, vol. 57, no. 1, pp. 2–13.
[3] Ronda, H. and Carolyn, C. (2005). AHRQ commentary: working conditions that support patient safety. Journal of Nursing Care Quality, vol. 20, no. 4, pp. 289–292.
[4] Needleman, J. and Buerhaus, P. (2003). Nurse staffing and patient safety: current knowledge and implications for action. International Journal for Quality in Health Care, vol. 15, no. 4, pp. 275–277.
[5] Vincent, C., Neal, G., and Woloshynowych, M. (2001). Adverse events in British hospitals: preliminary retrospective record review. British Medical Journal, vol. 322, no. 7285, pp. 517–519.
[6] Page, A. (2004). Keeping Patients Safe: Transforming the Work Environment of Nurses (p. 488). Washington, DC: The National Academies Press.
[7] Donaldson, S. (2004–2012). WHO Patient Safety. Retrieved from http://www.who.int/patientsafety/about/en/
[8] Kohn, L. T., Corrigan, J. M., and Donaldson, M. S. (Ed.). (1999). Committee on Quality of Health Care in America, Institute of Medicine. To err is Human: Building a Safer Health System. Washington, DC: National Academy Press.
[9] Canadian Nurses Association and University of Toronto Faculty of Nursing (2004). Nurses and Patient Safety (p. 3). Ottawa, ON: Canadian Nurses Association.
[10] Kevin, A. (2014). National Patient Safety Goals (pp. 1–12). Retrieved from www.IvyLeagueNurse.com
[11] Noel, E., Ryan, W., Debora, P., et al. (2010). Joint commission national patient safety goals. Topics in Patient Safety, vol. 10, no. 1, pp. 1–4.
[12] Government of Sudan. (2016). National Human Resources for Health Strategic Plan for Sudan 2012–2016 (pp. 3–6). Sudan.
[13] Cintia, M., Ariane, F., da Luz Gonçalves Pedreira, M. (2015). Interruptions of nurses’ activities and patient safety: an integrative literature review. Revista Latino-Americana de Enfermagem, vol. 23, no. 1, pp. 169–179.
[14] Lin, L. and Liang, B. A. (2007). Addressing the nursing work environment to promote patient safety. Nursing Forum, vol. 42, no. 1, pp. 20–23.
[15] Hubbard, I. J., Harris, D., Kilkenny, M. F., et al. (2012). Adherence to clinical guidelines improves patient outcomes in Australian audit of stroke rehabilitation practice. Archives of Physical Medicine and Rehabilitation, vol. 93, no. 6, pp. 965–971.
[16] Ann, R. E., Wei-Ting, H., Linda, S. D., et al. (2004). The working hours of hospital staff nurses and patient safety. Health Affairs, vol. 23, no. 4, pp. 202–212.
[17] Yakusheva, O., Lindrooth, R., and Weiss, M. (2014). Economic evaluation of the 80% baccalaureate nurse workforce recommendation: a patient-level analysis. Medical Care, vol. 52, no. 10, pp. 864–869.
[18] McHugh, M. D., Kelly, L. A., Smith, H. L., et al. (2013). Lower mortality in magnet hospitals. The Journal of Nursing Administration, vol. 43, no. 10 0, pp. S4–S10.
[19] Keenan, P. (2003). The Nursing Workforce Shortage: Causes, Consequences, Proposed Solutions (Commonwealth Fund Issue Brief No. 619), pp. 1–8.
[20] Laschinger, H. K. S. and Leiter, M. P. (2006). The impact of nursing work environments on patient safety outcomes: the mediating role of burnout engagement. The Journal of Nursing Administration, vol. 36, no. 5, pp. 259–267.
[21] Curtin, L. L. (2003). An integrated analysis of nurse staffing and related variables: effects on patient outcomes. Online Journal of Issues in Nursing, vol. 8, no. 3, p. 118.
[22] Kane, R. L., Shamliyan, T., Mueller, C., et al. (2007). Nurse staffing and quality of patient care. Evidence Report/Technology Assessment, vol. 151, no. 1, p. 115.
[23] Abduelazeez, A. E. and Tahir, M. M. (2016). Job satisfaction and related factors among intensive care nurses in governmental hospitals at Khartoum state–Sudan. Journal of Community & Public Health Nursing; vol. 2, no. 2, p. 114.