Workload, Stress, and Patient Safety in Emergency Nursing Units: An Analytic Cross-Sectional Study

Rasi Rahagia; Zusana A.Sasarari; Yunita Kristina; Darmi Arda; Chanchal Kurup

doi:10.35816/jiksh.v15i1.221

Authors

Rasi Rahagia Nurse Professional Education, Institut Kesehatan dan Bisnis Surabaya, East Java https://orcid.org/0009-0003-1269-5460
Zusana A.Sasarari Department of Nursing, Fakultas Kedokteran Universitas Cenderawasih, Papua https://orcid.org/0009-0009-5960-0143
Yunita Kristina Nursing Science Study Program, Faculty of Medicine, Cenderawasih University, Papua https://orcid.org/0009-0005-4983-8933
Darmi Arda Departement of Nursing, Politeknik Sandi Karsa, South Sulawesi https://orcid.org/0000-0001-8153-153X
Chanchal Kurup Australian Catholic University School of Nursing Midwifery and Paramedicine, Melbourne, Victoria https://orcid.org/0000-0003-0526-2539

DOI:

https://doi.org/10.35816/jiksh.v15i1.221

Keywords:

Emergency Nursing, Occupational Stress, Patient Safety, Workload, Workforce Health

Abstract

Introduction: Emergency departments represent high-risk clinical environments where workforce strain may compromise patient safety. The World Health Organization reports a global shortage of health workers exceeding 10 million, disproportionately affecting acute care settings. According to the Global Burden of Disease study, non-communicable diseases and injury-related conditions continue to drive emergency service utilization worldwide. In many middle-income countries, increasing patient volume and limited staffing contribute to excessive nurse workload and occupational stress, which are recognized determinants of adverse events and reduced safety compliance. To examine the association between workload, occupational stress, and patient safety practices among nurses working in emergency units.

Research Methodology: An analytic cross-sectional study was conducted among 80 emergency nurses in a tertiary hospital. Total sampling was applied. Data were collected using validated self-administered questionnaires measuring workload, occupational stress, and patient safety practices. Bivariate analysis was performed using Chi-square tests, followed by multivariate logistic regression to estimate adjusted odds ratios (AOR) with 95% confidence intervals (CI). Statistical significance was set at α = 0.05.

Results: High workload was significantly associated with inadequate patient safety practice (AOR = 3.05; 95% CI: 1.14–8.15; p = 0.026). High occupational stress also independently predicted inadequate safety practice (AOR = 2.47; 95% CI: 1.01–6.05; p = 0.048). The final model explained 31% of the variance in patient safety outcomes.

Conclusion: Excessive workload and occupational stress are significant determinants of patient safety performance in emergency nursing units. Workforce regulation, staffing optimization, and stress mitigation strategies should be integrated into hospital quality improvement and public health workforce policies.

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