Date of Award

11-4-2024

Degree Type

Thesis

Degree Name

MSc in Nursing

First Advisor

Dr. Saleema Gulzar

Second Advisor

Babar Islam

Third Advisor

Zahira Amir Ali

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: Optimal care provision is the major concern of most leaders worldwide, often influenced by inadequate staffing levels and linked with negative patient outcomes. Nurses in tertiary care settings, face several challenges related to heavy workloads, decreased manpower, and high patient acuity which is impacting their ability to provide comprehensive care. The majority of studies have demonstrated this relation but none is being done in the Pakistani context.
Purpose: It aims to explore the experiences and perceptions of nurses working in the emergency care setting at AKUH regarding the adequacy of staffing levels, variations in shifts, and their perceived ability to deliver quality care.
Methodology: A Qualitative Exploratory Descriptive Design utilizing semi-structured in-depth interviews, grounded in Donabedian's conceptual model was used to enquire this study. Through purposeful sampling, 13 participants were selected from the tertiary care hospital in Karachi from June 2024 to August 2024. Furthermore, it employed thematic analysis to identify patterns and insights related to staffing ratios and patient outcomes.
Findings: The finding disclosed that inadequate staffing is linked with heavy workloads, compromised care quality, and increased likelihood of unfavourable events like medication errors, falls, pressure ulcers, HCAIs, frequent readmissions, and sometimes even delayed identification of worsening symptoms, ultimately compromising patient safety. It also leads to burnout, emotional exhaustion, and job discontentment, which can result in higher turnover rates among nursing professionals. They also shared that hospital leadership recognized this burning issue but cited budget constraints and other factors as a significant barrier to improving nurse staffing levels.
Conclusion: The study concludes that there is a dire need for adequate staffing which is crucial for enhancing quality care and improving effective patient outcomes. Moreover, the study also identified gaps, including the need for retaining experienced staff, investment in career-enhancing opportunities for nurses, and adoption of evidence-based staffing models along with self-scheduling of working hours which could significantly enhance nurse’s work-life balance.

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1

Last Page

115

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