Relationship Between Perceived Excessive Workload and Medical Error Tendency Among Intensive Care Nurses

Öz

Objective: The aim of this study is to examine the relationship between excessive workloads among nurses in intensive care units and their tendencies toward medical errors, as well as the factors influencing this relationship. Materials and Methods: This study is a cross-sectional, descriptive, and correlational study. The study sample consists of nurses (n:105) working in intensive care units at a university teaching and research hospital. The data collection instruments used were a professional and personal information form, the Excessive Workload Scale, and the Medical Errors Tendency Scale in Nursing (METSN). Results: 96.2% of intensive care nurses are women, 61.9% are married, and their average age is 34.42 ± 7.73. 69.5% of the nurses work in Level 3 intensive care units. Intensive care nurses reported that the top three causes of medical errors were long shift duration (88.4%), misunderstanding of physicians’ orders (64.0%), and communication problems within the team (56.5%). The mean score on The Excessive Workload Scale of intensive care nurses was 40.02 ± 7.68, and the mean score on The Medical Error Tendency Scale in Nursing was 231.11 ± 14.98. No correlation was found between the mean scores on The Excessive Workload Scale and the Medical Error Tendency Scale in Nursing (p>0.05). Conclusion: Although nurses’ average excessive workload scores are high, their tendency to make medical errors is low. In this context, it is recommended that the factors associated with medical errors be identified using qualitative research methods.

Anahtar Kelimeler

• Intensive care nurse
• intensive care unit
• medical error
• workload

Etik Beyan

This study was approved by the Izmir Bakırçay University Non-Interventional Clinical Ethics Committee (Date: 25.03.2021, decision no:232). All procedures complied strictly with the ethical principles of the Declaration of Helsinki. Participants were provided with comprehensive information about the study, and written and verbal consent was obtained.

Yoğun Bakım Hemşirelerinde Algılanan Aşırı İş Yükü ile Tıbbi Hata Eğilimi Arasındaki İlişki

Öz

Amaç: Çalışmanın amacı, yoğun bakımda çalışan hemşirelerin iş yükleri ile tıbbi hata eğilimleri arasındaki ilişkiyi ve etkili faktörleri incelemektir. Materyal ve Metot: Bu çalışma kesitsel tanımlayıcı ve ilişkisel türde bir araştırmadır. Çalışmanın örneklemini, bir üniversite eğitim ve araştırma hastanesinde yoğun bakım ünitelerinde çalışan hemşireler (n=105) oluşturmaktadır. Veri toplama araçları olarak mesleki ve kişisel bilgi formu, Aşırı İş Yükü Ölçeği ve Hemşirelikte Tıbbi Hata Eğilimi Ölçeği (HTHEÖ) kullanılmıştır. Bulgular: Yoğun bakım hemşirelerinin %96,2’si kadın, %61,9’u evli ve yaş ortalaması 34,42±7,73’tür. Hemşirelerin %69,5’i 3. basamak yoğun bakımda görev yapmaktadır. Yoğun bakım hemşireleri, tıbbi hataların nedenlerinde ilk üç sırada uzun çalışma saatleri (%88,4), hekim istemlerinin yanlış anlaşılması (%64,0) ve ekip içi iletişim sorunları (%56,5) olduğunu belirtmişlerdir. Yoğun bakım hemşirelerinde Aşırı İş Yükü Ölçeği puan ortalaması 40,02±7,68 ve Hemşirelerin Tıbbi Hata Eğilim Ölçeği puan ortalaması 231,11±14,98’dir. Aşırı İş Yükü Ölçeği ile Hemşirelikte Tıbbi Hata Eğilimi Ölçeği puan ortalamaları arasında bir ilişki bulunmamıştır (p>0,05). Sonuç: Hemşirelerin aşırı iş yükü puan ortalamaları yüksek olmasına rağmen, tıbbi hata eğilimleri düşüktür. Bu kapsamda tıbbi hataya neden olan ilişkili faktörlerin nitel araştırma teknikleri ile ortaya çıkarılması önerilmektedir.

Anahtar Kelimeler

• İş yükü
• yoğun bakım hemşireleri
• yoğun bakım ünitesi
• tıbbi hata

Etik Beyan

Bu çalışma, İzmir Bakırçay Üniversitesi Girişimsiz Klinik Etik Komitesi tarafından onaylandı (Tarih: 25.03.2021, karar no:232). Tüm prosedürler, Helsinki Deklarasyonu'nun etik ilkelerine sıkı sıkıya uydu. Katılımcılara çalışma hakkında kapsamlı bilgiler verildi ve yazılı ile sözlü onay alındı.

Kaynakça

1. 1. Waydhas C, Riessen R, Markewitz A. et al. Recommendations on the structure, personal, and organization of intensive care units. Fronteirs in Medicine. 2023;10:1-9. doi:10.3389/fmed.2023.1196060
2. 2. Seo MH, Kim EA, Kim HR. How the nursing work environment moderates the relationship between clinical judgment and person-centered care among intensive care unit nurses. PLoS One. 2025;20(1):e0316654. doi:10.1371/journal.pone.0316654
3. 3. Er F, Altuntas S. Assessment of Causes and conditions of making A Medical Error from viewpoint of nurses. Journal of Health and Nursing Management. 2016;3(3):132-139.| doi:10.5222/SHYD.2016.132
4. 4. Avsar G, Atabek Armutcu E, Karaman Özlü Z. Determining the Level of Tendency in Malpractice of Nurses:A Hospital Sample. Journal of Health Sciences and Professions. 2016;3(2):115-122.
5. 5. Kucukoglu S, Ası Karakas S, Celebioglu A. The tendency of nurses to make medical errors and associated impacting factors. International Refereed Journal of Nursing Researches. 2016;(8):88-102.
6. 6. Chard R, Tovin M. The Meaning of Intraoperative Errors: Perioperative Nurse Perspectives. AORN J.2018;107(2):225-235. doi:10.1002/aorn.12032
7. 7. Ozen N, Onay T, Terzioglu F. Determination of Nurses' Tendency to Make Medical Errors and Affecting Factors. Journal of Health Sciences and Professions. 2019;6(2):286-92.
8. 8. Minister of Health Safety Reporting System (SRS) 2017 Statistics and Analysis Report https://dosyamerkez.saglik.gov.tr/Eklenti/6483,grs2016raporr1pdf.pdf? Accesed June 5, 2026.

9. 9. Demir Dikmen Y, Yorgun S, Yesilcam N. Identification the Level of Tendency in Malpractice Among Nurses. Journal of Hacettepe University Faculty of Nursing. 2014;1(1):44–56.
10. 10. Basturk Kulahlı H, Cınar Pakyuz S. Determination of medical errors tendency and the factors affecting nurses. EGEHFD. 2024;40(1):91-101.
11. 11. Yilmaz A, Yilmaz Keskin A, Yesildal M. Medical error attitudes of nurses and affecting factors. Gümüşhane University Journal of Health Sciences. 2022;11(3):1151-1159.
12. 12. Ozata M, Altunkan H. Frequency of medical errors in hospital errors in hospitals, determination of medical error types and medical errors: Konya Sample. Medical Research Journal. 2010;8(2):100-111.
13. 13. Peterson MF, Smith PB, Akande A,Ayestaran S.Role conflict, ambiguity, and overload: A 21-nation study. Academy of Management Journal. 1995;38:429-452.
14. 14. Derya S. Crossover of Work-Family Conflict: Antecedent and Consequences of Crossover Process in Dual-Earner Couples. Koç University Institute of Social Sciences Doctora Thesis. İstanbul, Türkiye.2008.
15. 15. Akin Korhan E, Dilemek H, Mercan S, Uzelli Yilmaz D. Determination of attitudes of nurses in medical errors and related factors. International Journal of Caring Sciences. 2017;10(2):794-801
16. 16. Zarea K, Mohammadi A, Beiranvand S, Hassani F, Baraz S. Iranian nurses’ medication errors: A survey of the types, the causes, and the related factors. International Journal of Africa Nursing Sciences. 2018;8I112-116. doi:10.1016/j.ijans.2018.05.001
17. 17. Bozkurt G, Tepehan Eraslan S. Investigation of relationship between intensive care nurses’ tendency to malpractice and self-handicapping. University of Health Sciences Journal of Nursing. 2023;5(2):123-128. doi:10.48071/sbuhemsirelik.1219198
18. 18. Ordu Y, Acun A. Nurses ’tendencies to make medical errors and their attitudes towards evidence-based nursing: A descriptive and correlational research. Turkiye Klinikleri J Nurs Sci. 2025;17(3):752-60. doi:10.5336/nurses.2024-105287
19. 19. Ersun A, Basbakkal Z, Yardımcı F, Muslu G, Beytut D. A Study of the malpractice trends in pediatric nurses. Journal of Ege University Nursing Faculty. 2013;29(2):33-45.
20. 20. Bozkurt G, Turkmen E, Zengin N. Work load related to independent functions of intensive care nurses. Journal of Intensive Care Nursing. 2017;21(2):36-41.
21. 21. Wondmieneh A, Alemu W, Tadele N, Demis A. Medication administration errors and contributing factors among nurses: a cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nurs. 2020;19:4. doi:10.1186/s12912-020-0397-0
22. 22. Münger N, Yılmaz E. The effects of professional experience of nurses working at surgical clinics on their tendency to make malpractice: Manisa sample. Van Health Sciences Journal. 2023;16(2):136-146.
23. 23. JCI (Joint Commission International) International Patient Safety Goals https://www.jointcommission.org/en/standards/international-patient-safety-goals. Accessed June 24, 2026
24. 24. World Health Organization (WHO) Global patient safety action plan 2021-2030: Towards eliminating avoidable harm in health care. Geneva: World Health Organization. https://www.who.int/teams/integrated-health-services/patient-safety. Accessed May 2, 2026.
25. 25. Celik Durmus S, Erdem Y, Doğan Yılmaz E. Tendency of Nurses to Make Medical Error: The case of A Public University Medical Faculty Hospital. The Journal of Kırıkkale University Faculty of Medicine. 2022;24(1):153-162.
26. 26. Gundoğan G, Erdagı Oral S. The effects of alarm fatigue on the tendency to make medical errors in nurses working in intensive care units, Nursing in Critical Care. 2023;28:996-1003.
27. 27. Karaca Sivrikaya S, Simsek Kara A. Determination the tendency of the hurses to make medical mistake. Balıkesir Health Science Journal. 2019;8(1):7-14.
28. 28. Cakmak C, Konca M, Teles M. The Evaluation of Medical Errors Through Turkey National Safety Reporting System (SRS). Hacettepe Journal of Health Administration. 2018;21(3):423-448.
29. 29. Gulsen M, Arslan S. The Effect of Alarm Fatigue on the Tendency to Make Medical Errors in Surgical Intensive Care Nurses: A Correlational Study Examining the Role of Moderating Factors. Healthcare. 2025;13:631. doi.org/ 10.3390/healthcare13060631
30. 30. Aslan Y, Alp F. Bibliometric Network Analysis of Medical Errors Based on Web of Science Database Between 1986-2023. Journal of Performance and Quality in Health. 2024;21(3):157-183
31. 31. Mohanna Z, Kusljic S, Jarden R. Investigation of interventions to reduce nurses’ medication errors in adult intensive care units: A systematic review. Australian Critical Care. 2022;35:466- 479. doi:10.1016/j.aucc.2021.05.012
32. 32. Nurmeksala A, Mikkonen S, Kinnunen J, Kvist T. Relationships between nurse managers’work activities, nurses’job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study. BMC Health Services Research. 2021; 21:296.doi:10.1186/s12913-021-06288-5
33. 33. Yilmaz M, Baykara Mat ST. Workload and medical error tendency in nurses: A descriptive and correlational study. BANU Journal of Health Science and Research. 2025;7(3):744-753. doi:10.46413/boneyusbad.1586736
34. 34. Hoogendoorn ME, Brinkman S, Spijkstra JJ, et al.The objective nursing workload and perceived nursing workload in intensive care units: Analysis of association. International Journal of Nursing Studies. 2020;114:103852. doi: 10.1016/j.ijnurstu.2020.103852