Operational efficiency effect on nursing workload of tertiary hospital wards in China: A prospective observational study

To investigate the effect of ward operational efficiency on nursing workload and identify the factors that influence nursing workload. It remains unclear how and to what extent ward operational efficiency can influence nursing workload. A prospective observational study was conducted from July 1, 2022 to June 30, 2023, in one tertiary general hospital in China. Purposive and convenience sampling was used, and 266 470 patients from 66 wards and 52 nurses from 13 wards were recruited. The relationships between operational efficiency and nursing workload and the predictors of nursing workload were analyzed. The STROBE guidelines were followed. The operational characteristics vary by the type of wards. Nursing workloads were positively correlated with case mix index (CMI), rate of level 4 surgery, the number of patients transferred in and out, the number of deaths, total bed days, and the number of emergency admissions and critical illnesses (γ : 0.35-0.56, p