Nurses' Reports of Working Conditions and Nursing Care Left Undone in Thailand

Background:Hospitals are facing challenges to provide high quality of care and to ensure patient safety in controlled health care expenditure and uncertain environment. Understanding the working condition of nurses may identify additional strategies to ensure quality and safety.

Objectives: to demonstrate nurses’ perception of their hospital environments and nursing care left undone in Thai hospitals.

Methods: A retrospective design was used for this study. Survey data was collected from large random samples of registered nurses who were employed in hospitals in Thailand in the years 2007, 2012, and 2015. This data used to derive rates of nurse work environment using the practice environment scale of the nursing work index (PES-NWI), nurse staffing measured by patient to nurse ratio and the number of working hour, as well as nursing care left undone. The samples of the study consisted of 8,010 nurses working in thirteen general and 26 regional hospitals, 92 community hospitals, and five university hospitals in Thailand who had at least one year of experience in clinical nursing practice. Analyses were made by descriptive statistics.

Results: Study results indicated that there was variation in the mean of work environment subscales. The patient to nurse ratio average was 1:8-13. The average number of working hours of was 50-55 hour per week. Nurses reported that important nursing tasks such as educating patients and family, preparing patients and their families for discharge, comforting and talking with patients, providing skin care and oral hygiene, and adequately documenting nursing care were often left undone because of lack of time.

Conclusions: The result of inadequate staffing and resources as well as deficiencies in human resource management may affect nurses who did not have enough time to do essential nursing tasks. Further research is needed to look at the impact of work conditions on nursing care left undone.