Associations between nursing workload, burnout, and patient safety: a scoping review

Abstract

Patient safety is a fundamental component of healthcare quality, with nurses playing a critical role in maintaining safe clinical practice. However, excessive workload, inadequate staffing, and workplace stressors may contribute to burnout and compromise patient safety. This scoping review aimed to synthesize empirical evidence on the associations between nursing workload, burnout, and patient safety and identify relevant organizational factors. A literature search was conducted in the Scopus database using the Population–Concept–Context (PCC) framework, with study selection guided by predefined eligibility criteria and PRISMA-ScR guidelines. Five studies met the inclusion criteria. The findings indicated that high nursing workload and inadequate nurse-to-patient ratios were associated with increased stress and burnout. Burnout was also associated with adverse events, medication and patient identification errors, and reduced clinical performance. Organizational factors, including staffing adequacy, communication, teamwork, and institutional support, were identified as important determinants of patient safety. These findings highlight the interconnected relationships between nursing workload, burnout, and patient safety. Strengthening staffing management, organizational support, interprofessional communication, teamwork, and patient safety culture may promote safer nursing practice. Further research is needed to evaluate the effectiveness of organizational interventions in reducing burnout and improving patient safety outcomes.