A well accepted human factors concept is that poorly designed work systems can produce workload levels that pose a threat to safety and performance. The purpose of this study was to assess a systems model of workload and safety developed for nursing/healthcare. Using survey data from six nursing units in two pediatric hospitals, the study measured the relationship between self-reported workload at the unit, job, and task levels on the one hand and job dissatisfaction, burnout, and medication error likelihood on the other. Multiple linear and logistic regression revealed that staffing adequacy and medication administration workload strongly predicted the above patient and employee safety outcomes. Design priorities and strategies for future research are discussed, including the need for multiple-level approaches.
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