Increases in nursing workload are associated with patient safety and quality of outcomes. Therefore, understanding the complex relationship between nursing workload and patient safety has emerged as a pressing health care priority. However, the conceptual delineation between nursing workload and other similar concepts is poor. For example, certain nursing activities related to managing distractions, interruptions, inefficient information exchange, and cognitive functioning might best be described by the concept of turbulence. Turbulence is poorly defined in nursing and lacks psychometrically sound instruments for measurement. Given these short comings and emerging concerns that nurses may prioritize turbulence management rather than patients’ needs, the investigators contend that turbulence may serve as a concept essential for understanding nursing workaround practice behaviors that affect patient safety and quality of outcomes.

In response, the investigators designed a 2-phase exploratory sequential mixed-methods study to specify a definition and develop a preliminary measure for turbulence. Phase 1...

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