The Nursing Organisational Context and the Surgical Site Infections: A Structural Equational Model

Aim: To assess the relationships existing among variables of the organisational context-staffing, stress-related demands, workloads-and the occurrence of Surgical Site Infections (SSIs). Design: An observational study was conducted. Methods: A convenience sample of nurses directly involved in patient care was recruited. Staffing levels, workload and stress were measured using valid and reliable instruments. The prevalence of SSIs was recorded over 30 days using the European Centre for Disease Prevention and Control (ECDC) classification. Data were analysed using structural equation modelling. Results: This study enrolled 133 nurses. Higher SSI rates were associated with inadequate nurse staffing during daily shifts, increased workloads, evolving patient care needs and elevated stress levels among nurses due to work demands. Discussion: While the prevention of SSIs requires multidisciplinary collaboration, findings from this study suggest that the nursing organisational context-especially staffing and workload-had a direct impact on nurses' stress levels and an indirect influence on the prevalence of SSIs. Conclusion: Nurse managers and head nurses should improve nurses' working conditions and promote specific interventions for their organisational well-being to influence SSI prevalence. Patient or public contribution: Despite patients and the public not being involved in the study's design and interpretation, the findings suggest new insights for healthcare organisations. Managing staffing levels, workloads and stress levels among nurses could improve patient safety and reduce the rates of SSIs. These outcomes advocate for strategic planning and organisational changes to boost the quality of care in surgical environments.