Aims To assess nurses' burnout and its association with their perceived quality of patient care and occurrence of adverse events (AEs) during COVID‐19. Background Burnout is a serious problem among nursing staff internationally with negative impacts on the quality of care and patient safety. Methods We conducted a cross‐sectional online study among 1,004 Iranian nurses through the convenience sampling technique. Data were collected using the Maslach Burnout Inventory, five items of questions related to self‐reported poor patient care quality and estimated occurrence of AEs. Results Prevalence of high burnout among nurses was 31.5%. The risk of AEs ranged from 26.1% to 71.7%. Self‐reported quality of patient care was found to be poor. A positive correlation was found between emotional exhaustion and depersonalization scores and patient care quality, whereas a negative correlation was found between personal accomplishment scores and all poor care item scores. Depersonalization was found to increase the risk of the onset of all AEs (odds ratio [OR] = 1.06–1.08). Also, Personal accomplishmentreduced the risk of occurrence of ‘medication errors’ (OR = 0.99) and the onset of ‘patient and their family verbal abuse’ (OR = 0.97). Conclusions Our findings confirmed the hypothesis that a higher degree of burnout is correlated with a perceived higher number of AEs and reduced perceived patient care quality. Implications for Nursing Management Reducing burnout among nurses through implementing interventions may be an effective strategy to enhance patient care quality and reduce the number of AEs in Iranian public hospitals. Therefore, in order to minimize work burnout, primary approaches include access to psychosocial support, including Web‐based services, psychological first aid, mental support hotlines and self‐care techniques during the COVID‐19 pandemic.

Background Although the Depression Anxiety Stress Scale-21 Items (DASS-21) has been used in different countries and translated into different languages, the Persian version of this scale has not been validated for healthcare professions in Iran. Therefore, the purpose of this study was to examine the psychometric properties of the Persian version of DASS-21 for nurses. Methods This cross-sectional study was conducted among 1135 nurses working in public hospitals, who were selected through convenience sampling. DASS-21, which consists of 21 items and three dimensions (depression, anxiety, and stress), has been translated into Persian, and there is an online version available. A confirmatory factor analysis (CFA) was performed to examine the factor structure of this scale. Cronbach’s alpha coefficient was also measured to establish internal consistency. Besides, the intraclass correlation coefficient (ICC) was calculated to assess the test-retest reliability. Results The Cronbach’s alpha coefficient was acceptable for anxiety (0.79), stress (0.91), and depression (0.93). An acceptable test-retest reliability (0.740-0.881, P < 0.01) was also reported for DASS-21 and its three dimensions. The results of CFA showed acceptable model fit (χ2/(df) = 1457/(186), P < 0.001), root mean square error of approximation (RMSEA = 0.078), Tucker-Lewis index (TLI = 0.906), comparative fit index (CFI = 0.917), and standardized root mean square residual (SRMR = 0.047). Fifty-seven nurses were included in the test-retest. The ICCs for all dimensions ranged from 0.75 to 0.86, indicating the acceptable test-retest reliability of the scale. Conclusion The Persian version of DASS-21 showed good psychometric characteristics, and it was confirmed as a valid and reliable tool for evaluating depression, anxiety, and stress among Iranian nurses. However, further validation studies of the Persian DSASS-21 are needed among other healthcare professionals, including physicians, midwives, and allied health professionals.