A cross‐sectional multisite exploration of Italian paediatric nurses’ reported burnout and its relationship to perceptions of clinical safety and adverse events using the RN4CAST@IT‐Ped

Abstract

To explore Italian paediatric nurses' reported burnout and it relationship to their perceptions of safety and adverse events. DesignA cross-sectional study utilizing the RN4CAST@IT-Ped database using a web based survey design. MethodsThe RN4CAST@IT-Ped questionnaire was used to collect data in 2017. This comprised three main components: three dimensions (22 items) of the Maslach Burnout Inventory including emotional exhaustion, depersonalization and personal accomplishment.Participants also scored an overall grade of patient safety and estimated the occurrence of adverse clinical events. ResultsNurses (n=2243) reported high levels of burnout. Most rated clinical safety highly. The risk of adverse events ranged from 1.3-12.4%. The degree of burnout appeared to influence the perception of safety and adverse events. ConclusionThe association between nurses' burnout and perceptions of higher rates of adverse events and reduced safety in clinical practice is an important finding. However, it is unclear whether this was influenced by a negative state of mind, and whether reduced safety and increased adverse events negatively influenced nurses' well-being, thus leading to burnout. Regardless, the association between nurses' burnout and these quality concepts needs further exploration to examine the effect, if any, on burnout and safety, and identify supportive mechanisms for nurses. Impact:• The association between reported burnout and perception of safety and risk of adverse events in Italian paediatric nurses has been reported for the first time.• Nurses reporting burnout are at greater risk of intensely negative perceptions of clinical safety and adverse events. This is an important finding as perceptions can influence practice and behaviours.• Quality measures in children's clinical environments need to go beyond obvious indicators to examine nurses' well-being as this also influences quality and safety.

Burnout and its relationship to self‐reported quality of patient care and adverse events during COVID‐19: A cross‐sectional online survey among nurses

“…While studies investigating the occurrences of AEs among the health care staff during the COVID-19 pandemic are limited, a review of the studies conducted before the COVID-19 pandemic revealed that 29.1% of the surveyed nurses had experienced AEs in the last 6 months (Kakemam, Kalhor, et al, 2019). Findings of a study conducted in China show the occurrence of AEs ranging from 47.8% to 75.6% (Wang et al, 2014), which is higher than the findings of a study conducted among Italian paediatric nurses that showed the occurrence of AEs ranging from 1.3% to 12.4% (Bagnasco et al, 2020). One study found that the rate of AEs reporting has reduced following the onset of the COVID-19 pandemic (Denning, Goh, Scott, et al, 2020).…”

“…The findings of the study are congruent with similar ones in the literature in which high levels of burnout are reported to correlate with increased medication errors and increased patient falls (Nantsupawat et al, 2016;Van Bogaert et al, 2014), increased patient and family verbal abuse, as well as patient and family complaints (Van Bogaert et al, 2014), and increased infections (Cimiotti et al, 2012;Nantsupawat et al, 2016;Van Bogaert et al, 2014) and revealed a similar association between nurse burnout and AEs in the Iranian setting. A study in the Italian paediatric context has consistently shown that nurse burnout is associated with higher AEs (Bagnasco et al, 2020). Burnout was found to raise medical errors among health care staff, particularly in physicians (Fahrenkopf et al, 2008;Shanafelt et al, 2010).…”

“…4. Adverse events: We considered nursing perceptions as appropriate estimates of AEs, as in previous international studies (Bagnasco et al, 2020;Van Bogaert et al, 2014;Wang et al, 2014). We identified the most common AEs that often occur with hospital nurses and evaluated them on an individual level.…”

“…However, several studies have been carried out before the onset of COVID-19. A study conducted in Italian paediatric settings found that the level of burnout influences the perception of patient safety and AEs (Bagnasco et al, 2020). Another study at an Irish non-consultant hospital showed that burnout is associated with the frequency of the quality of patient care and self-reported AEs (Sulaiman et al, 2017).…”

Burnout in Palliative Care Nurses, Prevalence and Risk Factors: A Systematic Review with Meta-Analysis

“…Some authors have reported negative consequences of burnout on nurses' health such as insomnia, irritability, headaches, or related it with anxiety and depression [9,10]. In addition, there are also studies that report that burnout increases the number of mistakes at work, reduced the quality and safety of care, and that it favors sick leave or abandonment of the profession [11][12][13][14].…”