Burnout in the NICU setting and its relation to safety culture

Abstract

Background Burnout is widespread among healthcare providers and is associated with adverse safety behaviours, operational and clinical outcomes. Little is known with regard to the explanatory links between burnout and these adverse outcomes. Objectives (1) Test the psychometric properties of a brief four-item burnout scale, (2) Provide neonatal intensive care unit (NICU) burnout and resilience benchmarking data across different units and caregiver types, (3) Examine the relationships between caregiver burnout and patient safety culture. Research design Cross-sectional survey study. Subjects Nurses, nurse practitioners, respiratory care providers and physicians in 44 NICUs. Measures Caregiver assessments of burnout and safety culture. Results Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. The percentage of respondents in each NICU reporting burnout ranged from 7.5% to 54.4% (mean=25.9%, SD=10.8). The four-item burnout scale was reliable (α=0.85) and appropriate for aggregation (intra-class correlation coefficient−2=0.95). Burnout varied significantly between NICUs, p<0.0001, but was less prevalent in physicians (mean=15.1%, SD=19.6) compared with non-physicians (mean=26.9%, SD=11.4, p=0.0004). NICUs with more burnout had lower teamwork climate (r=−0.48, p=0.001), safety climate (r=−0.40, p=0.01), job satisfaction (r=−0.64, p<0.0001), perceptions of management (r=−0.50, p=0.0006) and working conditions (r=−0.45, p=0.002). Conclusions NICU caregiver burnout appears to have ‘climate-like’ features, is prevalent, and associated with lower perceptions of patient safety culture.

Factors associated with career satisfaction and burnout among US neurosurgeons: results of a nationwide survey

“…one of the highest reported rates among surgical 8,25,33,37,44,45 and nonsurgical specialties, 10,13,14,26,27,31,32,40 including those in previously published reports for neurosurgeons (Table 9). 7,23,37 Burnout was associated with malpractice litigation and uncertainty regarding future earnings and health care reform, which was also shown to decrease the odds of being satisfied with neurosurgery.…”

Cultura e clima organizacional para segurança do paciente em Unidades de Terapia Intensiva

“…A study that applied the SAQ in 44 NICUs in the United States revealed that professionals who suffered from burnout tended to have worse perception toward safety culture, which indicates a relationship between stress and safety culture (19) .…”

Work-Related Burden on Physicians and Nurses Working in Neonatal Intensive Care Units: A Survey

“…In our study we explored only two elements of burnout, namely exhaustion and relationship deterioration included in most burnout questionnaires. The large variability of burnout prevalence ranging from 7.5% to 86% in healthcare workers including two NICUs [20,21] might depend on the burnout questionnaire used and on the cultural and socio-demographic conditions of the interviewed samples.…”

“…A large cross-sectional survey study on burnout in the NICU setting by Profit et al, involved 2073 nurses, nurse-practitioners, respiratory care providers and neonatal physicians working in 44 NICUs. The burnout rate of the staff varied significantly between NICUs, ranging from 7.5% to 54.4% and was less prevalent in physicians compared with non-physicians [21].…”

“…Braithwaite and Oehler showed that stress and burnout among pediatric nurses represent a concerning issue [18,19]. Important stress and burnout in HCPs have been shown to have strong effects on quality of patient care [16,[20][21][22][23]. In a recent survey to measure burnout in a cohort of Italian neonatal physicians, Bellieni and co-workers called attention to the alarming situation.…”