Nurse burnout linked to lower quality, safety
Burnout was also heavily associated with medication errors, patient safety incidents and other adverse events.
Photo: Dean Mitchell/Getty Images
Burnout among nurses is linked to worse patient safety, and lower healthcare quality and satisfaction, according to a new study published in JAMA Network Open.
Aggregating and reviewing more than 80 different studies on the issue, researchers found that nurse burnout resulted in lower safety grades and contributed to an overall lower safety culture. It was also heavily associated with medication errors and patient safety incidents and other adverse events, as well as an increased frequency of nosocomial infections.
These findings were consistent across age groups, gender, location and work experience.
WHAT'S THE IMPACT?
Nurse burnout was also tied to lower patient satisfaction ratings, though it was not linked to patient mortality, complaints, pressure ulcers or the frequency of patient abuse.
The association of nurse burnout with patient safety was persistent over time, and the association with quality of care was increasingly negative over the course of about three decades, even after accounting for the COVID-19 pandemic. This finding, authors said, is concerning considering decades of national and organizational efforts for quality improvement.
In terms of education level, about 42% of nurses had at least a bachelor's degree; more highly educated nurses saw less of an association between burnout and lower patient safety.
The emotional exhaustion and depersonalization dimensions of burnout, more so than personal accomplishment, were most closely associated with patient safety, the analysis showed.
To date, authors said that most anti-burnout efforts have focused on individual interventions, such as mindfulness or personal resilience training designed to help people more effectively cope with stress, instead of interventions to reduce stress and burnout in the workplace. Many effective interventions are at the work unit level, they said, where healthcare workers experience teamwork, feelings of community, professional development and recognition.
Numerous healthcare organizations have begun to take action, authors said, including appointing senior leaders to develop an organizational strategy to address the root causes of burnout, such as low staffing levels and long work hours or overtime.
THE LARGER TREND
A 2023 nurse.org survey showed 60% of nurses still love the profession. But 62% are concerned about the future.
The numbers are an improvement from 2021, but nurses are still reporting high levels of burnout, mental health issues and lack of support, among other hardships. About 39% of them said they were dissatisfied with their current job, though this answer varied based on education level and specialty.
Staffing issues and an ongoing nursing shortage continue to cause challenges for the nation's nursing workforce. A full 91% of respondents believe the nursing shortage is getting worse and that burnout, poor working conditions and inadequate pay are the primary causes.
Meanwhile, 79% said their units are inadequately staffed, while 71% said improving staffing ratios would have the greatest impact on the nursing shortage. And, of course, nurses want better pay. Fifty-five percent saw a pay increase during the last year, but 75% still feel underpaid and 52% believe their hospital does not pay nurses with similar experience equally.
In the 2022 Nurse Salary Research Report, 29% of nurses said they were considering leaving the profession, a steep rise from the 11% who were considering such a move in the 2020 survey.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
