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Burnout in the NICU setting and its relation to safety culture.

CPQCC Publication
TitleBurnout in the NICU setting and its relation to safety culture.
Publication TypeJournal Article
Year of Publication2014
AuthorsProfit J, Sharek PJ, Amspoker AB, Kowalkowski MA, Nisbet CC, Thomas EJ, Chadwick WA, J Sexton B
JournalBMJ Qual Saf
Date Published2014 Oct
KeywordsAdult, Burnout, Professional, California, Cross-Sectional Studies, Female, Humans, Intensive Care Units, Neonatal, Male, Organizational Culture, Patient Safety, Prevalence, Psychometrics, Safety Management, Surveys and Questionnaires, Workforce

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.

Alternate JournalBMJ Qual Saf
PubMed ID24742780
PubMed Central IDPMC4167972
Grant ListK24 HD053771-01 / HD / NICHD NIH HHS / United States
1UC1HS014246 / HS / AHRQ HHS / United States
K23 HD056298-01 / HD / NICHD NIH HHS / United States
K23 HD056298 / HD / NICHD NIH HHS / United States
K24 HD053771 / HD / NICHD NIH HHS / United States
UC1 HS014246 / HS / AHRQ HHS / United States