Abstract
To explore Italian paediatric nurses' reported burnout and its relationship to their perceptions of safety and adverse events. A cross-sectional study using the RN4CAST@IT-Ped database with a web-based survey design. The 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. Nurses (N=2,243) reported high levels of burnout. Most rated clinical safety as high. 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. The 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. 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.
Highlights
The World Health Organization (WHO) has recently recognized burnout as an "occupational phenomenon" and, as such, has included it in the 11thRevision of the International Classification of Diseases (ICD-11) (2019)
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
Summary
The World Health Organization (WHO) has recently recognized burnout as an "occupational phenomenon" and, as such, has included it in the 11thRevision of the International Classification of Diseases (ICD-11) (2019). The sense of responsibility seems greater to nurses in this environment given the high risks, associated with medication errors for example (Manias, Cranswick, Newall et al 2019, Lan, Wang, Yu et al 2014), risk of injuries (Jamerson 2014) and the potential detrimental effects of illness (Murni, Duke, Daley, Kinney & Soenarto, 2019, Becknell, Schober, Korbel, & 2015) or tragic events on children and their families (Jestico & Finlay 2017) Within this context there are a number of unreported errors (Khan et al 2017), which can add to nurses’ emotional burden through guilt of inaction. These potentially protected factors have not been fully explored
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