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Observational Study
. 2017 Mar;37(3):315-320.
doi: 10.1038/jp.2016.211. Epub 2016 Nov 17.

Burnout in the neonatal intensive care unit and its relation to healthcare-associated infections

D S Tawfik  1 , J B Sexton  2   3 , P Kan  4   5 , P J Sharek  5   6   7 , C C Nisbet  5   7 , J Rigdon  8 , H C Lee  4   5 , J Profit  4   5
Affiliations
Observational Study

Burnout in the neonatal intensive care unit and its relation to healthcare-associated infections

D S Tawfik et al. J Perinatol. 2017 Mar.

Abstract

Objective: To examine burnout prevalence among California neonatal intensive care units (NICUs) and to test the relation between burnout and healthcare-associated infection (HAI) rates in very low birth weight (VLBW) neonates.

Study design: Retrospective observational study of provider perceptions of burnout from 2073 nurse practitioners, physicians, registered nurses and respiratory therapists, using a validated four-item questionnaire based on the Maslach Burnout Inventory. The relation between burnout and HAI rates among VLBW (<1500 g) neonates from each NICU was evaluated using multi-level logistic regression analysis with patient-level factors as fixed effects.

Results: We found variable prevalence of burnout across the NICUs surveyed (mean 25.2±10.1%). Healthcare-associated infection rates were 8.3±5.1% during the study period. Highest burnout prevalence was found among nurses, nurse practitioners and respiratory therapists (non-physicians, 28±11% vs 17±19% physicians), day shift workers (30±3% vs 25±4% night shift) and workers with 5 or more years of service (29±2% vs 16±6% in fewer than 3 years group). Overall burnout rates showed no correlation with risk-adjusted rates of HAIs (r=-0.133). Item-level analysis showed positive association between HAIs and perceptions of working too hard (odds ratio 1.15, 95% confidence interval 1.04-1.28). Sensitivity analysis of high-volume NICUs suggested a moderate correlation between burnout prevalence and HAIs (r=0.34).

Conclusion: Burnout is most prevalent among non-physicians, daytime workers and experienced workers. Perceptions of working too hard associate with increased HAIs in this cohort of VLBW infants, but overall burnout prevalence is not predictive.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Burnout distribution in 44 NICUs, n=2073. Burnout was variable among NICUs (F=2.86, P<0.001) and physicians reported lower burnout prevalence than non-physicians (17±19% vs 28±11%, P<0.001). Physicians in textured bars.
Figure 2
Figure 2
Burnout by years of service. n=2073 respondents in 44 NICUs, with 95% CIs. Providers with fewer than 3 years experience reported the lowest burnout (16±6% vs 30±4% in >20 years group, P=0.001). *denotes statistical significance (P<0.05) from the fewer than 3 years group.
Figure 3
Figure 3
Relation between burnout prevalence and adjusted HAI rates, limited to NICUs with 60 or more VLBW infants and >50% survey response rate. n=1188 respondents in 20 NICUs. Positive Pearson's correlation between burnout and infections was noted, but this was not statistically significant (r=0.34, P=0.14).
See this image and copyright information in PMC

References

    1. Kohn LT, Corrigan JM, Donaldson MS. To Err is Human: Building a Safer Health System. National Academy Press: Washington, DC, USA, 2000. - PubMed
    1. James JT. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf 2013; 9(3): 122–128. - PubMed
    1. Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ 2016; 353: i2139. - PubMed
    1. Sharek PJ, Horbar JD, Mason W, Bisarya H, Thurm CW, Suresh G et al. Adverse events in the neonatal intensive care unit: development, testing, and findings of an NICU-focused trigger tool to identify harm in North American NICUs. Pediatrics 2006; 118(4): 1332–1340. - PubMed
    1. Stoll BJ, Gordon T, Korones SB, Shankaran S, Tyson JE, Bauer CR et al. Late-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network. J Pediatr 1996; 129(1): 63–71. - PubMed

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