Relationship between burnout and nursing practice environment in pediatric cardiology: a cross-sectional study. (25th November 2020) - Bagnasco, A
Abstract: Introduction: The relationship between burnout and patient safety is widely demonstrated in the literature. Recent studies have shown that in pediatrics the burnout rates are even higher, thus increasing young patients' exposure to risks. Pediatric cardiology is often characterized by acute onset in the pre-natal period and requires long periods of hospitalization. Strategies to reduce burnout and its impact on patient safety is a priority. Purpose: To test the relationship between nursing work environment and emotional exhaustion in nurses in pediatric cardiology. Methods: Data were drawn from the database of a larger study, RN4CAST@IT-Ped, a cross-sectional study in which 13 Italian hospitals were involved. Convenience sampling was adopted, and inclusion criteria were nurses providing direct routine care in wards. For this study, only data relating to nurses working in Pediatric Cardiology were extracted. The data were collected through a web survey from September 2017 to January 2018. The questionnaire investigated several aspects relating to care and nursing staff including workload, skill mix, work environment measured with PES-NWI, and emotional exhaustion with the Maslach Burnout Inventory. Descriptive statistical analyses were conducted to describe the sample and variables taken into consideration; a binomial logistic regression model was built to test the relationships between the dependent variable "high Emotional Exhaustion" and the independent variables "PES-NWI composite score", adjusted for "workload" and "skill mix". Results: The responses from eighty-five pediatric nurses from 7 units (mixed cardiology-cardiac surgery, cardiology, arrhythmology, cardiac surgery and a cardiology intensive care unit), in 5 hospitals, were analyzed. These findings show that with the same skill mix and workload, the improvement of the workplace environment conditions decreased by 81% (OR 0.192; 95% CI 0.062–0.591) the risk that nurses working in pediatric cardiology would develop a high level of Emotional Exhaustion. Conclusions: Demonstrating the association between emotional exhaustion and work environment in pediatric cardiology is only a first step towards improvement. Workplace environment includes relational, logistic, and organizational aspects that require further investigation to ensure that nursing in pediatric cardiology is even safer and of better quality in all its key aspects: urgency, intensity, chronicity and complexity. Funding Acknowledgement: Type of funding source: None