![]() The California Perinatal Quality Care Collaborative (CPQCC) is a multi-stakeholder group of public and private neonatal healthcare providers, including over 130 member hospitals and accounting for the majority of preterm infants requiring critical care in the state of California. This cross-sectional study links survey data to subsequent clinical outcomes data derived from a population-based clinical registry among 44 California NICUs. ![]() The objectives of this study were to:ĭescribe variation of NICU caregiver burnout by provider characteristics.Īnalyze the relation between caregiver burnout and healthcare-associated infection (HAI) rates among VLBW (<1500 gm) infants. Levels of burnout among different types of NICU providers are poorly characterized, and the effect of burnout on neonatal quality of care is unknown. 14, 15, 16, 17 Burnout affects 27–86% of healthcare workers, 18, 19, 20 with over half of physicians reporting burnout 21 and around one-third of nurses and physicians meeting criteria for severe burnout. 13 In the critical care setting, burnout rates may be driven by high workload, frequent changes in technology and guidelines, endeavors for high-quality care and emotional challenges of dealing with critically ill patients and their families. ![]() 5, 7, 8 Higher infection rates have been linked to poor performance in other areas of safety culture including teamwork and safety climate, 9, 10 raising concern for burnout as a source of decreased quality of healthcare, 11, 12 particularly in relation to critically ill pediatric patients.īurnout describes a condition of fatigue, detachment and cynicism resulting from prolonged high levels of stress. Neonatal infections are especially hazardous, with sequelae including prolonged length of stay, 5 adverse neurodevelopmental outcomes 6 and increased mortality. Very low birth weight (VLBW) infants are particularly vulnerable to errors, and adverse events occur with up to 10-fold variation among neonatal intensive care units (NICUs). 2, 3 Critically ill patients often require fast-paced, complex and precise care, resulting in an increased propensity toward errors along with increased vulnerability. 1 Recent studies suggest that this may have been an underestimate, with the true number of premature deaths related to preventable harm estimated up to 440 000, or approximately one-sixth of the deaths in the country each year. In 1999, the Institute of Medicine estimated that medical errors are responsible for up to 98 000 deaths annually in the United States of America. Perceptions of working too hard associate with increased HAIs in this cohort of VLBW infants, but overall burnout prevalence is not predictive. Conclusion:īurnout is most prevalent among non-physicians, daytime workers and experienced workers. Sensitivity analysis of high-volume NICUs suggested a moderate correlation between burnout prevalence and HAIs ( r=0.34). 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). Overall burnout rates showed no correlation with risk-adjusted rates of HAIs ( r=−0.133). Highest burnout prevalence was found among nurses, nurse practitioners and respiratory therapists (non-physicians, 28☑1% vs 17☑9% physicians), day shift workers (30☓% vs 25±4% night shift) and workers with 5 or more years of service (29☒% vs 16☖% in fewer than 3 years group). Healthcare-associated infection rates were 8.3±5.1% during the study period. We found variable prevalence of burnout across the NICUs surveyed (mean 25.2☑0.1%). 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. ![]() 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. 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. ![]()
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