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Pediatrics. 2017 May;139(5). pii: e20164134. doi: 10.1542/peds.2016-4134. Epub 2017 Apr 18.

Factors Associated With Provider Burnout in the NICU.

Author information

1
Division of Pediatric Critical Care Medicine, dtawfik@stanford.edu.
2
Department of Health Research and Policy.
3
Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, and.
4
Health Economics Research Center and Center for Innovation to Implementation, Veteran's Affairs Palo Alto Health Care System, Palo Alto, California.
5
Department of Psychiatry, Duke University School of Medicine, and.
6
Duke Patient Safety Center, Duke University Health System, Durham, North Carolina.
7
California Perinatal Quality Care Collaborative, Palo Alto, California; and.
8
Division of Pediatric Hospitalist Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California.
9
Center for Quality and Clinical Effectiveness, Lucile Packard Children's Hospital, Palo Alto, California.
10
Quantitative Sciences Unit, and.
11
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.

Abstract

BACKGROUND:

NICUs vary greatly in patient acuity and volume and represent a wide array of organizational structures, but the effect of these differences on NICU providers is unknown. This study sought to test the relation between provider burnout prevalence and organizational factors in California NICUs.

METHODS:

Provider perceptions of burnout were obtained from 1934 nurse practitioners, physicians, registered nurses, and respiratory therapists in 41 California NICUs via a validated 4-item questionnaire based on the Maslach Burnout Inventory. The relations between burnout and organizational factors of each NICU were evaluated via t-test comparison of quartiles, univariable regression, and multivariable regression.

RESULTS:

Overall burnout prevalence was 26.7% ± 9.8%. Highest burnout prevalence was found among NICUs with higher average daily admissions (32.1% ± 6.4% vs 17.2% ± 6.7%, P < .001), higher average occupancy (28.1% ± 8.1% vs 19.9% ± 8.4%, P = .02), and those with electronic health records (28% ± 11% vs 18% ± 7%, P = .03). In sensitivity analysis, nursing burnout was more sensitive to organizational differences than physician burnout in multivariable modeling, significantly associated with average daily admissions, late transfer proportion, nursing hours per patient day, and mortality per 1000 infants. Burnout prevalence showed no association with proportion of high-risk patients, teaching hospital distinction, or in-house attending presence.

CONCLUSIONS:

Burnout is most prevalent in NICUs with high patient volume and electronic health records and may affect nurses disproportionately. Interventions to reduce burnout prevalence may be of greater importance in NICUs with ≥10 weekly admissions.

PMID:
28557756
PMCID:
PMC5404731
DOI:
10.1542/peds.2016-4134
[Indexed for MEDLINE]
Free PMC Article

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