Impact of Nurse Burnout on Patient Safety in Liaoning China

Monday, July 11, 2011

Deena M. Kelly, MS, RN
School of Nursing Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA

Learning Objective 1: Describe the effect of nurse burnout on perceived patient outcomes in Liaoning China

Learning Objective 2: Identify global policy implications for the association between burnout and patient safety

Purpose: The prevalence of nurse burnout and its impact on patient safety outcomes is unknown in China. This study evaluates the impact of nurse burnout on nurse-assessed patient safety outcomes in Liaoning China. Methods: It is a cross-sectional analysis of a unique, publicly unavailable Chinese national dataset and is part of a larger research collaboration with the China Medical Board. The final sample for this study included over 800 nurses in 20 different hospitals in Liaoning province. Logistic regression modeling was used to evaluate the relationship between burnout and patient safety, accounting for clustering of nurses within units. Burnout was measured using the emotional exhaustion subscale of Maslach’s Burnout Inventory Human Services Survey. Patient safety was measured by nurse-assessed frequency of adverse events and overall patient safety grade. Results: In Liaoning, nurses who are burned out are twice as likely to report a poor patient safety grade and two and half times more likely to indicate pressure ulcers and surgical site infections as frequent occurrences in their units, compared to non burned out nurses. Burned out nurses are also three times more likely to identify medication errors and patient falls as a frequent occurrence, controlling for nurse and hospital characteristics. Conclusion: Burned out nurses are more likely to report poor patient safety in Liaoning. Similar to the U.S., nurse burnout has a significant impact on perceived patient safety and highlights the importance for policy initiatives to target nurse burnout. Previous research on burnout and patient outcomes in the U.S has influenced policy and the organization of nursing care. This is the first study to present findings that may influence the organization of nursing services and patient safety in China. U.S. innovations to address burnout may hold promise for improving nurse burnout and patient safety in China.