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Factors Associated With Provider Burnout in the NICU.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title pediatrics
Publication Year Start




PMID- 28557756
OWN - NLM
STAT- MEDLINE
DA  - 20170530
DCOM- 20170810
LR  - 20170810
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 139
IP  - 5
DP  - 2017 May
TI  - Factors Associated With Provider Burnout in the NICU.
LID - e20164134 [pii]
LID - 10.1542/peds.2016-4134 [doi]
AB  - 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.
CI  - Copyright (c) 2017 by the American Academy of Pediatrics.
FAU - Tawfik, Daniel S
AU  - Tawfik DS
AD  - Division of Pediatric Critical Care Medicine, [email protected]
AD  - Department of Health Research and Policy.
FAU - Phibbs, Ciaran S
AU  - Phibbs CS
AD  - Perinatal Epidemiology and Health Outcomes Research Unit, Division of
      Neonatology, and.
AD  - Health Economics Research Center and Center for Innovation to Implementation,
      Veteran's Affairs Palo Alto Health Care System, Palo Alto, California.
FAU - Sexton, J Bryan
AU  - Sexton JB
AD  - Department of Psychiatry, Duke University School of Medicine, and.
AD  - Duke Patient Safety Center, Duke University Health System, Durham, North
      Carolina.
FAU - Kan, Peiyi
AU  - Kan P
AD  - Perinatal Epidemiology and Health Outcomes Research Unit, Division of
      Neonatology, and.
AD  - California Perinatal Quality Care Collaborative, Palo Alto, California; and.
FAU - Sharek, Paul J
AU  - Sharek PJ
AD  - Division of Pediatric Hospitalist Medicine, Department of Pediatrics, Stanford
      University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, 
      California.
AD  - Center for Quality and Clinical Effectiveness, Lucile Packard Children's
      Hospital, Palo Alto, California.
FAU - Nisbet, Courtney C
AU  - Nisbet CC
AD  - California Perinatal Quality Care Collaborative, Palo Alto, California; and.
AD  - Division of Pediatric Hospitalist Medicine, Department of Pediatrics, Stanford
      University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, 
      California.
FAU - Rigdon, Joseph
AU  - Rigdon J
AD  - Quantitative Sciences Unit, and.
FAU - Trockel, Mickey
AU  - Trockel M
AD  - Department of Psychiatry and Behavioral Sciences, Stanford University School of
      Medicine, Palo Alto, California.
FAU - Profit, Jochen
AU  - Profit J
AD  - Perinatal Epidemiology and Health Outcomes Research Unit, Division of
      Neonatology, and.
AD  - California Perinatal Quality Care Collaborative, Palo Alto, California; and.
LA  - eng
PT  - Journal Article
DEP - 20170418
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
SB  - AIM
SB  - IM
MH  - Allied Health Personnel/psychology
MH  - Burnout, Professional/*epidemiology
MH  - California/epidemiology
MH  - Cross-Sectional Studies
MH  - Electronic Health Records
MH  - Hospitals, High-Volume/statistics & numerical data
MH  - Humans
MH  - Intensive Care Units, Neonatal/*organization & administration/statistics &
      numerical data
MH  - Nurses/psychology
MH  - Nursing Staff, Hospital/psychology
MH  - Physicians/psychology
MH  - Prevalence
MH  - Surveys and Questionnaires
PMC - PMC5404731
COI - POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential
      conflicts of interest to disclose.
EDAT- 2017/05/31 06:00
MHDA- 2017/08/11 06:00
CRDT- 2017/05/31 06:00
PMCR- 2018/05/01
PHST- 2017/02/23 [accepted]
AID - peds.2016-4134 [pii]
AID - 10.1542/peds.2016-4134 [doi]
PST - ppublish
SO  - Pediatrics. 2017 May;139(5). pii: e20164134. doi: 10.1542/peds.2016-4134. Epub
      2017 Apr 18.