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Concerns about the impact of health worker depletion on patient safety

New concerns have been raised about the negative impact of fatigue among nurses and other health professionals on patient safety, following the results of a new study.

Systematic review, published in British Medical Journalfound that physicians working in emergency care who experienced burnout were twice as likely to be involved in a patient safety incident.

“We continue to see an increase in mental health and well-being issues”

Nikki Credland

It adds to the mounting evidence that high workloads, long working hours, staff shortages, and a lack of public support, causing burnout in nurses and other health professionals, are putting patient safety at risk.

The review included data from 170 previous studies on physician self-reported fatigue and its effects on career progression and quality of patient care. Data from nearly 240,000 physicians were included in the analysis.

Fatigue was more common in hospitals, and specifically, in those working in emergency medicine and intensive care.

Physicians who reported burnout were four times less likely to experience job satisfaction, and more than three times as likely to regret their career choice and consider leaving their job.

Nikki Credland

Fatigue was associated with a doubling of the risk of patient safety accidents. This risk was higher in physicians aged 20 to 30 years who work in emergency medicine.

Nikki Credland, President British Association of Critical Care Nurses (BACCN) and Chair of Paramedical, Perioperative and Advanced Medical Practice at the University of Hull, the same problems have been found in intensive care unit nursing.

“We continue to see an increase in mental health and well-being issues that translate into increased employee illness, lower job satisfaction, intent to leave, and poor employee retention,” she said.

She added that nurses experiencing burnout need access to mental health and well-being support.

Other ways to deal with burnout include making sympathetic checklists and dedicated correctional supervision time, Ms. Credland noted.

“Nurses are on their knees, facing a combination of massive backlogs, workforce crunch, and deteriorating morale”

Leona Cameron

In addition, safe staffing levels, adequate pay, protected annual leave, and supported career advancement were essential to prevent burnout in critical care nurses, she said.

Head of Health, Safety and Welfare at the Royal College of Nursing, Leona Cameron, agreed that the link between burnout and patient safety risks presented in the new study also applies to nurses.

“Although this study is about physicians and not nursing staff, it appears to support what we already know – which is that when there are not enough nurses on hand, it is patient care that suffers,” she said.

“Academic studies have shown that if there are not enough nurses, the risk of death increases,” Ms Cameron said.

“The nursing staff are on their knees, facing a combination of massive backlogs, a workforce crunch, and deteriorating morale.”

Ms Cameron reiterated RCN’s calls for “urgent” investment in nursing, including fair pay for staff, and warned “until these issues are addressed, these patients will continue to suffer”.

Nursing times Covid-19 turned on: are you okay? Campaign since 2020 to lobby to support the appropriate mental well-being of nurses.

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