583 - Nurse Burnout in Neonatal Intensive Care Units During the COVID-19 Pandemic

Neonatal intensive care unit (NICU) nurses provide care to vulnerable neonates comprising 10% of infants born in the United States. The COVID-19 pandemic stressed the nursing workforce with workforce shortages and organizational upheaval. Clinicians of all types reported high stress and burnout levels. In NICU environments, burnout from heavy workloads can result in delayed or missed nursing care, jeopardizing patient safety. 

Objective:

To assess burnout levels among NICU nurses and to examine relationships between neonatal nurses’ perceived stress, hours working in direct patient care, work experience in NICU and burnout. 

Design/Methods:

A cross-sectional analysis of survey data collected during NICU nurses’ enrollment (n=257) in a larger parent study from April 2021 to September 2022. The 9-item emotional exhaustion subscale of the Maslach Burnout Inventory (MBI) assessed burnout. The 10-item Perceived Stress Scale (PSS) measured nurse stress and a researcher-developed questionnaire captured demographic and professional characteristics including average weekly hours worked in direct patient care, years of NICU experience, and primary unit of employment. Relationships between stress, weekly direct patient care hours, NICU experience, and burnout were evaluated with multivariable linear regression. 

Results:

Nurses’ mean emotional exhaustion at enrollment was 19.7 representing moderate burnout; 54% of nurses reported moderate or high burnout levels. Regression models revealed significant associations between variables of interest and burnout. Each 1-point increase in a nurse’s perceived stress score was associated with a 1-point increase in burnout score (CI 0.848-1.231, p< .05). Each additional direct care hour per week was associated with a 0.2-point increase in burnout score (CI 0.058-0.375, p< .05). Compared to new NICU nurses (0-2 years of NICU experience), more experienced nurses reported significantly higher burnout scores especially among the most senior nurses ( >10 years: β 6.0, CI 2.250-9.722, p< .05). Nurses’ burnout scores varied substantially across NICUs. 

Conclusion(s):

Our results demonstrate the need for attention to work environments to combat burnout. Most interventions target clinician resilience. System-focused interventions addressing working conditions associated with burnout, such as periodic reduction in direct patient care hours and attention to the varying nursing workforce needs based on career stage, are both feasible and testable.