English abstract
Background: Neonatal Intensive Care Units (NICU) induce a significant stress that drives
and predispose nurses to a significant degree of job burnout. Job burnout has been found
to compromise patient safety. One of the factors that can play a role in the relationship
between job burnout and patient adverse events, specifically during this era of post COVID-19 pandemic, is nurses’ resilience. Studies examining the job burnout levels
among NICU nurses in Oman and its association with patient adverse events and level of
resilience are limited.
Purpose: The study aimed to assess the relationship between job burnout, patient adverse
events and resilience among nurses working at NICU in selected hospitals in Oman.
Method: The study utilized a cross-sectional survey design. Convenience sampling
technique was used to recruit staff nurses working at the NICU at three large tertiary
hospitals within Muscat area between February and March 2023.
Masclah Burnout Inventory was used to assess job burnout, Brief Resilience Scale was
used to assess nurses’ perception of resilience, and Patient Adverse Event Measurement
Tool was used to assess the self-reported frequency of patient adverse events. Pearson
correlation was used to assess the relationship between job burnout and resilience.
Multivariate regression analysis was conducted to assess the relationship between job
burnout and patient adverse events. Moderation analysis was used to assess the role of
resilience in moderating the relationship between job burnout and patient adverse events.
Results: A total of 173 staff nurses participated. NICU nurses reported low levels of
burnout in the emotional (M = 14.41, SD = 11.91) and depersonalisation (M = 3.65, SD =
5.15) subscales but moderate levels in the personal accomplishment (M = 36.48, SD =
10.32). Nurses reported moderate levels of resilience (M = 0.4, SD = 3.14). A significant
correlation was found between resilience and the three dimensions of job burnout,
including emotional exhaustion, depersonalisation, and personal accomplishment (r = -
0.260, p = 0.001, r = - 0.176, p = 0.020, r = 0.218, p = 0.004) respectively. The most
frequently reported patient adverse events were ventilator-associated infection (19%),
phlebitis (14%), transfusion site swelling (13%), and catheter-related bloodstream
infection (12%). Regression model showed a significant positive relationship between the
two dimensions of job burnout EE (β = 0.237±0.003; t = 2.29; p = 0.024) and DP (β =
0.268±0.08; t = 2.55; p = 0.012) and AEs. The findings demonstrated a significant
moderating effect of resilience on the relationship between emotional exhaustion and
patient adverse events (p = .008), suggesting that the negative influence of EE on the AEs
was reduced as the resilience level increased.
Conclusions: Utilization of the study findings by hospital administration is a crucial first
step in creating a safer healthcare system and staff well-being. Specifically, identifying the
role of resilience in reducing burnout can help promote safe practices.
