Burnout, technology use, and ICU performance.

Abstract

A stranger on entering an ICU is at once bombarded with a massive array of sensory stimuli, some emotionally neutral but many highly charged. Initially the greatest impact comes from the intricate machinery with its flashing lights, buzzing and beeping monitors, gurgling suction pumps and whooshing respirators. Simultaneously one sees many people rushing around busily performing life saving tasks. The atmosphere is not unlike that of a tension charged strategic war bunker. One becomes aware of desperately ill, sick and injured human beings and they are hooked up to the machinery. And in addition to the mechanical stimuli one can discern moaning, crying, screaming and the last gasps of life. Sights of blood, vomitus, excreta, exposed genitals, mutilated and wasted bodies, and unconscious and helpless people assault the sensibilities. Many are neither alive nor dead. Most have tubes in every orifice. Their sounds and action or inaction are almost inhuman. (Hay & Oken, 1972, p. 112) This vivid, impressionistic observation suggests that working in a n intensive care unit (ICU) is stressful. ICU staff are confronted with human suffering, grief, and death and are exposed to distasteful, degrading, and sometimes even disgusting sights. What is perhaps even more characteristic for ICUs, however, is the surreal environment that is dominated by sophisticated equipment. More than other hospital wards, ICUs have developed into high-tech environments that require complex cognitive skills such as monitoring the equipment and responding to alarms, in addition to traditional nursing (Fitter, 1987).Aside from emotional demands and the use of advanced technology, various stressors have been identified in ICUs, such as conflicting communications with physicians, administrators, and other nurses; heavy workload; inadequate knowledge and skill; ethical problems; and responsibility for life and death decisions (for a review, see Caldwell & Weiner, 1981). Viewed from this perspective, it is not surprising that, one decade ago, burnout was listed among the top research priorities for ICUs (Lewandowski & Kositsky, 1983).Burnout is considered to be a long-term stress reaction (Maslach & Schau-

Linking physician burnout and patient outcomes

“…For example, Leiter et al (1998) also found relationships between depersonalization and patient satisfaction. Our findings echo some of the findings of Schaufeli et al (1995) with regard to perceived effectiveness (e.g., lower satisfaction); however, they did not find a significant relationship between burnout and an objective outcome measure (standard mortality ratio), whereas we found significant relationships between burnout and patient outcome. Our findings echo some of the findings of Schaufeli et al (1995) with regard to perceived effectiveness (e.g., lower satisfaction); however, they did not find a significant relationship between burnout and an objective outcome measure (standard mortality ratio), whereas we found significant relationships between burnout and patient outcome.…”

“…Although Schaufeli et al (1995) explored ICU performance measures, their results were contradictory, with the only finding consistent with theory coming from nurses' perceptions of effectiveness. Although health care organizations recognize the importance of patient satisfaction in our contemporary clientcentered climate, they may also be interested in other patient outcomes.…”

“…One study linked intensive care unit (ICU) nurse burnout with ICU performance, again aggregating burnout and performance to the care unit level (Schaufeli, Keijsers, & Reis Miranda, 1995). The study found significant relationships between burnout levels and the outcomes efficiency and perceived effectiveness.…”

Burnout contagion among intensive care nurses

“…2002), time pressure and task complexity (DeRijk et al. 1998), intensive use of sophisticated technology (Schaufeli et al. 1995), low decision authority (Tummers et al.…”

Development and Psychometric Qualities of the SEIPS Survey to Evaluate CPOE/EHR Implementation in ICUs

“…quality of care and patient safety (Carayon, Alvarado, et al, 2006; Carayon, et al, 2005; Hoonakker, Carayon, Douglas, et al, 2008), workload (Battiste & Bortolussi, 1988; Hill, et al, 1992; Rubio, Díaz, Martín, & Puente, 2004), and burnout (Schaufeli, Keijsers, & Reis Miranda, 1995; Schaufeli, et al, 1996). Reliability of the workload scale (the NASA TLX) is low in our study (0.61, 063, and 0.64 in R1, R2, and R3 respectively).…”