Maternal and neonatal health care worker well-being and patient safety climate amid the COVID-19 pandemic

Haidari, Eman S.; Main, Elliott K.; Cui, Xin; Cape, Valerie; Tawfik, Daniel S.; Adair, Kathryn C.; Sexton, Bryan; Profit, Jochen

doi:10.1038/s41372-021-01014-9

Cited by 34 publications

(50 citation statements)

References 60 publications

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“…Differently from the first published report on burnout experienced by NWs and NICUs workers, 28 in our Italian context a limited percentage of NWs and NICUs professionals exhibited a level of emotional exhaustion compatible with a full-blown burnout. The effects of COVID-19-related stress on the depressive symptomatology were apparently limited, suggesting that depression may be a less reactive outcome during emergency crisis.…”

Section: Discussioncontrasting

confidence: 91%

“…Our study has limitations. Firstly, the response rate of our survey (32.9%), though similar to that of another recent study, 28 does not allow us to claim representativeness of our sample. Secondly, the cross-sectional study design does not allow to assess the causal directions of the relationship between the COVID-related stress and the professionals' wellbeing.…”

Section: Discussionmentioning

confidence: 66%

“…A recent report about neonatal healthcare workers' well-being showed a significant worsening, with more than the 60% of the sample exhibiting emotional exhaustion and only a third of it reporting sufficient institutional strategies to meet these emotional challenges. 28 It is important for both professionals and healthcare systems to adequately measure and report on this mental health risk to promote appropriate preventive and therapeutic actions. As such, between May and December 2020 we launched the "Staff and Parental Adjustment to COVID-19 Epidemics -Neonatal Experience in Tuscany" (SPACE-NET) survey, with the aim of documenting the potential mental health risk faced by neonatal and pediatric healthcare professionals in Italy.…”

Section: Introductionmentioning

confidence: 99%

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The COVID-related mental health load of neonatal healthcare professionals: A multicentre study in Italy

Gagliardi

Grumi

Gentile

et al. 2021

Preprint

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BackgroundThe COVID-19 pandemic has dramatically affected healthcare professionals’ lives. We investigated the potential mental health risk faced by healthcare professionals working in neonatal units in a multicentre cross-sectional observational study.MethodsWe included all healthcare personnel of 7 level-3 and 6 level-2 neonatal units in Tuscany, Italy. We measured the level of physical exposure to COVID-19 risk, self-reported COVID-related stress, and mental health load outcomes (anxiety, depression, burnout, psychosomatic, and post-traumatic symptoms) via validated, self-administered, on-line questionnaires.ResultsWe analysed 314 complete answers. Scores above the clinical cutoff were reported by 91% of participants for anxious symptoms, 29% for post-traumatic symptoms, 13% for burnout, and 3% for depressive symptoms. Moreover, 50% of the participants reported at least one psychosomatic symptom. COVID-related stress (but not actual physical exposure) was significantly associated with all the measured mental health load outcomes, with a Risk Ratio of 3.33 (95% Confidence interval: 1.89, 5.85) for clinically relevant anxiety, 2.39 (1.69, 3.38) for post-traumatic symptoms, 1.79 (1.16, 2.75) for emotional exhaustion, and 2.51 (0.98, 6.44) for depression.ConclusionsDespite a low clinical impact of COVID-19 in neonatology, neonatal professionals are a specific population at risk for psychological consequences during the pandemic.KeynotesWe studied the mental health load (anxiety, post-traumatic, psychosomatic symptoms, burnout, depression) of healthcare professionals working in 13 neonatal units in Tuscany during the COVID-19 pandemic.We found very high levels of anxiety and psychosomatic symptoms, and moderate-high post-traumatic and burnout symptoms.Mental health load was higher in neonatal intensive (vs non-intensive) settings and in nurses (vs physicians). Mental health load outcomes were associated with COVID-related stress (rather than actual physical exposure to the virus).

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

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The COVID-related mental health load of neonatal healthcare professionals: A multicentre study in Italy

Gagliardi

Grumi

Gentile

et al. 2021

Preprint

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“…Our findings suggest that personal well-being interventions based on positive psychology research may help stem and reverse the rising tide in HCW burnout. This may be especially salient during the current SARS-CoV-2 pandemic, which is overwhelming the well-being landscape of HCWs and will require innovative interventions that can be delivered at scale and on-demand to HCWs that are suffering [ 34 ]. Effect sizes for improvement suggest that our results are clinically meaningful, comparing favorably with lengthier and more resource-dependent interventions intended to improve well-being and mental health [ 16 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of the “WISER” intervention to reduce healthcare worker burnout

et al. 2021

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Objective Test web-based implementation for the science of enhancing resilience (WISER) intervention efficacy in reducing healthcare worker (HCW) burnout. Design RCT using two cohorts of HCWs of four NICUs each, to improve HCW well-being (primary outcome: burnout). Cohort 1 received WISER while Cohort 2 acted as a waitlist control. Results Cohorts were similar, mostly female (83%) and nurses (62%). In Cohorts 1 and 2 respectively, 182 and 299 initiated WISER, 100 and 176 completed 1-month follow-up, and 78 and 146 completed 6-month follow-up. Relative to control, WISER decreased burnout (−5.27 (95% CI: −10.44, −0.10), p = 0.046). Combined adjusted cohort results at 1-month showed that the percentage of HCWs reporting concerning outcomes was significantly decreased for burnout (−6.3% (95%CI: −11.6%, −1.0%); p = 0.008), and secondary outcomes depression (−5.2% (95%CI: −10.8, −0.4); p = 0.022) and work-life integration (−11.8% (95%CI: −17.9, −6.1); p < 0.001). Improvements endured at 6 months. Conclusion WISER appears to durably improve HCW well-being. Clinical Trials Number NCT02603133; https://clinicaltrials.gov/ct2/show/NCT02603133

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“…Denning’s study assessed the impact of the Covid-19 pandemic on the patient safety culture of health workers in London that showed improvements in safety attitudes during Covid-19 compared with baseline in allied health professionals and doctors, but no change in nurses [ 11 ]. Patient safety and professionalism are context-based concepts that are influenced by a variety of factors [ 1 , 7 , 9 , 12 , 13 ]. Different results in the studies can be due to differences in safety culture and professionalism in the investigated environments [ 1 , 7 , 9 , 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of safety attitudes, professionalism and exploration of medical students’ experiences

Keshmiri

Raadabadi

2022

BMC Med Educ

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Background The present study was conducted to examine the interns’ perceptions of safety attitude and professionalism and to explore their experiences about adherence to the principles during the COVID-19 pandemic. Method The present study was a mixed-method that was performed in two quantitative and qualitative stages. The medical interns at X University (n = 140) were entered. In the quantitative phase, the assessment of the interns’ Safety Attitudes and Professionalism was conducted by a survey. In the qualitative phase, data were gathered by semi-structured interviews. The experiences of participants were analyzed by the inductive content analysis approach of Graneheim and Lundman. Results Participants’ perception scores on safety attitude and professionalism were 98.02 (14.78). The results were explained in a theme of “weakness in systemic accountability in compliance with professionalism and safety”. The theme included three categories: ‘support system inadequacy’, and ‘null curriculum in safety and professionalism education’. Conclusion The present results showed participants’ perception scores on safety attitude and professionalism were below the moderate level. The systemic issues were explored as influencing factors in the occurrence of unsafe and unprofessional behaviors. They reported the weakness of the support system (individual, teamwork, mental health, well-being, management, and culture), and the null curriculum in education of professional, and safety principles effective on unprofessional and unsafe behaviors. During the COVID-19 pandemic, it is recommended to create mechanisms to support the development of professionalism of healthcare workers, especially, novice providers and students, and pay attention to the safety and professionalism in formal and informal educational programs.

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Maternal and neonatal health care worker well-being and patient safety climate amid the COVID-19 pandemic

Cited by 34 publications

References 60 publications

The COVID-related mental health load of neonatal healthcare professionals: A multicentre study in Italy

The COVID-related mental health load of neonatal healthcare professionals: A multicentre study in Italy

Randomized controlled trial of the “WISER” intervention to reduce healthcare worker burnout

Assessment of safety attitudes, professionalism and exploration of medical students’ experiences

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