Primary Care Practice Environment and Burnout Among Nurse Practitioners

Abstract

Poor practice environments contribute to burnout, but favorable environments containing support, resources, autonomy, and optimal relations with colleagues may prevent burnout. Compared with all nurse practitioners (NPs), 69% of these NPs provide primary care to patients, yet whether the practice environment is associated with NP burnout is unknown. A study to examine environmental factors related to NP burnout was conducted. Overall, 396 NPs completed the survey, and 25.3% were burnt-out. Higher scores on the professional visibility, NP-physician relations, NP-administration relations, independent practice, and support subscales were associated with 51%, 51%, 58%, and 56% lower risk of NP burnout, respectively.

Primary care nurse practitioner burnout and perceptions of quality of care

“…This current study is a secondary analysis of cross‐sectional survey data obtained from the parent study, 24 which investigated ways to reduce health disparities in outcomes for older adults receiving primary care services from NPs. A description of the study methodology is described below 25 …”

“…Primary care NPs were recruited from the SK&A OneKey primary care practice database which is a comprehensive database containing information on health care providers in the U.S 26 . Three different types of primary care practices employing NPs were included: (1) an independent practice with a physician who has a primary care specialization and no less than one NP employed in that practice, (2) a medical group practice that delivers primary care and employs no less than one NP in the practice, or (3) a medical group practice containing one or more physician, at‐least half of the physicians have a primary care specialization, and no less than one NP employed in that practice 25 . As there were more NPs in geographically larger states than in smaller states, a random sampling of NPs was conducted 25 …”

“…From 2018 to 2019, primary care NPs completed surveys containing valid measures of burnout, quality of care, practice environment, demographics, and characteristics of their main practice site. Researchers from the parent study collected survey data using a modified Dillman approach for mixed‐mode surveys 25,27 . Overall, there were three rounds of mailed surveys sent to NPs and two rounds of reminder postcards which were sent two weeks after the first and second survey mailings 25 .…”

“…Researchers from the parent study collected survey data using a modified Dillman approach for mixed‐mode surveys 25,27 . Overall, there were three rounds of mailed surveys sent to NPs and two rounds of reminder postcards which were sent two weeks after the first and second survey mailings 25 . To maximize the overall response rate, follow‐up phone calls to non‐responding NPs were also conducted.…”

“…To maximize the overall response rate, follow‐up phone calls to non‐responding NPs were also conducted. During some of these calls, researchers could not confirm whether the NPs were truly eligible (e.g., actually worked in that practice) and so these NPs were labeled as “unknown,” non‐responding NPs 25 . In total, 1,244 NPs across six states completed the survey.…”