Burnout and its relationship to self‐reported quality of patient care and adverse events during COVID‐19: A cross‐sectional online survey among nurses

To assess nurses' burnout and its association with their perceived quality of patient care and occurrence of adverse events (AEs) during COVID-19.Burnout is a serious problem among nursing staff internationally with negative impacts on the quality of care and patient safety.We conducted a cross-sectional online study among 1,004 Iranian nurses through the convenience sampling technique. Data were collected using the Maslach Burnout Inventory, five items of questions related to self-reported poor patient care quality and estimated occurrence of AEs.Prevalence of high burnout among nurses was 31.5%. The risk of AEs ranged from 26.1% to 71.7%. Self-reported quality of patient care was found to be poor. A positive correlation was found between emotional exhaustion and depersonalization scores and patient care quality, whereas a negative correlation was found between personal accomplishment scores and all poor care item scores. Depersonalization was found to increase the risk of the onset of all AEs (odds ratio [OR] = 1.06-1.08). Also, Personal accomplishmentreduced the risk of occurrence of 'medication errors' (OR = 0.99) and the onset of 'patient and their family verbal abuse' (OR = 0.97).Our findings confirmed the hypothesis that a higher degree of burnout is correlated with a perceived higher number of AEs and reduced perceived patient care quality.Reducing burnout among nurses through implementing interventions may be an effective strategy to enhance patient care quality and reduce the number of AEs in Iranian public hospitals. Therefore, in order to minimize work burnout, primary approaches include access to psychosocial support, including Web-based services, psychological first aid, mental support hotlines and self-care techniques during the COVID-19 pandemic.