title: Nurse Burnout, Nurse-Reported Quality of Care, and Patient Outcomes in Thai Hospitals.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effect of nurse burnout on nurse-reported quality of care and patient adverse events and outcomes in Thai hospitals.
  
  
  METHODS
  Cross-sectional analysis of data from 2,084 registered nurses working in 94 community hospitals across Thailand. Data were collected through survey questionnaire, including the Maslach Burnout Inventory (MBI), which measures of nurse perceived quality of care and patient outcomes. Multiple logistic regression modeling was performed to explore associations between nurse burnout on quality of care and patient outcomes.
  
  
  RESULTS
  Thirty-two percent of nurses reported high emotional exhaustion, 18% high depersonalization, and 35% low personal accomplishment. In addition, 16% of nurses rated quality of care on their work unit as fair or poor, 5% reported patient falls, 11% reported medication errors, and 14% reported infections. All three subscales of the MBI were associated with increased reporting of fair or poor quality of care, patient falls, medication errors, and infections. Every unit of increasing emotional exhaustion score was associated with a 2.63 times rise in reporting fair or poor quality of care, a 30% increase in patient falls, a 47% increase in medication errors, and a 32% increase in infection.
  
  
  CONCLUSIONS
  Findings clearly indicate that nurse burnout is associated with increased odds of reporting negative patient outcomes. Implementing interventions to reduce nurse burnout is critical to improving patient care in Thai hospitals.
  
  
  CONCLUSIONS
  Hospital administrators, nurse managers, and health leaders urgently need to create favorable work environments supporting nursing practice in order to reduce burnout and improve quality of care.
authors.affiliation: Phi Omega, Instructor, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Apiradee
authors.initials: A
authors.lastname: Nantsupawat
authors.affiliation: Phi Omega, Associate Professor, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Raymoul
authors.initials: R
authors.lastname: Nantsupawat
authors.affiliation: Phi Omega, Professor, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Wipada
authors.initials: W
authors.lastname: Kunaviktikul
authors.affiliation: Tau Nu, Professor, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Sue
authors.initials: S
authors.lastname: Turale
authors.affiliation: Alpha Zeta, Assistant Professor, Columbia University, School of Nursing, New York, NY, USA.
authors.forename: Lusine
authors.initials: L
authors.lastname: Poghosyan
mesh_terms: D000328:Adult; D002055:Burnout, Professional; D003430:Cross-Sectional Studies; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D016015:Logistic Models; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D063868:Patient Outcome Assessment; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013785:Thailand
keywords: Nurse burnout; Thailand; patient outcomes; quality of care