Research Article|Articles in Press

Associations of pediatric nurse burnout with involvement in quality improvement

Published:November 16, 2022DOI:


      • Less burnout was associated with more open communication among nurses.
      • Less burnout was related to being more involved in quality improvement.
      • More burnout was linked to a greater quality improvement workload.
      • Unit-level teamwork was associated with less burnout.
      • Future research is needed to identify aspects of QI involvement that reduce burnout.



      Burnout among nurses negatively impacts patient care experiences and safety. Inpatient pediatric nurses are high-risk for burnout due to high patient volumes, inadequate staffing, and needing to balance the demands of patients, families and team members.
      We examined the associations of inpatient pediatric nurse burnout with their perspectives on the importance of quality at the hospital, patient experience measurement, quality improvement (QI), unit culture, and staffing.


      We conducted a cross-sectional study at an urban children's hospital. We surveyed pediatric nurses about their perspectives including the single-item Maslach Burnout Inventory. We fit separate regression models, controlling for role, location and unit, predicting outcome measures from the dichotomized burnout scale.


      Twenty-seven percent of pediatric nurses reported burnout. Nurses who had more confidence in patient experience measurement, received frequent patient experience performance reports, felt included in QI, and experienced QI efforts as integrated into patient care reported not being burned out (compared to those reporting burnout; all p-values<0.05). More open communication among nurses (e.g., about possible problems with care) and unit-level teamwork were also associated with not being burned out, whereas a larger QI workload was associated with burnout (p-values<0.05).


      Open communication among nurses and nurses being more involved and valued in QI efforts were related to not being burned out. Research is needed to further examine aspects of QI involvement that reduce burnout.

      Practice implications

      Supporting open communication among pediatric nurses, engaging them in QI and integrating QI into patient care while minimizing QI workload may decrease burnout.


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