Benessere professionale e staffing sicuro in area critica: studio osservazionale multicentrico nazionale. Professional well-being and safe staffing in the critical care setting: a national multicentre observational study.

Professional well-being and safe staffing in the critical care area: a national multicenter observational study. Background: The 2008 financial crisis and COVID-19 worsened healthcare work environments, especially for critical care healthcare workers, leading to high stress, burnout, job dissatisfaction, and poorer patient outcomes, highlighting the need for improved work conditions and professional well-being. Aim: To evaluate professional well-being and related factors among Italian critical care nurses and physicians. Methods: This multicenter cross-sectional observational study towards online surveys investigates stress and burnout levels, job satisfaction, work environment, mental health, sleep quality, general health, work environment quality, and patient safety perception. Results: The study involved 697 nurses and 63 physicians employed in critical care settings of 26 Italian hospitals. Key findings include high-stress levels (50.7% of nurses, 62.1% of physicians) and burnout symptoms (14.6% of nurses, 34.4% of physicians). Job dissatisfaction was reported by over half of the physicians and a third of the nurses. Poor mental health indicators were significant, with 19.9% of nurses and 23.3% of physicians at risk for generalized anxiety disorder, and 18.6% of nurses and 28.3% of physicians showing depressive symptoms. Sleep quality was poor among 44.1% of nurses and 45% of physicians. The work environment was rated as excellent by only 4.2% of nurses and 3.4% of physicians, with 19.2% of nurses and 18.9% of physicians perceiving patient safety as poor or absent. A critical care nurse works 37.3 hours per week; a physician performs 3.16 night guards per month. The care most frequently missed are health information and education to patients and family members (51.5%), developing or updating nursing care plans/pathways of care (49.2%), and frequent mobilization of the bedridden patient (49.2%). The nurse-to-patient ratio in critical care is 1:3.4, while in emergency rooms it is 1:6.5 per nurse. Burnout is associated with intention to leave, anxiety, perceived quality of work environment and workload (p< .001) as well as measured quality of work environment is related to job satisfaction and perceived quality of work environment (p< .001). The quality of care and the patient’s safety are related to job satisfaction and perceived quality of the work environment (p< .001). Discussion: The study underscores the detrimental effects of reduced healthcare funding and understaffing on work conditions, particularly in critical care. It highlights the profound impacts of burnout on staff well-being and patient care, advocating for effective leadership, supportive environments, and comprehensive policies to boost healthcare professionals' well-being and ensure high-quality patient care. Conclusions: The research findings underline the urgent need for comprehensive approaches and targeted health policies to improve staff well-being, which is crucial for patient safety and quality of care in high-intensity health care settings, as well as to counter the ever-increasing phenomenon of the intention to leave, which affects physicians and nurses and puts the Health System in serious crisis.