Depression among nurses may increase likelihood of medical errors

Depression is common among nurses and is linked to a higher likelihood they'll make medical errors, new research suggests.

The study found that more than half of nurses who took part in a national survey reported sub-optimal physical and mental health. Nurses in poorer health had a 26 to 71 percent higher likelihood of reporting medical errors than did their healthier peers. Depression stood out as a major concern among the 1,790 U.S. nurses who responded to the survey, and as the key predictor of medical errors.

"When you're not in optimal health, you're not going to be on top of your game," said lead author Bernadette Melnyk, dean of The Ohio State University's College of Nursing and chief wellness officer for the university.

"Hospital administrators should build a culture of well-being and implement strategies to better support good physical and mental health in their employees. It's good for nurses, and it's good for their patients."

The study, which appears online in the Journal of Occupational and Environmental Medicine, also found that nurses who perceived their workplace as conducive to wellness were more likely to report good health.

The National Academy of Medicine has prioritized clinician well-being in its recently launched action collaborative, acknowledging that burnout, compassion fatigue, depression and poor work-life balance affect a large percentage of doctors, nurses and other health professionals.

The new research is the first large-scale national study to link nurses' well-being to self-reported medical errors, Melnyk said.

"Nurses do a great job of caring for other people, but they often don't prioritize their own self-care," she said. "And their work lives are increasingly stressful - patients are sicker, hospitals are crunched financially and nurses are having to find ways to juggle patient care with all of their other assigned tasks, such as tending to the electronic medical record."

Limiting long shifts and providing easy-to-access, evidence-based resources for physical and mental health, including depression screenings, could go a long way toward improving nurses' wellness and decreasing the chances that mistakes will be made, Melnyk said.

The data came from a survey conducted by the American Academy of Nursing's million hearts sub-committee of the health behavior expert panel. The survey included 53 questions and was offered through nursing organizations and 20 U.S. hospitals. Only responses from nurses who were in clinical practice were included in the study. The majority of participants were white women and the average age of participants was 44, which closely resembles the demographics of the nursing workforce nationwide.

More than half (54 percent) of the nurses reported poor physical and mental health. About a third said they had some degree of depression, anxiety or stress. Less than half said they had a good professional quality of life.

And self-reported medical errors were common. About half the nurses reported medical errors in the past five years.

When researchers compared the wellness data to the medical error data, they saw a significant link between poor health - particularly depression - and medical errors.

While a survey that depends on self-reported perceptions has its limitations, the evidence should prompt efforts to improve the mental and physical health of nurses, physicians and other clinicians, Melnyk said.

"Health care systems and hospitals have to do a better job of creating wellness cultures for their clinicians," she said. "The National Academy of Medicine has identified this as a public health problem and has made clinician well-being a high priority for health care quality and safety."​

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