Contents:
The main reason for this recruitment was to avoid employer-biased responses, which might have occurred when recruiting EMS-workers via their employers. Three reminders were used in social media after one, two, and four months. EMS-workers in this study are defined as trained professionals in prehospital emergency medical care according to their level of qualification excluding emergency physicians. Their tasks cover medical care on-site and in ambulances as well as the transport of patients to hospitals.
With the aim of testing the comprehensibility of the instructions and the appropriateness concerning the order of questions in the questionnaire, a pilot survey including 10 EMS-workers was conducted. As a result, some minor changes regarding the order of questions were implemented before starting the large-scale survey. Data collection was performed from June to December using the online survey tool SoSciSurvey, which records data according to the German privacy policy.
The study makes use of a cross-sectional design by conducting a nationwide survey to EMS-workers. Most items of the RN4Cast study inclusion of questions regarding satisfaction and all items of the EMS-SAQ are not considered in this study as they are not focused in this study or were collected for a planned comparative study with nurses. Each statement is rated according to the frequency of occurrence adapting a seven-point Likert scale [ 1 ].
The subscale depersonalization DP measures the callousness and impersonal response towards people receiving service, care, treatment, or instruction. The subscale personal accomplishment PA assesses feelings of being competent and successful in working with people [ 1 , 24 ].
Based on the manual of Maslach et al. In line with current studies [ 6 , 25 , 26 ], high scores for emotional exhaustion and depersonalization were additionally considered. This self-reporting instrument is seen as an alternative to incomplete and inaccurate data of electronic patient care reports [ 27 , 28 ]. It includes 44 items within three safety outcome measures: Two nominal, seven-option, categorical scales were used A — 35 items, B — 19 items for extracting answers which have to be referred to the previous three months of working [ 27 ]. In addition, the respondents were asked about their age when reaching the highest level of EMS-education, satisfaction with occupational choice 6-point Likert scale , and the operating ranges.
The target population were EMS-workers actively working in their position at the time of the survey period. Before starting the survey, participants had to approve a data privacy statement including 1 details about the content and duration of the survey, 2 indications that participation may evoke negative experiences, and 3 information on the possibility to interrupt the survey at any time. In this context, participants received an e-mail address assuring that their data can be deleted anytime.
Therefore, they had to enter an eight-digit code. Missing approvals of the data privacy statement and the eight-digit code led to the exclusion of participants. For those participants who opened the survey link, the following criteria resulted in an exclusion of the questionnaires: The Fisher exact test was used to compare the dimensions of the MBI between EMS workers who reported negative safety outcomes and EMS workers who did not report negative safety outcomes.
Linear and logistic regression models were used to evaluate the association between the dimension of burnout and the three safety outcomes. The dimension personal accomplishment was not included in the linear regression models as several studies have questioned the validity of this dimension [ 31 , 32 ]. Analyses were performed using the statistical software package Stata Based on the data screening process described in the method section, questionnaires could be considered for the data analysis. The majority of all participants were male The majority of the respondents Half of the respondents Nearly half of the respondents Based on the cut-off point presented in the method section the answers of the participants regarding the three dimensions of the MBI were categorized in high degree and low degree of burnout.
High degrees could be shown for A high degree for EE and DP could be shown for Comparisons were conducted for the domains injury and errors and adverse events. As nearly all respondents Approximately one third of the participants Greatest contributing factors in the measure safety comprising behavior included speed limits and the check of the ambulance. For the measure error and adverse events factors are more diverse ranking from not printing and properly interpreting an EKG strip to not checking the glucose level in a patient with altered mental status.
All correlation coefficients are significant except the one between personal accomplishment and injury. Following Cohen [ 33 ] regarding the effect size of the Pearson correlation coefficient, a moderate and positive correlation can be shown between the measure safety comprising behavior and the dimensions EE and DP of the MBI. For the safety outcomes injury and error and adverse events a logistic regression was conducted, consequently the odds ratios are presented. For the safety outcome safety compromising behavior a linear regression was used as a differentiation between those who reported safety compromising behavior and those who did not was not possible.
The association between burnout and safety outcomes is assessed by the dimensions emotional exhaustion and depersonalization. We observed a positive and significant association between both dimensions and the three safety outcomes besides between emotional exhaustion and error and adverse events.
Age is negatively associated with the safety outcomes except the age category 40—49 for the safety outcomes injury. A positive association between experience in EMS and the safety outcomes injury and safety compromising behavior is observed.
Satisfaction with the current job is negatively associated with the safety outcome safety compromising behavior, satisfaction with the professional status with the safety outcome safety compromising behavior and error and adverse events. We observed a negative association between no intention to leave the current job within the next year and all safety outcomes. Additionally, a negative effect between the safety compromising behavior and the recommendation of the EMS area as a good place to work is observed.
Buy 30 Minuten Burn-out (German Edition): Read 1 Kindle Store Reviews - www.farmersmarketmusic.com Vom Burnout zum Traumberuf (German Edition) (): Stephan Start reading Nicht glauben, ausprobieren! on your Kindle in under a minute.
Burnout among health care workers is seen as an important issue in patient care. Several studies have analyzed the risk factors and potential consequences of the burnout syndrome for EMS-workers. Especially in the context of health threatening diseases medical errors and failure may lead to fatal consequences [ 34 ]. Therefore, this study focuses on investigating the association between burnout and safety outcomes by combining tools measuring the degree of burnout and adverse events safety outcomes for EMS-workers.
We got the result that between Compared with the prevalence of burnout for nurses and surgeons presented in the introduction our results for depersonalization were in the higher range. Our results are furthermore not fully in line with the results of the presented burnout studies for EMS-workers.
The only German study [ 14 ] examining the degree of burnout using the MBI, got the result that the dimension with the highest percentage of participants with a high degree of burnout was personal accomplishment. However, the number of 98 considered questionnaires was considerably low and the analysis was limited to two regions in Germany.
Alexander and Klein [ 18 ] could show for ambulance personnel in the UK that personal accomplishment is the dimension with the highest percentage of a high degree of burnout. In contrast Essex and Scott [ 15 ] showed the highest percentage of a high degree of burnout for the dimension depersonalization.
A potential reason might be the combination of full or part-time job and EMS volunteering which may result in a double burden. A potential reason for difference might be various regional settings. Furthermore, the regression results show that burnout is significantly associated with the safety outcomes injury, error and adverse events, and safety-compromising behavior.
This is especially in line with studies investigating the association of self-reported medical errors and self-reported burnout of healthcare staff [ 36 — 39 ]. One of those studies could furthermore show a mediating role of burnout for patient outcomes and job turnover indicating that the working environment supports psychological well-being and ensures patients safety [ 38 ]. Compared to a study of Linda Aiken and colleagues [ 40 ], who investigated these items for nursing professionals, our results exceed the findings for nurses surveyed in Germany, 11 other European countries and the US except for the item job satisfaction in Greece.
Furthermore, they could show a significant association between satisfaction and intention to leave and the quality of care. Results of Patterson and colleagues who investigated job satisfaction of EMT-Basics and EMT-Paramedics showed that satisfaction varies across several important personal and organizational factors. They recommend a longitudinal study design to explore fully the importance of these factors in predicting job satisfaction [ 41 ].
In summary, job satisfaction, the intention to leave the current position and burnout in the EMS-workers workforce are critical issues as they pose safety risks for patients as well as EMS-workers. Given the increasing numbers of cases in prehospital emergency care, EMS managers should be aware of factors that affect the items such as the intention to leave a job. Therefore, identifying predictors of job satisfaction, intention to leave and burnout is an essential issue to ensure prehospital emergency care and improve its safety outcomes.
Several limitations need to be mentioned. Online surveys might lead to a selection bias, as people without internet access are not able to participate. Another limitation is that the calculation of a response rate is not possible.
The study population is all EMS-workers in Germany. Since no standardized data on the number of EMS-workers on federal state level and information on the number of voluntary EMS-workers for Germany is available, a clear numerical number for the study population could not defined. A further methodological limitation of the study findings might be the use of self-report measures for burnout and safety outcomes.
Study participants with high burnout levels may over-report adverse events due to their negative emotional state [ 45 ]. Fahrenkopf and colleagues [ 46 ] used objective and subjective measures of error. They could show that burned out residents and non-burned out residents showed similar rates of error when using objective measurement. However, burned out residents reported a higher mean number of errors.
Reasons for underreporting might be a poor safety culture resulting in an unwillingness to report adverse events or that EMS-workers might not realize that an adverse event occurred. Finally, the cross-sectional study design prohibits determination of causality. Whether a high degree of burnout preceded negative safety oucomes cannot be analyzed. It could be shown that burnout is significantly associated with safety outcomes. An expansion of the psychological support of EMS-workers in Germany seems to be necessary.
Setting-based prevention could be a beneficial approach e. Further analysis is needed to understand the nature and complex relations between various factors for example by using a structural equation model. Those further investigations have the potential to identify predictors for negative safety outcomes as well as determinants of burnout. Policymakers and managers of EMS should take care of the burnout prevalence and safety outcomes when qualifying EMS-workers and planning their working environments. NB had the main role in the conception of the manuscript.
Descriptive statistics were performed by SF and NB. Regression analysis was performed by NB.
All listed authors were responsible for reading, commenting upon, and approving the final manuscript. Individual written informed consent was obtained. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. National Center for Biotechnology Information , U. Published online Aug Author information Article notes Copyright and License information Disclaimer.
Received Nov 13; Accepted Aug Associated Data Supplementary Materials Additional file 1: EMS Qualification in Germany. Abstract Background The association between burnout and patient safety has been analyzed in many studies for nurses, physicians, and residents. Methods EMS-workers were recruited via German EMS-journals, social media and a professional association to participate in an online survey. Get to Know Us.
English Choose a language for shopping. Amazon Music Stream millions of songs. Amazon Advertising Find, attract, and engage customers. Amazon Drive Cloud storage from Amazon. Alexa Actionable Analytics for the Web. AmazonGlobal Ship Orders Internationally. Amazon Inspire Digital Educational Resources. Amazon Rapids Fun stories for kids on the go.
Amazon Restaurants Food delivery from local restaurants. ComiXology Thousands of Digital Comics. East Dane Designer Men's Fashion. Shopbop Designer Fashion Brands. Withoutabox Submit to Film Festivals. Amazon Renewed Refurbished products with a warranty.