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  1. Montgomery, Aoyjai P. PhD, BSN
  2. Patrician, Patricia A. PhD, RN, FAAN
  3. Azuero, Andres PhD, MBA


Background: Burnout impacts nurses' health as well as brain structures and functions including cognitive function, which could lead to work performance and patient safety issues. Yet, few organization-level factors related to patient safety have been identified.


Purpose: This study examined nurse-reported patient safety grade and its relationship to both burnout and the nursing work environment.


Methods: A cross-sectional electronic survey was conducted among nurses (N = 928) in acute care Alabama hospitals.


Results: In multilevel ordinal mixed-effects models with nurses nested within hospitals, all burnout dimensions of the Copenhagen Burnout Inventory (OR for +1 SD ranging 0.63-0.78; P < .05) and work environment (OR for +1 SD ranging 4.35-4.89; P < .001) were related to the outcome of patient safety grade after controlling for nurse characteristics.


Conclusions: Results indicate that health care organizations may reduce negative patient safety ratings by reducing nurse burnout and improving the work environment at the organization level.