Impact of adverse event reporting system on burnout and job satisfaction of nurses in China: a nationwide cross-sectional study using a multilevel modeling approach

IMPORTANCEMany organizational and personal factors may contribute to burnout and poor job satisfaction experienced by nurses. Adverse Event Reporting System (AERS) is a key component of organizational-level quality improvement system which impacts workplace wellness for nurses. However, little is known about the underlying influence and mechanism that AERS have on nurse well-being. OBJECTIVETo explore the relationship between the implementation of AERS, burnout, and job satisfaction among psychiatric nurses in China. To uncover the mechanism through which AERS influences burnout and job satisfaction, while examining the mediating effect of workplace violence from patients. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study used the multilevel linear regression analyses with a national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China. Data collection was performed in March 2019, and the analyses were conducted from May to July 2022. MAIN OUTCOMES AND MEASURESThe main outcomes were self-reported burnout and job satisfaction. Burnout was measured by the Maslach Burnout Inventory and job satisfaction was measured using Minnesota Satisfaction Questionnaire. RESULTSAmong 9,744 nurses (mean [SD] age, 34.7 [8.8] years) interviewed, 8064 (82.8%) were female. AERS was positively associated with job satisfaction ({beta}=3.70; p<0.05), but negatively with burnout ({beta}=-3.42; p<0.01) and workplace violence ({beta}=-0.55; p<0.1). Workplace violence was positively associated with burnout ({beta}=2.27; p< 0.01), while negatively associated with job satisfaction ({beta}=-0.81; p<0.01). Mediation analysis indicated that the association between AERS, burnout, and job satisfaction was mediated by workplace violence. CONCLUSIONS AND RELEVANCEThis study highlights that the implementation of AERS is associated with less workplace violence in hospitals, and it may also contribute to lower levels of burnout and higher levels of job satisfaction among psychiatric nurses. Key pointsO_ST_ABSQuestionC_ST_ABSHow does hospitals Adverse Event Reporting System (AERS) impact nurses well-being? What are the underlying mechanisms? FindingsIn this cross-sectional study of 9744 psychiatric nurses, nurses in hospitals with AERS reported significantly lower burnout and job dissatisfaction than those in hospitals without AERS. AERS seems to impact well-being by reducing workplace violence. MeaningAlthough Chinese authorities recently stipulated AERS, not all healthcare organizations have fully implemented it. Reporting and consequent quality improvement actions seem to alleviate workplace violence, especially in patient-provider relationship. This will inform hospital management to further leverage AERS for workplace well-being and satisfaction.