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Linking Emotional Exhaustion to Adverse Patient Events in Paediatric and Women's Health Nursing Units: The Mediating Role of Nurses' Adherence to Patient Safety Protocols.

L. Labrague,S. A. Al Sabei,Omar Al Rawajfah,Ikram Burney,R. AbuAlRub

Published 2025 in International Journal of Nursing Practice

ABSTRACT

BACKGROUND Emotional exhaustion among nurses is a critical factor that significantly impacts patient safety and the overall quality of care in healthcare settings. Despite its recognized importance, the specific mechanisms by which emotional exhaustion influences adverse patient events are not fully understood. AIM This study examined whether adherence to patient safety protocols could mediate the relationship between emotional exhaustion and adverse patient events. METHODS This cross-sectional study involved a sample of 318 registered nurses from various paediatric and women's health units across selected hospitals in nine governorates of the Sultanate of Oman. Data were collected using self-administered questionnaires, including the Emotional Exhaustion Subscale of the Maslach Burnout Inventory, the Patient Safety Adherence Scale and the Adverse Patient Events Scale. Hayes' PROCESS macro in SPSS (Model 4) was used to conduct mediation analysis. FINDINGS Higher levels of emotional exhaustion among nurses were associated with lower adherence to patient safety protocols (β = -0.26, p < 0.001) and increased adverse patient events (β = 0.32, p < 0.001). Adherence to patient safety protocols partially mediated the relationship between emotional exhaustion and adverse patient events (β = 0.014). CONCLUSIONS Addressing emotional exhaustion through theoretically driven interventions, supportive policies and leadership can enhance adherence to safety protocols and improve patient safety outcomes. By mitigating the impact of emotional exhaustion, healthcare organizations strengthen workforce resilience and promote a culture of safety.

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