SCOPING REVIEW ON THE EFFECTS OF BURNOUT AMONG INTENSIVE CARE UNIT STAFF

Abstract

Background: Burnout among intensive care unit (ICU) staff—characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment—is a major global concern linked to high turnover, deteriorating mental health, and compromised patient care. The COVID-19 pandemic intensified existing structural and emotional stressors in ICU settings.

Objective: This scoping review aimed to synthesize evidence on the prevalence of burnout among ICU staff, associated risk factors, impacts on staff well-being and patient care, and the effectiveness of interventions, with particular attention to the COVID-19 and post-pandemic context.

Methods: A total of 22 peer‑reviewed articles focusing on adult ICUs were included, primarily involving ICU nurses and physicians. Burnout was most commonly measured using the Maslach Burnout Inventory. Study designs comprised systematic reviews and meta-analyses (n = 9), cross-sectional/prevalence studies (n = 8), longitudinal/observational studies (n = 3), and intervention studies (n = 2). Extracted outcomes included prevalence of burnout, associated systemic and personal factors, effects on staff well-being and retention, implications for patient care, and evaluated interventions.

Results: Pre-pandemic estimates indicated high emotional exhaustion in 31% of ICU nurses, high depersonalization in 18%, and low personal accomplishment in 46%. During COVID-19, burnout prevalence reached 41–44% among ICU physicians and up to 61–73% among nurses. Systemic factors—poor work environments, chronic understaffing, high patient-to-nurse ratios, and limited organizational support—were consistently stronger predictors of burnout than individual characteristics such as age or experience. Burnout was associated with reduced quality of life, anxiety, depression, sleep disturbances, and high intention to leave, with up to 43% of ICU nurses considering leaving their jobs. Patient care outcomes linked to higher burnout included more missed nursing care, poorer safety indicators, and lower patient satisfaction. Mindfulness-based interventions and structured resilience programs, including peer-support models such as the Battle Buddies program, demonstrated short-term reductions in emotional exhaustion and depersonalization and improvements in well-being, though evidence on long-term sustainability and physician-specific outcomes remains limited.

Conclusions: Burnout among ICU staff is highly prevalent, especially among nurses, and is primarily driven by modifiable structural factors such as heavy workload, chronic understaffing, and inadequate organizational support, all exacerbated by the COVID-19 pandemic. Burnout adversely affects staff mental health, retention, and patient safety. While mindfulness-based and peer-support interventions show promise for short-term symptom reduction, enduring improvements in ICU staff well-being and care quality will require system-level reforms in staffing, workflow, and leadership, alongside continued development and evaluation of individual-level interventions.