H ealthy Work Environments ©2020 American Association of Critical-Care Nurses doi:https://doi.org/10.4037/ajcc2020831 Background Burnout is a maladaptive response to work- related stress that is associated with negative consequences for patients, clinicians, and the health care system. Critical care nurses are at especially high risk for burnout. Previ- ous studies of burnout have used survey methods that simultaneously measure risk factors and outcomes of burnout, potentially introducing common method bias. Objectives To evaluate the frequency of burnout and individual and organizational characteristics associated with burnout among critical care nurses across a national integrated health care system using data from an annual survey and methods that avoid common method bias. Methods A 2017 survey of 2352 critical care nurses from 94 sites. Site-level workplace climate was assessed using 2016 survey data from 2191 critical care nurses. Results Overall, one-third of nurses reported burnout, which varied significantly across sites. In multilevel anal- ysis, workplace climate was the strongest predictor of burnout (odds ratio [OR], 2.20; 95% CI, 1.50-3.22). Other significant variables were overall hospital quality (OR, 1.44; 95% CI, 1.05-1.99), urban location (OR, 1.93; 95% CI, 1.09-3.42), and nurse tenure (OR, 2.11; 95% CI, 1.44-3.10). In secondary multivariable analyses, workplace climate subthemes of perceptions of workload and staffing, super- visors and senior leadership, culture of teamwork, and patient experience were each significantly associated with burnout. Conclusions Drivers of burnout are varied, yet interven- tions frequently target only the individual. Results of this study suggest that in efforts to reduce burnout, emphasis should be placed on improving local workplace climate. (American Journal of Critical Care. 2020;29:380-389) I MPACT OF WORKPLACE CLIMATE ON BURNOUT AMONG CRITICAL CARE NURSES IN THE VETERANS HEALTH ADMINISTRATION By Lakshmana Swamy, MD, MBA, David Mohr, PhD, Amanda Blok, PhD, MSN, PHCNS-BC, Ekaterina Anderson, PhD, Martin Charns, DBA, Renda Soylemez Wiener, MD, MPH, and Seppo Rinne, MD, PhD 1.0 Hour C E This article has been designated for CE contact hour(s). See more CE information at the end of this article. 380 AJCC AMERICAN JOURNAL OF CRITICAL CARE, September 2020, Volume 29, No. 5 www.ajcconline.org Downloaded from http://aacnjournals.org/ajcconline/article-pdf/29/5/380/130862/380.pdf by guest on 24 November 2020