Primary care nurse practitioner burnout and perceptions of quality of care

Nurs Forum. 2021 Jul;56(3):550-559. doi: 10.1111/nuf.12579. Epub 2021 Apr 19.


Background: Burnout threatens patient care and clinicians are experiencing challenges within the practice environment. Little is known about nurse practitioner (NP) perceptions of burnout and its relationship to care quality and practice environment. We investigate the relationship between primary care NP burnout on perceptions of care quality and if the practice environment moderates the relationship between burnout and care quality.

Methods: This is a secondary analysis of cross-sectional survey data from 396 NPs. Burnout and care quality were measured using a single item, but the practice environment was measured using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. Multi-level proportional odds cumulative logit models were built to test for associations between burnout and care quality and for moderation.

Results: Total, 25.3% of NPs reported burnout. Odds of perceiving higher quality of care was 85% less for NPs experiencing burnout compared to those not experiencing burnout. Practice environment did not moderate the relationship between burnout and care quality, but with a one unit increase in the practice environment subscales, the odds of NPs perceiving higher care quality increased anywhere from 3.83 to 7.57 times.

Conclusion: Burnout is related to lower perceptions of care quality but favorable environments were related to higher perceptions of quality.

Keywords: Primary Health Care; burnout; nurse practitioners; quality of care.

MeSH terms

  • Burnout, Professional*
  • Cross-Sectional Studies
  • Humans
  • Nurse Practitioners*
  • Perception
  • Primary Health Care
  • Quality of Health Care