A new study has found that nurses who report mental health symptoms like anxiety and burnout also perceive that their patients receive a lower quality of care.

While the link between nurse mental health and quality and safety of patient care delivery was well documented prior to the COVID-19 pandemic, few research studies have examined this relationship in the context of COVID-19.

That was what this study attempted to explore, by comparing the mental health symptoms experienced by nurses on quality and safety before and during the COVID-19 pandemic.

The researchers based their analysis on survey data. The first survey was carried out in December 2019 and included about 5,500 respondents. The second, conducted in June and July, 2020, included about 3,500 nurses.

Nurses who took part in the two 25-minute online surveys were asked questions like, 'How likely are you to recommend your unit to family and friends if they needed care?'

Analysis shows that compared to pre-COVID-19, nurses during COVID-19 reported a higher safety grade and a lower quality of nursing care.

Most mental health symptoms were higher during COVID-19, and higher levels of mental health symptoms were correlated with lower ratings of quality and safety both pre- and during COVID-19.

The findings included important factors in nurses' mental health and burnout, like heavy workloads, staffing inadequacies, access to personal protective equipment, and support from the organizations where health workers are employed.

In a comment at the time of the study’s release, Farinaz Havaei, an assistant professor at the University of British Columbia's school of nursing and the study lead, said that “we actually found that there was an association — or a correlation — between the severity of nurses' mental health symptoms, and their ratings of quality and safety of care”.

She acknowledged that a limitation of the study was that patient care was determined by the nurses' self-reported perceptions, rather than a survey of patients themselves.

Havaei said recommendations resulting from the study include the need for administrators to regularly assess nurses' mental health through anonymous surveys, and to make the findings of those surveys public.

"By making that information publicly available, the public could essentially— by looking at that information — find out which hospitals or health-care organisations are high-performing or effective organisations," she said.

Havaei also said the study's findings show an urgent need to better detect, prevent and treat mental health symptoms among health-care workers, particularly nurses.

A similar survey hasn't been carried out since 2020, but Havaei fears the results would only show an increase in mental health issues among nurses and the associated decline in patient care, as the pandemic wears on.