# Occupational burnout mediates the association between team climate and nurses’ safety behaviours: a multicentre cross-sectional study

## TL;DR

This study shows that a positive team climate improves nurses' safety behaviors partly by reducing burnout, which is crucial for patient safety.

## Contribution

The study identifies occupational burnout as a mediator between team climate and nurses’ safety behaviors, offering new insights into how workplace environments affect nursing performance.

## Key findings

- Burnout negatively predicts nurses’ safety behaviors.
- Team climate positively predicts safety behaviors and partially mediates them through reduced burnout.
- Interventions targeting burnout and team climate can enhance patient safety.

## Abstract

In contemporary healthcare, nurses are pivotal to patient safety, and their behaviours are integral to care quality and adverse event prevention. However, escalating organisational complexity and sustained workload demands have made burnout prevalent among nurses, with demonstrable adverse effects on performance and patient safety. Although prior research indicates that a positive team climate fosters desirable nursing behaviours, the extent to which it promotes safety behaviours by alleviating burnout remains unclear. Clarifying whether and how burnout mediates the association between team climate and nurses’ safety behaviours would refine theoretical accounts of behavioural formation in nursing practice and provide actionable evidence to guide organisational strategies and managerial interventions that optimise workforce well-being and enhance the quality and safety of care.

To examine whether occupational burnout mediates the association between team climate and nurses’ safety behaviours.

Between March and April 2025, we conducted a multicentre cross-sectional survey using convenience sampling among registered nurses from three tertiary grade A hospitals in Anhui and Jiangsu provinces, China. Data were collected using self-administered questionnaires comprising a sociodemographic form, the Nurses’ Safety Behaviours Scale, the Maslach Burnout Inventory–General Survey (MBI–GS), and the short form of the Team Climate Inventory (TCI).

Among 925 nurses, the mean (SD) safety behaviours score was 52.89 (9.14). Safety behaviours correlated positively with team climate and negatively with overall burnout and each burnout dimension (all p < 0.05). In regression analyses, burnout negatively predicted safety behaviours, whereas team climate positively predicted them; the model explained 45.6% of the variance (R2 = 0.456). Mediation analysis indicated a partial mediation effect of burnout in the association between team climate and safety behaviours: the total effect was B = 0.599 (95% CI 0.552–0.646; p < 0.001), and the indirect effect via burnout was B = 0.084 (95% CI 0.058–0.114; p < 0.001).

Occupational burnout undermines nurses’ safety behaviours, whereas a favourable team climate strengthens them. Moreover, team climate indirectly enhances safety behaviours by mitigating burnout. These findings have practical implications for nursing management and training. Interventions should prioritise mitigating burnout and cultivating a positive team climate to strengthen nurses’ safety behaviours.