Depression in nurses, which is common, is linked to a higher likelihood that they will make a medical error, according to a study published online in the Journal of Occupational and Environmental Medicine.

Researchers found that nurses in poorer physical and mental health had a 26 to 71% higher chance of reporting a medical error than their peers in good health. Among the 1,790 nurses who participated in the study, depression was not only a major concern but a significant predictor of medical errors. Additionally, the study found that nurses who felt their workplace was conducive to wellness were likelier than other nurses to report good health.

For the national study, a cross-sectional descriptive survey was conducted with nurses across the United States. The study authors concluded: “Wellness must be a high priority for healthcare systems to optimize health in clinicians to enhance high-quality care and decrease the odds of costly preventable medical errors.”

“Nurses take great care of other people, but they don’t necessarily take great care of themselves,” says Bernadette Mazurek Melnyk, Ph.D., RN, APRN-CNP, FAANP, FNAP, FAAN, Dean and Professor in the College of Nursing, University Chief Wellness Officer, and a professor of pediatrics and psychiatry in the College of Medicine at The Ohio State University. “About 25% of the nurses that took part in our survey had depressive symptoms, and depression was the leading cause of medical errors in our study.”

Dr. Melnyk says this was the first study to pinpoint that nurses’ depression leads to medical errors. “And that is why it is so critical that we call attention to nurses’ health and well-being,” she explains. “If nurses are suffering from physical and mental health issues, they won’t be able to be fully engaged in their work, and that affects health care quality.”

She added that more than 50% of clinicians now suffer from burnout, a figure described in the National Academy of Medicine’s “Action Collaborative on Clinician Well-Being and Resilience.”

“Burnout is a syndrome characterized by a high degree of emotional exhaustion and depersonalization (i.e., cynicism), and a low sense of personal accomplishment at work,” explains the National Academy of Medicine’s initiative. “Clinician burnout can have serious, wide-ranging consequences, from reduced job performance and high turnover rates to—in the most extreme cases—medical error and clinician suicide.”

Conversely, the National Academy of Medicine stated, “Clinician well-being supports improved patient-clinician relationships, a high-functioning care team, and an engaged and effective workforce. In other words, everyone wins when we invest in clinician well-being.”

As one of some 60 nationwide leaders working actively on the National Academy of Medicine’s initiative, Dr. Melnyk feels that clinicians’ self-care needs to be prioritized. “Nurses need to ensure they are engaging in physical activity, practicing stress reduction, and eating healthy,” she says. “If we expect our patients to engage in these activities, we must role-model them ourselves.”

Dr. Melnyk also believes that clinicians should be screened for depression; if they suffer from it, they should be taught cognitive and coping skills. “This is a big public health issue,” she says. “We must equip our clinicians with the tools they need for optimal well-being.”

Dr. Melnyk says that Limiting long shifts and supplying easy-to-access resources for both physical and mental health could help improve nurses’ wellness and decrease the chance that medical errors will occur.