Interventions for preventing or reducing nurse burnout: A systematic review and meta-analysis

Nursing burnout, recognised in the International Classification of Diseases 11th Revision (ICD-11) as emotional exhaustion, depersonalisation, and reduced professional efficacy, threatens staff retention, patient safety, and quality of care, and also undermines the psychological wellbeing and overall quality of life of nurses themselves. Although numerous interventions exist, it is unclear which approaches (individual-level vs. organisational-level) yield the greatest and most durable reductions in burnout.

Guided by Maslach's tripartite burnout model and the Job Demands-Resources framework, to quantify the effects of nurse-targeted interventions on global burnout, and its three dimensions (emotional exhaustion, depersonalisation, and professional efficacy/personal accomplishment), and to explore durability and moderators (intervention type) across both individual- and organisational-level strategies.

Systematic review and meta-analysis.

Six databases (MEDLINE, CENTRAL, PsycINFO, CINAHL, Scopus and Web of Science) were searched from inception to October 2025. Randomised, quasi-experimental or controlled before-after studies targeting registered nurses were eligible. Risk of bias was assessed with RoB 2 (RCTs) or ROBINS-I (non-randomised). Random-effects meta-analyses generated Hedges g; heterogeneity was explored with I² and subgroup tests. GRADE informed certainty ratings. The review followed PRISMA 2020 and was prospectively registered (PROSPERO CRD420251041394).

Sixty-three studies met inclusion criteria; forty-six contributed to quantitative synthesis. Interventions produced significant reductions in global burnout (g = -0.71, 95% CI -1.27 to -0.14; k = 11). Effects were strongest for emotional exhaustion (g = -1.46, 95% CI -2.64 to -0.27) and depersonalisation (g = -0.89, 95% CI -1.54 to -0.24), whereas personal accomplishment showed small, imprecise, and inconsistent changes. By intervention type, mindfulness and yoga programmes produced the most consistent improvements in exhaustion and depersonalisation; workshop-based approaches yielded smaller but favourable effects. Sensitivity analyses restricted to randomised controlled trials confirmed the direction of benefit and attenuated extreme values. No evidence of publication bias was detected.

Mindfulness-based and brief positive-psychology interventions offer the most reliable and scalable pathway to mitigating nurse burnout, particularly emotional exhaustion. Hybrid relational formats (Balint groups, reflective supervision) show additional promise when paired with protected time and managerial endorsement, whereas passive educational packages are insufficient. Health-system leaders should integrate accessible digital mindfulness or gratitude-based micro-interventions into routine wellness platforms and reinforce these with team-level reflective structures. Future research should include head-to-head trials, cost-effectiveness analyses, and studies in resource-constrained settings with follow-up beyond six months.