Burnt-Out Nurses are Linked to More Hospital-Acquired Infections

It’s called burnout – that feeling of emotional exhaustion and disillusionment with your current job that can creep up on you when you’re under stress. It definitely affects you both personally and professionally, but a new study published in the American Journal of Infection Control shows it may affect your patients as well.

A team of researchers at the University of Pennsylvania used a survey tool called the Maslach Burnout Inventory to analyze nurses’ job related attitudes. It then compared a hospital’s percentage of burned out nurses to its rates of catheter associated urinary tract infections (CAUTIs) and surgical site infections (SSIs). Every ten percent increase in the number of high-burnout nurses correlated with one additional CAUTI and two additional SSIs per 1,000 patients annually.

At first glance, this might not seem like a big deal, but a news release from the Association for Professionals in Infection Control (APIC) summed it up this way:

Using the per-patient average costs associated with CAUTIs ($749 to $832 each) and SSIs ($11,087 to $29,443 each), the researchers estimate that if nurse burnout rates could be reduced to 10 percent from an average of 30 percent, Pennsylvania hospitals could prevent an estimated 4,160 infections annually with an associated savings of $41 million.

The impact of work environment

A large body of evidence has linked nurse-to-patient staff ratios with patient outcomes. It seems rather clear-cut that fewer caregivers would translate into a lower standard of care, from time constraints alone. But this study goes a step further, suggesting the issue is not simply the number of nurses on staff, but the quality of the work environment. When nurses feel there is a lack of teamwork, or that management’s values conflict with their own – putting financial concerns ahead of patient safety, for instance – stress can build up to the point that some nurses simply detach from their work.

Since Medicare and some private insurers are no longer reimbursing for CAUTIs and SSIs, it only makes sense that hospitals would do everything possible to eliminate these adverse events. That includes not only encouraging nurses to adhere to infection control practice guidelines, but also to improve the work environment as well. The study authors sum it up this way:

Healthcare facilities can improve nurse staffing and other elements of the care environment and alleviate job-related burnout in nurses at a much lower cost than those associated with healthcare-associated infections. By reducing nurse burnout, we can improve the well-being of nurses while improving the quality of patient care.

Infection control resources are available

There are simple steps you can take to help reduce the incidence of hospital-acquired infections (HAIs) – and of course, handwashing is at the top of the list. Other preventive measures bring your role as patient advocate into play. For example, you could conduct a daily review of all your patients that have catheters, and advocate for the removal of those that are no longer necessary. Research shows that “forgotten catheters” are often inappropriate catheters – so don’t assume that physicians are always aware of a patient’s catheter status.

For more tips like this, check out the online resources that recommend nursing interventions for preventing common types of HAIs. The CDC’s latest recommendations are compiled in the 2009 Guideline for Prevention of CAUTIs (PDF) and in the Guideline for Prevention of Surgical Site Infection, 1999 (PDF).

If you’re interested in planning, implementing, and evaluating infection prevention and control measures, consider making this your career specialty. As a first step, you can develop new skills and empower yourself with knowledge through an online RN to BSN or an RN to MSN degree with a specialization in infection control. American Sentinel University also offers an Infection Prevention and Control Certificate program for health care professionals seeking additional credentials.

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