A study recently published in the American Journal of Infection Control reports greater healthcare-associated infection rates linked to nurses with job-related burnout at a cost of millions of dollars annually. The data was collected in 2006 from a survey of more than 7,000 registered nurses from 161 hospitals in Pennsylvania. The survey tracked catheter-associated infections and surgical site infections.
A score of 27 or greater on the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) constitutes healthcare burnout. More than one-third of the survey respondents had an emotional exhaustion score of 27 or greater. The average patient load was 5.7 patients. The research showed that for each additional patient assigned to a nurse, there was approximately 1 additional infection per 1,000 patients. For each 10 percent increase in the rate of emotionally exhausted nurses, there was 1 additional catheter related infection and 2 additional surgical site infections per 1,000 patients annually.
Researchers estimated that reducing burnout rates to one-tenth instead of one-third could prevent an estimated 4,160 infections, annually saving $41 million. The cost of improving nursing staffing and other elements of the care environment to relieve nursing burnout would be much more cost-effective and improve quality of patient care.
What is it that causes the infection rates to increase?
- Are we forgetting the very basics of good nursing care?
- Are we so emotionally exhausted that we donít really care anymore?
- Or is our patient load too high?
- Are we so focused on the tasks we need to complete in a given shift that we donít take the time to provide very basic catheter care or hurry through dressing changes and become slack with aseptic technique?
It does seem to me that the very basic tasks associated with good nursing care take a back seat as nurse-to-patient ratios increase and patients present with more acute illness. Sometimes, we just run out of time and are exhausted. What do you think?
- Cimiotti J, et al. "Nurse staffing, burnout, and health care-associated infection." American Journal of Infection Control, 2012; 40: 486-490. Available at: http://www.ajicjournal.org/article/S0196-6553%2812%2900709-2/fulltext.