Healthcare News & Insights

Nurse burnout increases likelihood of infection

A new study shows the negative effects that “burned-out” nurses can have on a hospital’s quality of care.

The study, appearing in the American Journal of Infection Control, was conducted by the University of Pennsylvania and examined infection rates in hospitals throughout the state.

Using this data, along with a separate survey of nurses who worked at each hospital, researchers discovered a correlation between the hospitals’ nurse-to-patient ratios, nurses’ burnout levels, and the number of infections patients contracted in the hospital.

Specifically, the analysis focused on two common hospital infections: catheter-associated urinary tract infections and surgical site infections.

The key finding: Hospitals with nurses who have high caseloads and described themselves as being burned out had higher infection rates than others.

Increasing a nurse’s caseload by just one patient was found to increase the likelihood of both infections.

And for every 10% increase in the number of nurses who said they were burned out, urinary tract infections increased by nearly 1 per 1,000 patients, and surgical site infections increased by nearly 2 per 1,000 patients.

On average, the responding nurses from each hospital cared for 5.7 patients, and nearly one-third of them reported high levels of burnout.

Solutions to dilemma?

Some states, including New York, are kicking around the idea of creating mandatory nurse-to-patient ratios in hospitals that must be strictly followed.

Currently, California is the only state in the nation that has a law creating minimum nurse-to-patient ratios in hospitals. The ratios vary depending on the type of hospital, and the type of unit. For example, California must have one nurse for every five patients in its surgical units.

(For comparison’s sake, in a previous study, it was found that if Pennsylvania hospitals matched that ratio in its surgical units, deaths would decline by 11%.)

So far, since the ratios were implemented in California in 2005, they’ve been credited with reducing patient mortality, and increasing face-to-face interaction between nurses and their patients, which contributes to more personalized care.

Since most states don’t have mandated nurse-to-patient ratios, it’s up to each hospital to determine the number of nurses needed on each shift to avoid high levels of burnout.

To maximize your nurses’ attention to patients without having them feel overwhelmed, evaluate the patient flow in the various units in your hospital, and staff each one accordingly. You may want to use California’s guidelines as a benchmark for where your hospital should be.

And talk to your nurses so you can get an honest opinion about whether they’re feeling overburdened.

If you think nurse burnout is affecting patient care, look into the possibility of bringing on more nurses. As more insurers move toward refusing to compensate hospitals for treating hospital-acquired infections, any initial upfront cost involved with hiring more nurses will more than make up for itself in the end.

Consider this piece of the study: Based on researchers’ analysis of the data, if these hospitals could reduce nurse burnout by 30%, there would be over 6,200 fewer infections, leading to a cost savings of up to $69 million.

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