In past posts I have written about how infections take hold and the nurse’s responsibility in preventing them. I just recently posted a piece about methods for avoiding nurse burnout, a problem affecting thousands of nurses nationwide. Now it seems, researchers have found a correlation between the two—nursing burnout and higher patient infection rates.
A study recently published in the American Journal of Infection Control concludes that not only does nurse burnout lead to higher healthcare-associated infections (HAIs) but it ultimately cost hospitals millions of additional dollars annually.
Researchers from the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing analyzed data from the Pennsylvania Health Care Cost Containment Council, the American Hospital Association Annual Survey, and a 2006 survey of more than 7,000 registered nurses from 161 hospitals in Pennsylvania. They were specifically looking to study the effect of nurse staffing and burnout on catheter-associated urinary tract infections (CAUTI) and surgical site infections (SSI), two of the most common HAIs.
To measure job-related burnout the research team used the nurse survey responses and the Maslach Burnout Inventory (MBI). The MBI has been recognized for more than a decade as the leading measure of burnout. It incorporates extensive research conducted over more than 25 years and addresses three general scales:
- Emotional Exhaustion – Measures feelings of being emotionally overextended and exhausted by one’s work.
- Depersonalization -Measures an unfeeling and impersonal response toward recipients of one’s service, care treatment, or instruction.
- Personal Accomplishment – Measures feelings of competence and successful achievement in one’s work
The MBI filters 22 items on job-related attitudes against the three scales, identifying emotional exhaustion as the key component to burnout syndrome. More than one-third of the survey respondents received an emotional exhaustion score of 27 or greater, the MBI definition for healthcare personnel burnout.
Comparing CAUTI rates with nurses’ patient loads (5.7 patients on average), the researchers found that for each additional patient assigned to a nurse, there was roughly one additional infection per 1,000 patients (or 1,351 additional infections per year, calculated across the survey population). Additionally, each 10 percent increase in a hospital’s high-burnout nurses corresponded with nearly one additional CAUTI and two additional SSIs per 1,000 patients annually.
This is all very scientific and having facts to back up assertions makes for a better argument. However, this research study is hardly news to the millions of nurses out there working with patients.
”I believe burnout, chronic understaffing, wasted resources, workplace violence, and workplace injuries, are inter-related phenomenon that impact all sentinel events,” said Beth Boynton, RN, MSN and author of “Confident Voices: The Nurses’ Guide to Improving Communication & Creating Positive Workplaces.” “We need work environments that support our work…enough staff, enough time, enough training are key as well as respectful communication at all levels. If you look at the sentinel event data re: root causes on TJC (The Joint Commission) website with a focus on human behavior you’ll see profound links.”
So, research supports what we know as common sense. We all know, when you get tired, when you are angry or depressed, when you are physically exhausted or emotionally drained you may show up at the job but you often are just going through the motions.
Tired people make mistakes. Overworked people make mistakes. Unhappy people make mistakes. Cutting staff to save money ultimately seems to cost more money. When will our healthcare institutions learn?
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