July 31, 2012
Hospital Infections Linked To Nurse, Staffing Burnout
redOrbit Staff & Wire Reports - Your Universe Online
According to a study published in the August issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC), nurse burnout costs hospitals millions of additional dollars annually and leads to higher healthcare-associated infection rates (HAIs).
Researchers from the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing analyzed previous data collected from the American Hospital Association Annual Survey, Pennsylvania Health Care Cost Containment Council and a 2006 survey of more than 7,000 registered nurses from 161 hospitals in Pennsylvania to study the effect of nurse and staff burnout on surgical site infections (SSI) and catheter-associated urinary tract infections (CAUTI), two of the most common HAIs.
Job-related burnout was determined, using responses obtained from the nurse survey, by analyzing the emotional exhaustion subscale from the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). The MBI-HSS filters 22 items on job-related attitudes into emotional exhaustion, personal accomplishment and depersonalization identifying the key component to burnout syndrome as emotional exhaustion. More than one-third of survey respondents received an emotional exhaustion score of 27 or greater, the MBI-HSS 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 (average rate of CAUTIs across hospitals was 9 per 1,000 patients; for SSIs it was 5 per 1,000 patients)," according to the study.
Using the per-patient average costs associated with SSIs ($11,087 to $29,443 each) and CAUTIs ($749 to $832 each), the researchers estimate that if nurse burnout rates could be reduced from an average of 30 percent to 10 percent, hospitals in Pennsylvania could prevent an estimated 4,160 infections annually with an associated savings of $41 million.
"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," conclude the authors. "By reducing nurse burnout, we can improve the well-being of nurses while improving the quality of patient care."