Nurse Burnout = Patient Infections

Article Categories: Legal and Ethics & Nurse On the Job

Burnout is nothing new in nursing. Ask any experienced nurse: he or she will tell you that some days, it’s hard to get out of bed and go to work. According to the Mayo Clinic, nurses experience the second highest career burnout rate. (Interestingly, physicians are first.)

For nurses, the long hours and heavy patient loads are what lead to the physical, mental, and emotional exhaustion that signal burnout. Besides the nurses themselves being affected, what else can happen?

How about Hospital-Acquired Infections? HAIs are an enormous threat to patients and a burden to hospitals. Research to discover the cause of HAIs has suggested that invasive devices and clinical protocols were reasons that patients were getting serious infections. But it wasn’t until a 2012 study by Jeannie Cimiotti, DNSc, RN, and her colleagues that the relationship between HAIs and nurse burnout was demonstrated.

Cimiotti’s study found some startling facts, reported in The Journal of Infection Control, August 2012. Using data from the Pennsylvania Care Cost Containment Council and the American Hospital Association Annual Survey, Cimiotti followed urinary tract (UTI) and surgical site infection (SSI) records, two of the most common infections that could be found on any hospital unit. Over 7,000 nurses were surveyed, from 161 hospitals. Nurses were experienced, with an average of 17 years. They cared for about six patients during their shift. And 37% of them reported high levels of burnout, using the Maslach Burnout Inventory..

Two of the findings:

• For every patient who was added to the nurse’s patient load, there was one more HAI reported per 1,000 patients.
• For every 10% climb in nurses who reported high levels of burnout, there were two more SSIs per 1,000 patients and one more UTI per 1,000 patients.

The study reinforced earlier reports on the need for better staffing ratios:

• In 2002, a researcher found that adding a single patient to a nurse’s shift increased that patient’s risk of dying by 7%. Going from six to eight patients jumped the risk to 31%, compared to caring for four patients.
• A study by Linda Aiken, PhD, found that if New Jersey and Pennsylvania adopted the same California ratio of nurse-to-patient of 1:5, patients deaths would drop by 14% in both states.

Addressing the burnout rate, Cimiotti says, “Nurses deal with life and death every day. Not many people go to their job and say, ‘This one died and this one died and this one died.’ Often they see as much failure as good.”

When it comes to HAIs, nurses who are exhausted and feel unsupported can have lapses in technique. For people who are seriously ill--as most hospital patients are--even a normally uncomplicated infection can have a fatal outcome. If nurses and hospital administrators can work together to prevent burnout and improve the work environment, everyone will benefit.

Cimiotti sums up her study nicely: “Reducing reports of burnout by 30% would reduce UTIs by more than 4,000 incidents, and SSIs by more than 2,000. This would save between $28-$69 million a year in costs to treat those infections.”

It would also keep nurses satisfied and glad to do their jobs.