Reducing nurse burnout by just 10% could prevent thousands of hospital-acquired infections and reduce costs, estimate researchers at the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. The researchers analyzed data from a survey of 7,000 RNs who worked at 161 hospitals in Pennsylvania, as well as data collected by the state's Health Care Cost Containment Council and the American Hospital Association Annual Survey. The nurse surveys provided information related to job-associated burnout, such as emotional exhaustion, depersonalization, and personal accomplishment.

Job-related burnout was measured using the Maslach Burnout Inventory-Human Services Survey; 36.5% of the nurses were determined to have a high level of burnout. Statistical models showed that increasing the workload by one patient per nurse added one infection per 1,000 patients, or 1,351 infections annually. And a 10% increase in the proportion of nurses with burnout added one catheter-associated urinary tract and two surgical-site infections per 1,000 patients. However, according to the models, if nurse burnout rates could be reduced to 10%, hospitals could prevent 4,160 infections and save $41 million annually. The authors speculate that when nurses experience burnout, they may forget to wash their hands and practice other infection control procedures.

"Burnout is multifactorial and workload is only one contributing factor," says lead author Jeannie Cimiotti, now an associate professor and the executive director of the New Jersey Collaborating Center for Nursing at the Rutgers College of Nursing in Newark, New Jersey. The organizational climate and a nurse's relationship with colleagues, including other nurses, physicians, and administrators, also play roles, she says, adding that hospitals can alleviate burnout by fostering a climate in which nurses are supported by administration, can practice to the full extent of their skills, can work autonomously on units, are shown respect, and contribute to policy decisions. These characteristics are similar to those that define magnet hospitals, Cimiotti points out, yet any health care organization can foster them.-Carol Potera

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