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How Nurse Burnout Affects Hospital-Acquired Infections

How Nurse Burnout Affects Hospital-Acquired Infections

Previous research has linked invasive devices and clinical practice to hospital-acquired infections (HAIs). There is now evidence suggesting that elements of nursing care are also linked to the prevalence of HAIs. Few studies have rigorously examined the possible underlying mechanisms of the relationship between nurse staffing and HAIs. In the American Journal of Infection Control, my colleagues and I had a study published that assessed job-related burnout among registered nurses to determine its accountability for the relationship between nurse staffing and infections acquired during hospital stays. Burnout Affects Infection Rate Our findings show that job-related burnout among nurses appears to be a plausible explanation for some HAIs. Nurses had an average total of 17 years experience, caring for an average of about six patients. Almost 37% reported high levels of burnout. At the hospitals involved in the study, 16 of 1,000 patients acquired some type of infection, particularly urinary tract infections (UTIs), surgical site infections (SSIs), and gastrointestinal infections, as well as pneumonia. For modeling and further analysis, we limited the types of infection to UTIs and SSIs. As patient loads escalated, the number of UTIs and SSIs increased significantly. In additional modeling, nurse burnout was highly associated with these infections, a finding that hasn’t been reported in previous research. A 10% increase in a hospital’s composition of high-burnout nurses was linked to an increase of nearly one UTI and two SSIs per 1,000 patients. Perhaps the most important finding from our model was that reducing nurse burnout by 30% could prevent more than 4,000 UTIs and more than 2,200 SSIs each year and save up to $69 million...
Summary of New Healthcare Attire Guidelines

Summary of New Healthcare Attire Guidelines

Are banning wrist watches and providing hooks for white coats realistic solutions for reducing infections?   A new guideline released from the Society for Healthcare Epidemiology of America (SHEA) provides recommendations on reducing transmission of healthcare-associated infections (HAIs) through guidance of healthcare personnel (HCP) attire in non-operating room settings. The recommendations, published in Infection Control and Hospital Epidemiology, are based on limited evidence, theoretical rationale, and practical considerations. Acknowledging that more appropriately designed studies should be funded and performed to better define the relationship between HCP attire and HAIs, the following are based on evidence-based measures to prevent HAIs: 1)      “Bare below the elbows”: HCPs should wear short sleeves, no wristwatches or jewelry, and no ties during clinical practice. Even though the prevention impact is unknown, the recommendations rationalize that it is supported by “biological plausibility” and is unlikely to cause harm. 2)      White coats: Facilities that mandate or strongly recommend the use of white coats should require that HCPs possess 2 or more white coats in addition to institution-provided on-site laundering at no or low cost.  Institutions should also provide coat hooks so that HCPs can remove and hang their white coat before patient contact. 3)      Other HCP apparel: Use of other specific apparel items can’t be limited because transmission of pathogens remains undetermined. However, neckties, for example, should be secured. 4)      Laundering: Any apparel worn that comes in direct contact with patients or the patient environment should be laundered after daily use, no less frequently than once a week. 5)      HCP footwear: All footwear should have closed toes, low heels, and non-skid soles. The article also delves...

The Framework for Eliminating HAIs

Healthcare-associated infections (HAIs) are one of the leading causes of death in the United States and are becoming increasingly problematic for hospitals and healthcare facilities throughout the country. The World Health Organization has reported that approximately 1.4 million people have an HAI at any given time. Compounding the problem is that little is known about the burden of infections outside of hospitals, particularly in long-term care facilities, ambulatory surgical centers, and other outpatient settings. The emergence of HAIs caused by multidrug-resistant microorganisms is another increasing concern. As Americans continue to age and healthcare costs continue to rise, the elimination of HAIs is paramount for improving patient health and healthcare savings. “The number of people who become sick or die from HAIs is unacceptably high, and these infections cause a significant financial burden,” says Denise Cardo, MD. “As consumers are increasingly asking for transparency and accountability in healthcare, their expectations on how well these infections are managed will continue to increase. This is a unique and timely opportunity to move toward the elimination of these infections.” Inconsistent Implementation According to Dr. Cardo, tried and true preventive measures for HAIs are inconsistently implemented. “The success of prevention efforts has varied considerably from one setting to the next,” she says. “However, we have a growing body of knowledge that defines a full range of prevention interventions that can address specific HAIs when consistently applied across settings. HAIs can be eliminated by implementing a proven framework for prevention at all levels of healthcare delivery. For the infections that we know how to prevent, we must prevent them consistently and effectively. For the infections...
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