Do Burned-Out Nurses Increase Infection Rates?

Job-related burnout among nurses leads to an increase in healthcare-associated infection rates that costs hospitals millions of dollars each year, according to a new study.

Researchers from the Center for Health Outcomes and Policy Research at the University of Pennsylvania's School of Nursing analyzed data from a 2006 survey that studied the connection between nurse staffing and burnout and catheter-associated urinary tract infections (CAUTIs) and surgical site infections (SSIs).

In comparing CAUTI rates with nurses' daily patient loads - with an average of 5.7 patients - researchers found 1 additional infection per 1,000 patients per year for each additional patient assigned to a nurse. The group also determined that each 10% increase in a hospital's most stressed nurses correlated to roughly 1 additional CAUTI and 2 more SSIs per 1,000 patients annually.

Looking at per-patient average costs associated with CAUTIs ($749 to $832 each) and SSIs ($11,087 to $29,443 each), researchers estimated that reducing nurse burnout rates from an average of 30% to 10% could prevent about 4,160 infections and save $41 million in healthcare costs each year.

"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," say the authors. "By reducing nurse burnout, we can improve the well-being of nurses while improving the quality of patient care."

Mark McGraw

Many Surgical Staffers Lack Fire Safety Know-How

Many surgical team members don't know where fire safety equipment is located, despite having received formal OR fire safety training, according to a recent study presented at the 2012 World Congress of Anesthesiologists in Argentina.

A survey of 118 OR personnel at a hospital affiliated with the University of Texas in Houston revealed that nearly all of the circulating nurses received OR fire safety training. However, only 11% could locate the nearest fire alarm pull-station, 30% could locate the nearest fire extinguisher and 61% could locate the nearest gas cutoff. Of surgical techs, 82% received formal training, but only 24% could locate the nearest alarm, 41% knew where fire extinguishers were and 63% could locate the gas cutoff.

The nurses and techs appeared to be the most prepared surgical staffers. Out of 56 anesthesia providers surveyed, less than half received fire safety training. Only 25% knew where to find the gas cutoff, 11% the nearest fire extinguisher and 5% the alarm. Less than a quarter of the surgeons who were surveyed were trained in fire safety. Twelve percent knew where the gas cutoff and alarm were, and 6% the fire extinguisher.

Lead researcher Charles Cowles, MD, chief safety officer of perioperative enterprise at the University of Texas MD Anderson Cancer Center in Houston, speculates that hospital safety leaders might be avoiding the hustle and bustle of the OR in order to prevent contaminating the sterile environment during inspections and fire drills, which is likely contributing to the lack of fire safety knowledge among the surveyed surgical personnel.

"We found that a collaboration between our environmental safety department, anesthesiologists and nurses to coordinate a fire safety drill worked well," he says. "The operating room does not have to be a black box and off limits, as safety inspectors tend to think."

Daniel Cook

Are You Prepared For Natural Disasters?

Most regions of the country experience annual or seasonal bouts of extreme weather that, under certain circumstances, can become natural disasters. To ensure staff and patient safety and to minimize the risk of damage, every surgical facility needs a written emergency preparedness plan.

Medicare's Conditions For Coverage, government regulators and accreditation agencies require the drafting and annual updating of such a plan, which should plot out responses to emergency situations and educate staff as to their roles in the process.

For advice on creating a natural disaster preparedness plan, check out this overview of the subject, which includes a checklist that can be tailored to your facility and your region's possible emergencies.

David Bernard

InstaPoll: "You're Hired" or "You're Fired"?

What's the last personnel action that you've taken? Have you hired or fired a staff member? Tell us in this week's InstaPoll and check back next week to see the results.

Last week we asked whether your nurses suffer from depression. Four out of 5 (84%) of the 241 surgical facility leaders who answered suspect that some of their nurses do.

  • Many of them do: 19%

  • Some of them do: 34%

  • A few of them do: 31%

  • None of them do: 7%

  • Not sure: 9%

    Dan O'Connor

  • News & Notes
  • Cataract surgery's other benefit Medicare patients aged 65 years or older who undergo cataract surgery are 16% less likely to suffer hip fractures 1 year following the procedure, according to a study in the Aug. 1 issue of the Journal of the American Medical Association. The study's authors say visual impairment is strongly associated with an increased risk of fractures, with cataracts being the most common cause of fracture-related visual impairment. Patients who wait more than 6 months for cataract surgery had an increased rate of falls, the study notes.

  • Videos ease kids' pre-op anxiety Playing video clips while inducing inhalational anesthesia helps to reduce pre-op anxiety in pediatric patients, a new study finds. Researchers found that anxiety decreased more among children who were shown trailers for movies like Finding Nemo or Ice Age during induction than it did for patients whom they'd attempted to distract by joking or blowing up balloons.

  • Copper for improved infection control? Copper surfaces aren't often seen in clinical environments, but studies finding that significantly lower levels of bacteria live on them are leading a team of UCLA researchers to investigate whether the metal's reduction of bacterial colonization can be linked to a lower rate of healthcare-associated infections. Their 4-year clinical trial will observe the use of copper, stainless steel or plastic/coated surfaces on the bed rails, chairs, bed-tables and workstations in intensive care units.