Background
Each year, nearly 7 million hospitalized patients acquire infections while being treated
for other conditions. Nurse staffing has been implicated in the spread of infection
within hospitals, yet little evidence is available to explain this association.
Methods
We linked nurse survey data to the Pennsylvania Health Care Cost Containment Council
report on hospital infections and the American Hospital Association Annual Survey.
We examined urinary tract and surgical site infection, the most prevalent infections
reported and those likely to be acquired on any unit within a hospital. Linear regression
was used to estimate the effect of nurse and hospital characteristics on health care–associated
infections.
Results
There was a significant association between patient-to-nurse ratio and urinary tract
infection (0.86; P = .02) and surgical site infection (0.93; P = .04). In a multivariate model controlling for patient severity and nurse and hospital
characteristics, only nurse burnout remained significantly associated with urinary
tract infection (0.82; P = .03) and surgical site infection (1.56; P < .01) infection. Hospitals in which burnout was reduced by 30% had a total of 6,239
fewer infections, for an annual cost saving of up to $68 million.
Conclusions
We provide a plausible explanation for the association between nurse staffing and
health care–associated infections. Reducing burnout in registered nurses is a promising
strategy to help control infections in acute care facilities.
Key Words
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Article info
Footnotes
Research for this article was conducted at the Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA.
Supported by the National Institute of Nursing Research, National Institutes of Health (grant R01-NR004513).
The authors have no conflicts of interest to disclose.
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© 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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- ErratumAmerican Journal of Infection ControlVol. 40Issue 7
- PreviewIn the article “Nurse staffing, burnout, and health care-associated infection” by Cimiotti et al, in the August issue of the American Journal of Infection Control (2012;40:486-90), there is a reporting error in the discussion. The second sentence, in the second paragraph should read, “The average rate of urinary tract infections across hospitals was 9 per 1,000 patients,” not 7 per 1,000 as reported.
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