Nurse staffing, burnout, and health care-associated infection.

Cimiotti, Jeannie P.; Aiken, Linda H.; Sloane, Douglas M.; Wu, Evan S.

doi:10.1016/j.ajic.2012.02.029

Cited by 763Infection Control in HealthcareNursing education and managementOccupational Health and Burnout

Nurse staffing, burnout, and health care-associated infection.

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Cimiotti, Jeannie P., Aiken, Linda H., Sloane, Douglas M., Wu, Evan S.·2012·American Journal of Infection Control

DOI 10.1016/j.ajic.2012.02.029PMC PMC3509207

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Abstract

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.

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Nurse-to-patient ratios have been associated with higher rates of health care-associated infection.
“Nurse-to-patient ratios have been associated with higher rates of health care -associated infection. 103-105”
From Brief Mindfulness Practices for Healthcare Providers - A Systematic Literature Review. (2017) · cites this paper as [103]
Emotional Exhaustion is associated with catheter-associated urinary tract infections and surgical site infections.
“Cimiotti et al. found that Emotional Exhaustion was associated with catheter-associated urinary tract infections and surgical site infections [114]”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [114]
Higher nurse burnout has been linked to more patient infections.
“nurse burnout associated with increased levels of patient infection13.”
From A Small Randomized Pilot Study of a Workplace Mindfulness-Based Intervention for Surgical Intensive Care Unit Personnel: Effects on Salivary α-Amylase Levels (2015) · cites this paper as [13]

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Authors: Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S.
Affiliations: Rutgers, The State University of New Jersey (US)
University of Pennsylvania (US)
Corresponding author: Cimiotti, Jeannie P.
ORCID: Cimiotti, Jeannie P.
Aiken, Linda H.
Sloane, Douglas M.
Venue: American Journal of Infection Control
Publisher: Elsevier BV
Published: 2012-08
Volume: 40
Issue: 6
Pages: 486-490
ISSN: 0196-6553 (ISSN-L)
DOI: 10.1016/j.ajic.2012.02.029
PMC: PMC3509207
OpenAlex: W2163444373
Cited by: 763
References: 56
Citations by year: 2026: 38 · 2025: 42 · 2024: 41 · 2023: 60 · 2022: 61 · 2021: 91 · 2020: 92 · 2019: 70 · 2018: 56 · 2017: 61 · 2016: 45 · 2015: 44 · 2014: 34 · 2013: 20 · 2012: 4
FWCI: 22.63
Type: journal article
Language: en
Update notices: erratum (2012-09-01)
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: American Journal of Infection Control (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Nursing Research (R01NR004513)
Topics: Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Health Sciences › Nursing › Research and Theory › Nursing education and management
Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords: nurse staffing, nurse burnout, nosocomial infections, nurse-to-patient ratio, urinary tract infection, surgical site infection, infection control, cost reduction
MeSH terms: Adult, Attitude of Health Personnel, Burnout, Professional, Cross Infection, Female, Hospitals, Humans, Male, Middle Aged, Nurses, Surgical Wound Infection, Urinary Tract Infections

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Nurse staffing, burnout, and health care-associated infection.

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