A meningitis outbreak that was first diagnosed in September killed more than 30 and sickened more than 400. It was traced to tainted drugs shipped by a drug-compounding center in New England. According to Dr. Madeleine Biondolillo, director of the Bureau of Health Care Safety and Quality at the Massachusetts Public Health Department, sufficient time was not given to sufficiently assure sterilization. It was also noted that demand was so high, shipments were actually released prior to obtaining the final results of the sterilization testing. Despite the early release of these drugs, the company has claimed no contamination for any of the drugs that were shipped early. Operations have ceased at the compounding company
The corollary to this tragedy is the fragile nature of patients with compromised immune systems. In this particular case, the causal agent was identified as batches of drugs traced back to the compounding company. The magnitude of this event is displayed daily as the direct result of tainted drugs increases the death count.
At the core of this issue are standard sterilization procedures. According to the Centers for Disease Control and Prevention, each year nearly 100,000 hospitalized patients die from infections acquired while undergoing treatment for other conditions. A recent study by Dr. Jeannie P. Cimiotti of Rutgers College of Nursing and co-researchers concludes that the degree of “burnout” experienced by nurses could relate directly to the frequency with which patients acquire infections during hospital stays.
From a sample of 161 acute care hospitals in Pennsylvania and an average of 45 nurses working at each sampled hospital, Cimiotti and her team measured nurse burnout using the Maslach Burnout Inventory-Human Services Survey. According to Maslach’s theory, a critical component of burnout in nurses and other health care professionals is “emotional exhaustion.” Emotional exhaustion is associated with emotional and cognitive detachment from work as a mechanism for coping with the demands and responsibilities of the job.
The researchers found that every 10 percent increase in burned-out nurses in an acute care hospital increases the rate of urinary tract infections by nearly one per 1,000 patients and increases the rate of surgical site infections by more than two per 1,000 patients.
“These findings are both statistically and clinically significant,” the researchers posit. “If the proportion of nurses with high burnout could be reduced to 10 percent from the average 30 percent, some 4,160 infections would be prevented, leading to an estimated savings of $41 million. Not to mention the saving of many lives.”
As closer scrutiny accompanies the investigation of hospital-borne infections, it may be instructive to review patterns of overtime and staffing ratios in those problem areas.