Registered nurses (RN) make up the largest healthcare workforce across the globe; yet, the nursing shortage in the U.S. is growing due to poor working conditions that lead to high turnover rates. As nurses are working longer hours in a stressful environment with increasing patient loads, the incidence of medical errors and spread of infection increases notably (Stone, Clarke, Cimiotti, & Correa-de-Araujo, 2004). In order to develop solutions for these issues, it is necessary to identify what factors increase the spread of infectious diseases.
Foremost, nosocomial outbreaks originate in hospitals and can spread quickly in close quarters where patients and nurses are in frequent contact. Overworked nurses are correlated with an increased spread of infection because they typically have reduced compliance with aseptic techniques, such as hand washing and disposal of supplies between patients (Harbath et al., 1999). A related factor in hospital outbreaks is high patient density, which results in poor nurse-patient ratios.
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"Nurses’ Working Conditions".
Many outbreaks, including viral gastrointestinal infections, transmit more rapidly from patient to patient when there is a shortage of nurses on the hospital floor (Stegenga, Bell, & Matlow, 2015). Even more, nurses are highly susceptible to infection themselves; they were the largest group affected by the SARS outbreak due to contamination from caring for infected patients (Stone, Clarke, Cimiotti, & Correa-de-Araujo, 2004). Thus, it is probable that the risk of infection and unsafe work environments significantly decreases the satisfaction of nurses, which exacerbates the nursing shortage and the spread of infections.
The authors propose two main solutions to address the interconnected issues of retainment of qualified RNs and reduction of outbreaks. First, they suggest improving overall working conditions by supporting adequate minimum staff levels and increasing funding to protect nurses from being overworked, which will reduce the frequency of life-threatening errors. Second, further research can target the sanitation malpractices that often lead to the spread of infection and address them through ongoing training and provision of critical supplies (Stone, Clarke, Cimiotti, & Correa-de-Araujo, 2004). These initiatives are expected to help contain infectious diseases within hospitals by reducing the frequency of errors and increasing safety procedures.
- Harbarth, S., Sudre, P., Dharan, S., Cadenas, M., & Pittet, D. (1999). Outbreak of Enterobacter
cloacae related to understaffing, overcrowding, and poor hygiene practices. Infection Control & Hospital Epidemiology, 20(9), 598-603. - Stegenga, J., Bell, E., & Matlow, A. (2002). The Role of Nurse Understaffing in Nosocomial
Viral Gastrointestinal Infections on a General Pediatrics Ward. Infection Control & Hospital Epidemiology, 23(3), 133-136. doi:10.1086/502022 - Stone, P. W., Clarke, S., Cimiotti, J., & Correa-de-Araujo, R. (2004). Nurses’ Working
Conditions: Implications for Infectious Disease. Emerging Infectious Diseases, 10(11), 1984-1989. https://dx.doi.org/10.3201/eid1011.040253.
