Beware the thousand-yard stare. The unfocused gaze of the battle-weary surgical nurse is the telltale sign of job-related burnout.

Those empty eyes tell you that she's had it up to here with being overworked and underappreciated.

There's not much inside those scrubs she's wearing, either. Mind, body and soul have checked out; fatigue and emotional exhaustion have set in.

Burnout doesn't just threaten the well-being of your staff. Researchers say that it could be putting your patients at risk for, of all things, infection.

A new study published in the American Journal of Infection Control (tinyurl.com/cdyoae7) finds that nurses suffering from job-related burnout are more likely to make careless mistakes that lead to increases in both catheter-associated urinary tract infections and surgical site infections.

The survey of more than 7,000 registered nurses from 161 hospitals in Pennsylvania showed that more than one-third reported high levels of emotional exhaustion, a key component of burnout syndrome. We've long known that job-related stress and decreased morale in nurses adversely affect patient care. This study marks the first time that high stress and low morale have been linked as drivers of hospital-acquired infections.

Researchers describe a cascade effect in burned-out nurses. First, they begin to feel like they lack control. Then, they psychologically and cognitively detach from the care environment. The result? Sub-optimal nursing care that in this study manifested as a significant increase in both UTIs and SSIs.

"Reducing burnout rates of nurses is a win-win," says lead study author Jeannie P. Cimiotti, DNSc, RN, executive director of the N.J. Collaborating Center for Nursing and associate professor at Rutgers University College of Nursing. "By reducing nurse workload, we can protect our nurses from burnout and we may be protecting patients from infections."

The numbers back her up: Protecting your nurses from burnout (read: lighter workloads!) could help you lower your post-op infection rates. Using CDC data on the direct costs of treating infections, Ms. Cimiotti found that a 10% reduction in the number of nurses with high burnout would have prevented 1,335 UTIs and saved about $1 million in the 161 Pennsylvania hospitals. The same 10% reduction in burnout would have prevented 744 SSIs and saved from $8 million to $22 million.

Even though the experts beat the drum to do all you can to reduce your greatest expense — hire per diem nurses, cross-train them, hurry them home when the cases are done — this study should compel you to take a closer look at your staffing levels. When you compare the cost of treating an infection to more staffing, the right path is clear. "You can alleviate job-related burnout in nurses at a much lower cost than those associated with healthcare-associated infections," the researchers write. "By reducing nurse burnout, we can improve the well-being of nurses while improving the quality of patient care."