For years nurses — and their union representatives — have argued that inadequate staffing hurts patients.

A new study in the American Journal of Infection Control examines the problem and suggests that burnout drives some common lapses in patient care.

When workers are exhausted, their thinking and emotions detach from the workplace. Work suffers, says Rutgers University professor Jeannie Cimiotti. In a hospital, that means patient care suffers.

"I think it's the simple things that are getting overlooked, and I think that hand hygiene is one of them," said Cimiotti, executive director of the New Jersey Collaborating Center for Nursing.

Cimiotti and colleagues at the University of Pennsylvania linked burnout, lower staffing levels and higher rates of two health-care associated infections. Patients sometimes contract those costly and preventable infections when they are being treated for other conditions.

The study examines infection reports from 161 Pennsylvania hospitals and a survey of about 7,000 nurses.

Cimiotti said it costs hospitals very little to foster a supportive workplace for nurses. Those same steps, she says, can reduce hospital infections.

The researchers found that, on average, the nurses were caring for 5.7 patients.

"Maybe they are staffed a little bit above what they should, but if they [hospitals] can provide an organizational climate that's conducive to nursing, I think they'd be fine," Cimiotti said. "That doesn't mean you can overburden them because workload is one of those factors that does contribute to burnout."

Emergency room nurse Patricia Eakin is president of the Pennsylvania Association of Staff Nurses and Allied Professionals, a union in Philadelphia.

"Most burnout is related to high workload," Eakin said. "Patients nowadays need a whole lot of care. There's a lot of equipment, a whole lot of fancy things. A lot of things that take a lot of time and a lot of attention."

Eakin says inadequate staffing and burnout are tightly linked.

Her group supports two proposals that would set minimum nurse-to-patient ratios across Pennsylvania. Eakin says, right now, the legislation is stalled in Harrisburg.