Health Journal Online

Tag: Nursing

Nursing Home Study Finds Only Resident Decolonization Reduced Drug-Resistant Bacteria on Skin

Only decolonizing residents reduced the drug-resistant bacteria they carried on their skin, and adding daily enhanced cleaning produced no measurable additional benefit, according to a study of two Southern California nursing homes published August 5 in JAMA Network Open.

The comparison matters because infection control budgets in long-term care are finite. Facilities are frequently asked to do both, and this study suggests that when only one is affordable, the choice is not a coin flip.

For families with a relative in a nursing home, the finding translates into a question worth asking at the next care conference. Multidrug-resistant organisms are endemic in these settings, with studies showing more than half of residents carry them on their skin, and carriage precedes infection. What a facility does about that is a legitimate thing for a family to inquire about.

The Four-Phase Design and the Main Findings

Researchers at the University of California Irvine School of Medicine ran a four-phase quality-improvement study at two nursing homes, using data collected between March 2019 and April 2021. The phases were implemented in sequence: universal decolonization alone, routine care as the control, once-daily enhanced cleaning alone, and decolonization combined with enhanced cleaning.

The measured outcomes were carriage of multidrug-resistant organisms on resident skin and in nostrils, and contamination of high-touch objects in bedrooms and common areas.

In adjusted models, decolonization alone was associated with a 59 percent reduction in carriage compared with the control phase and a 64 percent reduction compared with enhanced cleaning, CIDRAP reported in its summary of the findings. Enhanced cleaning alone did not reduce carriage, and it added no benefit when combined with decolonization.

Decolonization in practice meant chlorhexidine used for routine bathing and showering, paired with a nasal iodophor such as povidone-iodine on a defined schedule. It is a resident-level intervention rather than an environmental one, which is precisely why the result is informative.

Shared Spaces Told a Different Story

Bedroom contamination followed the same pattern as skin carriage. Decolonization alone reduced it by 84 percent compared with control and by 74 percent compared with enhanced cleaning, while enhanced cleaning alone produced no reduction and added nothing to decolonization.

Common areas broke the pattern. There, the combined intervention reduced contamination better than either approach alone.

The logic is intuitive once stated. If bacteria on surfaces originate primarily from the people who touch them, reducing what residents carry reduces what ends up on the bed rail. Common areas gather traffic from many residents and staff over a day, and surface disinfection reaches contamination that resident-level treatment cannot.

The authors framed the practical implication in resource terms. Writing in JAMA Network Open, they noted that implementing multiple strategies is expensive and resource intensive, and that “it is necessary to prioritize the most effective strategies.” Their conclusion was that resource-constrained settings should prioritize decolonization alongside targeted disinfection in shared spaces after activities.

Families Choosing or Monitoring a Facility

Nothing here is a diagnosis or a treatment instruction, and no family should attempt decolonization on their own. Chlorhexidine and nasal antiseptics used in these protocols are administered under a facility program with clinical oversight, and improvising carries risks including skin reactions and allergic responses.

What a family can do is ask. Reasonable questions at a care conference include whether the facility uses chlorhexidine bathing, whether it has a nasal decolonization protocol, how it handles residents returning from hospital stays, and how it monitors infection rates. Facilities with active programs generally answer readily.

The stakes are concrete for people with the highest exposure to health care. Residents who move between hospital and nursing home, those with indwelling devices such as urinary catheters or feeding tubes, people with open wounds or pressure injuries, and those who have received multiple courses of antibiotics carry the greatest risk of both colonization and subsequent infection.

Older adults bear a disproportionate share of the burden from resistant infections generally. When a resistant organism causes an infection, treatment options narrow, hospital stays lengthen, and outcomes worsen. Prevention at the carriage stage is the intervention that happens before any of that.

There is a household dimension as well. Residents who return home for weekends or who are discharged to family care can carry these organisms with them, and the standard advice for relatives is unglamorous but effective: hand hygiene before and after contact, careful wound care under a clinician’s direction, and telling any new provider about a known colonization history so treatment decisions account for it.

Limits of a Two-Facility Study

The design constraints deserve to be stated clearly rather than buried. This was a quality-improvement study at two facilities, not a randomized controlled trial across many sites, as McKnight’s Long-Term Care News noted in its account of the design.

Phases were implemented sequentially over roughly two years, which means anything else that changed over that period, including staffing, resident turnover, seasonal factors, and pandemic-era infection control practices, could contribute to the differences observed. Two Southern California nursing homes may not represent facilities elsewhere with different staffing ratios, resident populations, or baseline practices.

The study also measured carriage and contamination rather than infections, hospitalizations, or deaths. Those are reasonable surrogate outcomes because carriage precedes infection, but they are not the same thing.

Importantly, this work builds on a stronger evidence base rather than standing alone. A large cluster-randomized trial in nursing homes previously found that universal decolonization reduced infection-related hospital transfers, with MDRO carriage prevalence falling from about 49 percent to 32 percent in the decolonization group while remaining near 47 percent under routine care. The new study addresses a narrower question about how decolonization compares with enhanced cleaning when resources force a choice.

An accompanying JAMA Network Open commentary framed the work as an argument for hypothesis-driven research in nursing home infection prevention rather than as settled guidance. Current infection control guidance has not changed on the basis of this study, and larger multi-site work would be needed to establish how broadly the comparison holds. For facility administrators weighing where to spend a limited infection prevention budget, the finding offers a data point that was previously missing.

Key Questions Answered

What did the study find? Universal decolonization of residents was associated with a 59 percent reduction in multidrug-resistant organism carriage compared with routine care. Enhanced daily cleaning alone reduced nothing and added no benefit when combined with decolonization.

What is decolonization? Chlorhexidine used for routine bathing and showering, paired with a nasal iodophor such as povidone-iodine on a set schedule, applied to all residents rather than only those known to be colonized.

Did cleaning help at all? In common areas, combining cleaning with decolonization reduced contamination better than either approach alone. For resident skin and bedrooms, cleaning added nothing.

How strong is the evidence? This was a four-phase quality-improvement study at two facilities, not a randomized trial. It measured carriage and surface contamination rather than infections or deaths.

Should families try this at home? No. These are facility-level protocols with clinical oversight. Do not attempt decolonization independently.

What can a family actually do? Ask whether the facility uses chlorhexidine bathing, whether it has a nasal decolonization protocol, how it handles residents returning from hospitals, and how it tracks infection rates.

Which residents face the highest risk? Those moving between hospital and nursing home, people with catheters or feeding tubes, residents with wounds or pressure injuries, and those who have had multiple antibiotic courses.

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August 9, 2026
Male Nurses Now Make Up 1 in 8 of the U.S. Nursing Workforce, with Growth Concentrated in Shortage Areas
Why This Matters

Nursing is among the fastest-growing and most in-demand professions in the United States. The Labor Department projects 189,000 registered nurse job openings annually for the next decade. Emergency departments are understaffed. Rural hospitals are closing labor and delivery units. The healthcare system is looking everywhere for qualified nurses.

Men make up approximately half the U.S. workforce, but only about 1 in 8 nurses. That gap represents not just an untapped workforce pipeline but a longstanding cultural assumption about nursing as women’s work that has depressed enrollment, discouraged qualified candidates, and narrowed the hiring pool for exactly the kind of work that is most urgently needed.

According to NPR labor and workplace correspondent Andrea Hsu, that ratio is shifting. The male nursing share is growing, driven by a combination of strong job market conditions and deliberate recruitment efforts at nursing schools, particularly in the South.

What We Know So Far

NPR’s July 21, 2026 report focused on the University of Alabama at Birmingham School of Nursing, which has been among the institutions actively recruiting men into nursing. The UAB program has deployed direct outreach, male peer mentorship, and reframing of nursing as a high-skill, well-compensated healthcare leadership career rather than a gendered support role.

Male nursing students interviewed for the NPR report described finding the work through pathways including athletic training, pharmacy interest, and military healthcare service, routes that have historically channeled men away from nursing rather than toward it.

The data point at the center of the report, approximately 1 in 8 registered nurses is now male, reflects a long-term upward trend from roughly 1 in 40 male nurses in 1970. The increase has been gradual over decades, but recent years have shown an acceleration, particularly in states where nursing employment growth has been fastest.

Where the Growth Is Most Significant

The NPR report notes that the male nursing share is growing fastest in the South, a region that simultaneously has:
- Some of the nation’s most severe nursing shortage conditions, particularly in rural areas
- The highest rates of rural hospital closure and labor and delivery unit closures, as documented by the Center for Healthcare Quality and Payment Reform
- Large unmet demand for primary care and emergency nursing staff, particularly in states including Alabama, Mississippi, Georgia, and the Carolinas
- Among the highest rates of uninsured and underinsured populations, whose primary care needs fall disproportionately on nursing staff at federally qualified health centers and community clinics
The UAB School of Nursing’s enrollment pattern mirrors a broader demographic shift: as healthcare jobs have become among the most stable, well-paying, and benefits-rich employment in the post-pandemic labor market, more men are reconsidering career paths that historically carried a gender stigma in their social and professional communities.

What Doctors and Experts Say

The nursing profession’s gender composition affects more than workforce numbers. Research on patient experience and care outcomes has found that patients benefit from a nursing workforce that reflects the demographic diversity of the population they serve, including gender diversity. Male patients in particular may be more comfortable discussing certain health concerns with male nurses. Men navigating chronic disease management, mental health issues, and preventive care are among the populations where male nurse-patient concordance may reduce barriers to disclosure.

Nursing faculty and administrators quoted in the NPR report emphasized that the core skills of nursing, including clinical judgment, interpersonal communication, attention to detail, and ability to act effectively under pressure, have no gender component. The barriers have been cultural and representational, not competency-based.

The Labor Department’s projection of 189,000 annual nursing job openings over the next decade reflects both retirements from an aging nursing workforce and growth in demand driven by an aging patient population. Those openings cannot be filled by any single demographic pipeline. Expanding the male nursing workforce is one necessary component of closing the gap.

What the Evidence Shows and What It Does Not

The 1-in-8 male nurse figure comes from workforce data reflecting the current registered nursing population. The NPR report does not provide a specific source for the exact figure beyond the framing in the headline and story; it is consistent with Bureau of Labor Statistics occupational workforce data showing male nurses at approximately 12-14% of the total registered nurse workforce in recent years.

The claim that male nursing growth is happening “fastest in the South” is supported by the NPR reporting’s geographic focus on UAB and Southern nursing programs, but the NPR piece does not present state-by-state enrollment data. This is a directional claim supported by reported patterns, not a formally quantified regional ranking.

MedicalDaily Evidence Check
- Source: NPR, published July 21, 2026 (Andrea Hsu, labor and workplace correspondent); Labor Department occupational projections
- What it shows: Approximately 1 in 8 registered nurses is male; the share is growing, with notable growth at Southern nursing programs; 189,000 annual RN job openings projected for next decade
- What it does not prove: Specific state-by-state male enrollment rankings; whether the gender shift is driven by recruitment programs specifically vs. labor market forces generally
- What readers should know: The nursing profession is actively seeking male applicants; the South’s nursing shortage means this growth is happening in the region where it is most needed
Who Benefits Most?

The workforce development implications of growing male nursing representation include:
- Rural Southern communities, which have the highest unmet nursing demand and are seeing the fastest male nursing enrollment growth
- Patients who prefer concordance-based care in specific clinical contexts, including men with mental health concerns, chronic disease, or situations requiring physical privacy during examination
- The nursing profession itself, which benefits from a broader and more diverse recruitment pool as it faces sustained demographic attrition from retirement of the baby-boom nursing generation
What You Can Do Now

For people considering nursing as a career:

For healthcare employers and policymakers:
- Hospitals and health systems seeking to address nursing shortages can partner with regional nursing schools on recruitment pipeline programs that actively reach men in high school and early college years.
- State-level workforce development funding through Title VIII nursing programs can support expanded nursing school capacity, particularly in shortage areas.
Cost and Access: What Patients Should Know

The nursing workforce shortage has direct effects on patient care: longer emergency department wait times, reduced availability of home health nursing, and reduced capacity for preventive and chronic disease management in underserved communities. Expanding the diversity and size of the nursing pipeline is a patient safety issue, not just a labor market issue.

What Happens Next

UAB and other Southern nursing programs with active male recruitment initiatives are expected to report enrollment trends annually. The Labor Department will update its occupational projections with 2025 and 2026 data in the coming years. Whether the male nursing share reaches 1 in 5 or higher within a decade will depend on whether the cultural shift documented in the NPR report extends beyond leading institutions and translates into broad enrollment patterns at community colleges and ADN programs that produce the largest total volume of nurses.

The Bottom Line

Approximately 1 in 8 U.S. registered nurses is now male, a share that is growing and growing fastest in the South, where nursing shortages are most acute. A strong job market, deliberate recruitment by nursing schools, and a gradual cultural shift in how nursing is understood as a profession are driving the change. With 189,000 RN job openings projected annually for the next decade, and with rural hospitals and clinics in the South facing the deepest shortfalls, the growth of male nursing in the region that needs nurses most is a workforce development trend worth watching.
Source link
July 25, 2026
Male Nurses Now Make Up 1 in 8 of the U.S. Nursing Workforce, with Growth Concentrated in Shortage Areas
Why This Matters

Nursing is among the fastest-growing and most in-demand professions in the United States. The Labor Department projects 189,000 registered nurse job openings annually for the next decade. Emergency departments are understaffed. Rural hospitals are closing labor and delivery units. The healthcare system is looking everywhere for qualified nurses.

Men make up approximately half the U.S. workforce, but only about 1 in 8 nurses. That gap represents not just an untapped workforce pipeline but a longstanding cultural assumption about nursing as women’s work that has depressed enrollment, discouraged qualified candidates, and narrowed the hiring pool for exactly the kind of work that is most urgently needed.

According to NPR labor and workplace correspondent Andrea Hsu, that ratio is shifting. The male nursing share is growing, driven by a combination of strong job market conditions and deliberate recruitment efforts at nursing schools, particularly in the South.

What We Know So Far

NPR’s July 21, 2026 report focused on the University of Alabama at Birmingham School of Nursing, which has been among the institutions actively recruiting men into nursing. The UAB program has deployed direct outreach, male peer mentorship, and reframing of nursing as a high-skill, well-compensated healthcare leadership career rather than a gendered support role.

Male nursing students interviewed for the NPR report described finding the work through pathways including athletic training, pharmacy interest, and military healthcare service, routes that have historically channeled men away from nursing rather than toward it.

The data point at the center of the report, approximately 1 in 8 registered nurses is now male, reflects a long-term upward trend from roughly 1 in 40 male nurses in 1970. The increase has been gradual over decades, but recent years have shown an acceleration, particularly in states where nursing employment growth has been fastest.

Where the Growth Is Most Significant

The NPR report notes that the male nursing share is growing fastest in the South, a region that simultaneously has:
- Some of the nation’s most severe nursing shortage conditions, particularly in rural areas
- The highest rates of rural hospital closure and labor and delivery unit closures, as documented by the Center for Healthcare Quality and Payment Reform
- Large unmet demand for primary care and emergency nursing staff, particularly in states including Alabama, Mississippi, Georgia, and the Carolinas
- Among the highest rates of uninsured and underinsured populations, whose primary care needs fall disproportionately on nursing staff at federally qualified health centers and community clinics
The UAB School of Nursing’s enrollment pattern mirrors a broader demographic shift: as healthcare jobs have become among the most stable, well-paying, and benefits-rich employment in the post-pandemic labor market, more men are reconsidering career paths that historically carried a gender stigma in their social and professional communities.

What Doctors and Experts Say

The nursing profession’s gender composition affects more than workforce numbers. Research on patient experience and care outcomes has found that patients benefit from a nursing workforce that reflects the demographic diversity of the population they serve, including gender diversity. Male patients in particular may be more comfortable discussing certain health concerns with male nurses. Men navigating chronic disease management, mental health issues, and preventive care are among the populations where male nurse-patient concordance may reduce barriers to disclosure.

Nursing faculty and administrators quoted in the NPR report emphasized that the core skills of nursing, including clinical judgment, interpersonal communication, attention to detail, and ability to act effectively under pressure, have no gender component. The barriers have been cultural and representational, not competency-based.

The Labor Department’s projection of 189,000 annual nursing job openings over the next decade reflects both retirements from an aging nursing workforce and growth in demand driven by an aging patient population. Those openings cannot be filled by any single demographic pipeline. Expanding the male nursing workforce is one necessary component of closing the gap.

What the Evidence Shows and What It Does Not

The 1-in-8 male nurse figure comes from workforce data reflecting the current registered nursing population. The NPR report does not provide a specific source for the exact figure beyond the framing in the headline and story; it is consistent with Bureau of Labor Statistics occupational workforce data showing male nurses at approximately 12-14% of the total registered nurse workforce in recent years.

The claim that male nursing growth is happening “fastest in the South” is supported by the NPR reporting’s geographic focus on UAB and Southern nursing programs, but the NPR piece does not present state-by-state enrollment data. This is a directional claim supported by reported patterns, not a formally quantified regional ranking.

MedicalDaily Evidence Check
- Source: NPR, published July 21, 2026 (Andrea Hsu, labor and workplace correspondent); Labor Department occupational projections
- What it shows: Approximately 1 in 8 registered nurses is male; the share is growing, with notable growth at Southern nursing programs; 189,000 annual RN job openings projected for next decade
- What it does not prove: Specific state-by-state male enrollment rankings; whether the gender shift is driven by recruitment programs specifically vs. labor market forces generally
- What readers should know: The nursing profession is actively seeking male applicants; the South’s nursing shortage means this growth is happening in the region where it is most needed
Who Benefits Most?

The workforce development implications of growing male nursing representation include:
- Rural Southern communities, which have the highest unmet nursing demand and are seeing the fastest male nursing enrollment growth
- Patients who prefer concordance-based care in specific clinical contexts, including men with mental health concerns, chronic disease, or situations requiring physical privacy during examination
- The nursing profession itself, which benefits from a broader and more diverse recruitment pool as it faces sustained demographic attrition from retirement of the baby-boom nursing generation
What You Can Do Now

For people considering nursing as a career:

For healthcare employers and policymakers:
- Hospitals and health systems seeking to address nursing shortages can partner with regional nursing schools on recruitment pipeline programs that actively reach men in high school and early college years.
- State-level workforce development funding through Title VIII nursing programs can support expanded nursing school capacity, particularly in shortage areas.
Cost and Access: What Patients Should Know

The nursing workforce shortage has direct effects on patient care: longer emergency department wait times, reduced availability of home health nursing, and reduced capacity for preventive and chronic disease management in underserved communities. Expanding the diversity and size of the nursing pipeline is a patient safety issue, not just a labor market issue.

What Happens Next

UAB and other Southern nursing programs with active male recruitment initiatives are expected to report enrollment trends annually. The Labor Department will update its occupational projections with 2025 and 2026 data in the coming years. Whether the male nursing share reaches 1 in 5 or higher within a decade will depend on whether the cultural shift documented in the NPR report extends beyond leading institutions and translates into broad enrollment patterns at community colleges and ADN programs that produce the largest total volume of nurses.

The Bottom Line

Approximately 1 in 8 U.S. registered nurses is now male, a share that is growing and growing fastest in the South, where nursing shortages are most acute. A strong job market, deliberate recruitment by nursing schools, and a gradual cultural shift in how nursing is understood as a profession are driving the change. With 189,000 RN job openings projected annually for the next decade, and with rural hospitals and clinics in the South facing the deepest shortfalls, the growth of male nursing in the region that needs nurses most is a workforce development trend worth watching.
Source link
July 24, 2026