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Overcrowding and understaffing in modern health-care systems : key determinants in meticillin-resistant Staphylococcus aureus transmission

Clements, Archie, Halton, Kate A., Graves, Nicholas, Pettitt, Anthony N., Morris, Anthony Kevin, Looke, David, & Whitby, Michael (2008) Overcrowding and understaffing in modern health-care systems : key determinants in meticillin-resistant Staphylococcus aureus transmission. Lancet Infectious Diseases, 8(7), pp. 427-434.

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Abstract

Recent decades have seen the global emergence of meticillin-resistant Staphylococcus aureus (MRSA), causing substantial health and economic burdens on patients and health-care systems. This epidemic has occurred at the same time that policies promoting higher patient throughput in hospitals have led to many services operating at, or near, full capacity. A result has been limited ability to scale services according to fluctuations in patient admissions and available staff, and hospital overcrowding and understaffing. Overcrowding and understaffing lead to failure of MRSA control programmes via decreased health-care worker hand-hygiene compliance, increased movement of patients and staff between hospital wards, decreased levels of cohorting, and overburdening of screening and isolation facilities. In turn, a high MRSA incidence leads to increased inpatient length of stay and bed blocking, exacerbating overcrowding and leading to a vicious cycle characterised by further infection control failure. Future decision making should use epidemiological and economic evidence to evaluate the effect of systems changes on the incidence of MRSA infection and other adverse events.

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60 citations in Web of Science®

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ID Code: 18320
Item Type: Journal Article
Additional URLs:
Keywords: Hospitals - overcrowding, Hospitals - understaffing, MRSA, meticillin-resistant Staphylococcus aureus
DOI: 10.1016/S1473-3099(08)70151-8
ISSN: 1473-3099
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > MEDICAL MICROBIOLOGY (110800)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > MEDICAL MICROBIOLOGY (110800) > Medical Infection Agents (incl. Prions) (110802)
Divisions: Past > QUT Faculties & Divisions > Faculty of Science and Technology
Current > Institutes > Institute of Health and Biomedical Innovation
Past > Schools > Mathematical Sciences
Deposited On: 07 Apr 2009 12:10
Last Modified: 29 Feb 2012 23:49

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