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

Clements, Archie, Halton, Kate, Graves, Nicholas, Pettitt, Anthony, Morton, Anthony, Looke, David and Whitby, Michael (2008) Overcrowding and understaffing in modern health-care systems: Key determinants in meticillin-resistant Staphylococcus aureus transmission. Lancet Infectious Diseases, 8 7: 427-434. doi:10.1016/S1473-3099(08)70151-8


Author Clements, Archie
Halton, Kate
Graves, Nicholas
Pettitt, Anthony
Morton, Anthony
Looke, David
Whitby, Michael
Title Overcrowding and understaffing in modern health-care systems: Key determinants in meticillin-resistant Staphylococcus aureus transmission
Formatted title
Overcrowding and understaffing in modern health-care systems: Key determinants in meticillin-resistant Staphylococcus aureus transmission
Journal name Lancet Infectious Diseases   Check publisher's open access policy
ISSN 1473-3099
1474-4457
Publication date 2008-07-07
Year available 2008
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/S1473-3099(08)70151-8
Open Access Status Not yet assessed
Volume 8
Issue 7
Start page 427
End page 434
Total pages 8
Editor John McConnell
Place of publication New York, U.S A.
Publisher The Lancet Publishing Group
Language eng
Subject C1
920499 Public Health (excl. Specific Population Health) not elsewhere classified
111799 Public Health and Health Services not elsewhere classified
1117 Public Health and Health Services
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.
Formatted 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.
Keyword Health care systems
Overcrowding
Understaffing
Staphylococcus aureus
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Faculty of Health and Behavioural Sciences -- Publications
2009 Higher Education Research Data Collection
Excellence in Research Australia (ERA) - Collection
 
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Created: Mon, 30 Mar 2009, 21:09:13 EST by Geraldine Fitzgerald on behalf of School of Public Health