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

Halton, Kate; Graves, Nicholas; Pettitt, Anthony; Morton, Anthony; Looke, D; Whitby, M; Clements, Archie

Description

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...[Show more]

dc.contributor.authorHalton, Kate
dc.contributor.authorGraves, Nicholas
dc.contributor.authorPettitt, Anthony
dc.contributor.authorMorton, Anthony
dc.contributor.authorLooke, D
dc.contributor.authorWhitby, M
dc.contributor.authorClements, Archie
dc.date.accessioned2015-12-13T22:29:13Z
dc.identifier.issn1473-3099
dc.identifier.urihttp://hdl.handle.net/1885/74582
dc.description.abstractRecent 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.
dc.publisherLancet Publishing Group
dc.sourceThe Lancet Infectious Diseases
dc.subjectKeywords: alcohol; meticillin; antibiotic resistance; Australia; bacterial infection; cost control; crowding; decision making; disease exacerbation; hand washing; health care cost; health care personnel; health care policy; health care system; high risk patient; ho
dc.titleOvercrowding and understaffing in modern health-care systems: key determinants in meticillin-resistant Staphylococcus aureus transmission
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume8
dc.date.issued2008
local.identifier.absfor111706 - Epidemiology
local.identifier.ariespublicationU3488905xPUB4195
local.type.statusPublished Version
local.contributor.affiliationClements, Archie, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationHalton, Kate, Queensland Health
local.contributor.affiliationGraves, Nicholas, Queensland University of Technology
local.contributor.affiliationPettitt, Anthony, Queensland University of Technology
local.contributor.affiliationMorton, Anthony, Princess Alexandra Hospital
local.contributor.affiliationLooke, D, Princess Alexandra Hospital
local.contributor.affiliationWhitby, M, Princess Alexandra Hospital
local.description.embargo2037-12-31
local.bibliographicCitation.issue7
local.bibliographicCitation.startpage427
local.bibliographicCitation.lastpage434
local.identifier.doi10.1016/S1473-3099(08)70151-8
dc.date.updated2015-12-11T08:47:22Z
local.identifier.scopusID2-s2.0-45749091707
CollectionsANU Research Publications

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