医院过度拥挤和人员配备不足对MRSA扩散的影响

David

Lancet Infect Dis. 2008 Jul;8(7):427-34.

Overcrowding and understaffing in modern health-care systems: key determinants in meticillin-resistant Staphylococcus aureus transmission.
医院过度拥挤和人员配备不足对MRSA扩散的影响
Clements A, Halton K, Graves N, Pettitt A, Morton A, Looke D, Whitby M.
Division of Epidemiology and Social Medicine, School of Population Health, University of Queensland, Herston, Queensland, Australia; Centre for Healthcare Related Infection Surveillance and Prevention, Queensland Health, Brisbane, Queensland.

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.

PMID: 18582835 [PubMed - in process]

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缭绕

人们经常说病室拥挤，容易导致院感，我总觉得有点没有科学依据！该好好读一下这篇论文了，看看老外是怎样设计的！

青暮

译出来有奖励吗？嘿嘿～

David

翻出来我给你加分！

青暮

觉得有些地方翻的不顺，也许没有彻底理解吧～希望大卫能多多指点啦～谢谢～^O  ^
      近数十年来，耐甲氧西林金黄色葡萄球菌（MRSA）在全球出现，对病人和医疗保健系统造成了重大的健康和经济负担。那些为促进提高医院患者量的政策使医院服务接近负荷的同时，MRSA开始流行。结果，因波动的入院病人和现有的工作人员而使规模服务能力受限，医院过度拥挤以及人员配备不足。由于过度拥挤和人员不足使医务人员手卫生执行次数减少，病房间病人和工作人员活动性增加，隔离水平降低，最终导致MRSA感染控制方案的失败（即MRSA产生）以及过度的筛选和隔离设施。反过来， 高MRSA感染率又增加了病人住院时间使床位减少，加剧了拥挤，形成一个恶性循环，进一步导致感染控制的失败。因此应以流行病学和经济学的证据来制定未来的政策，以评估系统变化对MRSA感染率和其他事件的影响。