Understaffing, overwork fuel superbugs

Tue 24 Jun 2008

Programs to control deadly superbugs in Australian hospitals are failing because wards are too overcrowded and understaffed, experts say.

A review study has blamed conditions in hospitals for the consistently high rates of infections with antibiotic-resistant bugs such as MRSA, or methicillin-resistant staphylococcus aureus.

Australian researchers say in the British journal, The Lancet, that pressures on the health system to churn patients through more quickly, at greater volumes and with fewer staff to manage them, was feeding the spread of the germs.

"The drive towards greater efficiency by reducing the number of hospital beds and increasing patient throughput has led to highly stressed health-care systems with unwelcome side-effects," said Dr Archie Clements, a population health specialist at the University of Queensland.

"And understaffing is both an ongoing and long-term future problem with severe consequences for hospital patients."

MRSA is spread by the hands, staff clothing and contaminated medical equipment, with infections usually affecting the bloodstream, lungs and surgical sites.

About 2,000 Australian hospital patients are infected every year, and about 35 per cent die as a result.

The report, published on Tuesday, said there had been a 40 per cent decrease in public hospital beds per person in Australia, yet a 20 per cent increase in the number of patients treated between 1982 and 2000.

Dr Clements said hospitals were trying to cope by treating patients in a single day instead of admitting them as inpatients.

He predicts the pressures will only increase as the population grows and people live longer lives.

"In Australia, the requirement for hospital beds is predicted to increase by 70 to 130 per cent by 2050," Dr Clements said.

The other major problem is that measures to control MRSA spread, like routine hand-washing, are not well adhered to by doctors, nurses and other health care workers.

Other strategies, like isolation of infected patients, also breakdown with understaffing and overwork.

Dr Clements said there was an urgent need for detailed study on the effects of resource constraints on the dynamics of MRSA infection.

But Canberra-based infectious diseases expert Professor Peter Collignon, an authority on superbug infection, said firm hospital policies needed to be implemented as soon as possible to stop infection spread.

"We have so much proof of this problem," Prof Collignon said.

"We don't need more research. We just need to act to stop it."