MRSA Transmission Reduction Using Agent-Based Modeling and Simulation

Authors:
Sean Barnes;Bruce Golden;Edward Wasil
Affiliations:
Applied Mathematics and Scientific Computation, Department of Mathematics, University of Maryland, College Park, Maryland 20742;Robert H. Smith School of Business, University of Maryland, College Park, Maryland 20742;Kogod School of Business, American University, Washington, DC 20016
Venue:
INFORMS Journal on Computing
Year:
2010

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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant ongoing problem in health care, posing a substantial threat to hospitals and communities as well. Its spread among patients causes many downstream effects, such as a longer length of stay for patients, higher costs for hospitals and insurance companies, and fatalities. An agent-based simulation model is developed to investigate the dynamics of MRSA transmission within a hospital. The simulation model is used to examine the effectiveness of various infection control procedures and explore more specific questions relevant to hospital administrators and policy makers. Simulation experiments are performed to examine the effects of hand-hygiene compliance and efficacy, patient screening, decolonization, patient isolation, and health-care worker-to-patient ratios on the incidence of MRSA transmission and other relevant metrics. Experiments are conducted to investigate the dynamic between the number of colonizations directly attributable to nurses and physicians, including rogue health-care workers who practice poor hygiene. We begin to explore the most likely threats to trigger an outbreak in hospitals that practice high hand-hygiene compliance and additional preventive measures.