Der Name Klinik ist von dem altgriechischen Wort klíne abgeleitet, das einen Gegenstand – das Bett oder die Liege benennt. Jedoch wird mit Klinik zunächst eine Praxis bzw. eine Methode bezeichnet: die „Medizin am Krankenbett“. In dieser Arbeit wird untersucht, welche Bedeutungen, Wirkungen und Entwicklungen das Bett in und mit der Klinik entfaltete. Seine Form, Materialität und symbolischen Eigenschaften wirken auf die Klinik als Institution, als architektonisches und organisatorisches Gebilde sowie auf die Patient_innen und die Art und Weise ihrer Behandlung. Seit dem späten 18. Jh. ist das eiserne Bettgestell, belegt mit einer Person, konstitutiv für den ‚zivilisierten‘ Menschen und zieht in dieser Form in Europas Hospitäler ein. Das Krankenbett hat außerdem stützende, unterstützende und schützende Funktionen. In Gestalt der ‚Bettmaschine‘ verspricht es um 1800 humanitären Halt und Trost. Im 20. Jh. übernimmt das Dispositiv Sicherheit: Bettgitter sollen ‚wehrlose Kranke‘ vor dem Herausfallen aus dem Bett schützen. Die Abrechnung und Planung der Krankenhausbehandlung wird seit dem 19. Jh. mehr und mehr an die Einheit Bett geknüpft. Anfang des 20. Jh. wurde zudem die Idee des Fortschritts mit dem Krankenhausbett als zeitgemäßes Industrieprodukt nach Normvorgaben verbunden. Designprojekte der 1960er Jahre richteten sich besonders auf die Körper einer Nutzergruppe: der Pflegefachkräfte. Bettennot, Fachkräftemangel, der Drang nach Verkürzung der Verweildauer und daraus resultierende Rationalisierungen veränderten das Bett, und mit ihm die Abläufe im Krankenhaus und wie Patient_innen versorgt und behandelt werden. Sichtbar wird zudem, dass zwei Mobilisierungsprojekte im Widerstreit zueinander stehen: Auf der einen Seite die Bemühungen, das Krankenhausbett für die klinische Logistik beweglich zu machen und auf der anderen Seite, die im langen Prozess der Aktivierung des Verkehrsapparats Krankenhaus passivierten Patient_innen zu mobilisieren. / Although the word ‘clinic’ refers to a practice or a method of "bedside teaching", it derives from the ancient Greek word klíne, which describes an object – the bed or the couch. This research project examines the evolution of the hospital bed itself and the meanings and effects associated with its development. Its form, materiality and symbolic properties have affected the clinic as an institution and as an architectural and organizational structure, as well as the patients and the way they have been treated. In the 18th century, the hospital bed became a means to draw distinctions between wild or civilized, healthy or ill etc. Historically, the sickbed has taken on reclining, supportive and protective functions. Around 1800, in the form of a new “bed-machine”, it promised humanitarian support and consolation. In the 20th century, the apparatus of security took over, and bed rails were installed to protect ‘helpless patients’ from falling out of bed. Since the 19th century, the planning of hospital treatment, and the accounting behind it, has been linked more and more to the bed as a unit. At the beginning of the 20th century, the idea of progress transformed the hospital bed into a state-of-the-art industrial product with fixed standards. Steel tube furniture has established itself as peculiarly adaptable and as the site of medical treatment. Design projects in the 1960s focused on the bodies of one user group – the nursing staff. Hospital bed shortages, lack of nursing staff and pressure to shorten the length of stay resulted in a rationalization that changed the bed’s structure, and with it hospital procedures, and how patients are treated. Two significant and controversial mobilization projects linked to this development are efforts to make the hospital bed mobile for the sake of logistics, and, as a countermeasure, current efforts to re-mobilize patients who were made passive by the former process.

The literature directly comparing the epidemiology of MRSA among adult and pediatric hospitalized patients is strikingly minimal. The objective of this thesis was to identify any differences between these two patient groups. The Canadian Nosocomial Infections Surveillance Program MRSA data (1995 to 2007: n=1,262 pediatric and 35,907 adult cases) were used to compare MRSA clinical and molecular characteristics and rates. Hospital characteristics were modeled using repeated measures Poisson regressions. The molecular and epidemiological characteristics of MRSA differed significantly between adults and children. Compared to children, MRSA in adults was more likely to be healthcare-associated, colonization, SCCmec type II, PVL negative, and resistant to most antibiotics. Rates of MRSA in Canada increased in both populations over time but were significantly higher in adults. The hospital characteristics associated with increased MRSA rates differed in adult and pediatric facilities. Implications for infection prevention and control strategies are discussed.

The literature directly comparing the epidemiology of MRSA among adult and pediatric hospitalized patients is strikingly minimal. The objective of this thesis was to identify any differences between these two patient groups. The Canadian Nosocomial Infections Surveillance Program MRSA data (1995 to 2007: n=1,262 pediatric and 35,907 adult cases) were used to compare MRSA clinical and molecular characteristics and rates. Hospital characteristics were modeled using repeated measures Poisson regressions. The molecular and epidemiological characteristics of MRSA differed significantly between adults and children. Compared to children, MRSA in adults was more likely to be healthcare-associated, colonization, SCCmec type II, PVL negative, and resistant to most antibiotics. Rates of MRSA in Canada increased in both populations over time but were significantly higher in adults. The hospital characteristics associated with increased MRSA rates differed in adult and pediatric facilities. Implications for infection prevention and control strategies are discussed.