Hospital Infection Dangers: Time to Put Up Your Own Defenses
By Margaret Eichman

With infections contracted in hospitals rising at alarmingly high rates, patients cannot simply rely on hospital hygiene practices and protocols to protect themselves. Patients need to proactively interact with health care staff to ensure their own safety. Being armed with questions to ask and specific hygiene practices to demand can help prevent patients from becoming victims of hospital-acquired illnesses.

According to the Committee to Reduce Infection Deaths (RID), germs leading to infections contracted in hospital settings kill more people each year in the United States than AIDS, breast cancer, and auto accidents combined. There are several steps that informed patients can take to help ensure that their health care givers are being as conscientious as possible when it comes to preventing the spread of germs that lead to infections.

It is absolutely within each patient's rights to ask that hospital staff (and visitors) clean their hands before being treated. Stethoscopes, used hospital scrubs, and cell phones, all can be carriers of infection-causing germs, too, and need to be antiseptically cleaned, changed or left outside out of the treatment area.

Patients should thoroughly discuss with their doctor the necessity of inserting a urinary catheter—and avoid them, if medically feasible. Patients also should request their doctor review with them the possibility of using antibiotic impregnated “central line” catheters, when procedures call for them.

Knowing the right questions to ask is just a start. Patients need to be aware of a few precautionary pre-surgical actions that can significantly reduce their receptivity to hospital-borne infections. To learn more, click on the following link to review the “15 Steps you can take to Reduce your risk of a hospital infection.”


Your Risk of a Hospital Infection (from the Committee to Reduce Infection Deaths*)

1. Ask that hospital staff clean their hands before treating you, and ask visitors to clean their hands too. This is the single most important way to protect yourself in the hospital. If you're worried about being too aggressive, just remember your life could be at stake. All caregivers should clean their hands before treating you. Alcohol-based hand cleaners are more effective at removing most bacteria than soap and water. Do not hesitate to say: "Excuse me, but there's an alcohol dispenser right there. Would you mind using that before you touch me, so I can see it?" Don't be falsely assured by gloves. If caregivers have pulled on gloves without cleaning their hands first, the gloves are already contaminated before they touch you. [1]

2. Before your doctor uses a stethoscope, ask that the diaphragm (the flat surface) be wiped with alcohol. Stethoscopes are often contaminated with Staphylococcus aureus and other dangerous bacteria, because caregivers seldom take the time to clean them in between patient use. [2]

3. If you need a "central line" catheter, ask your doctor about the benefits of one that is antibiotic-impregnated or silver-chlorhexidine coated to reduce infections. [3]

4. If you need surgery, choose a surgeon with a low infection rate. Surgeons know their rate of infection for various procedures. Don't be afraid to ask for it.

5. Beginning three to five days before surgery, shower or bathe daily with chlorhexidine soap. Various brands can be bought without a prescription. It will help remove any dangerous bacteria you may be carrying on your own skin [4]

6. Ask your surgeon to have you tested for methicillin-resistant Staphylococcus aureus (MRSA) at least one week before you come into the hospital. The test is simple, usually just a nasal swab. If you have it, extra precautions can be taken to protect you from infection. [6]

7. Stop smoking well in advance of your surgery. Patients who smoke are three times as likely to develop a surgical site infection as nonsmokers, and have significantly slower recoveries and longer hospital stays. [7]

8. On the day of your operation, remind your doctor that you may need an antibiotic one hour before the first incision. For many types of surgery, a pre-surgical antibiotic is the standard of care, but it is often overlooked by busy hospital staff. [8]

9. Ask your doctor about keeping you warm during surgery. Operating rooms are often kept cold, but for many types of surgery, patients who are kept warm resist infection better. This can be done with special blankets, hats and booties, and warmed IV liquids. [9]

10. Do not shave the surgical site. Razors can create small nicks in the skin, through which bacteria can enter. If hair must be removed before surgery, ask that clippers be used instead of a razor. [10]

11. Avoid touching your hands to your mouth, and do not set food or utensils on furniture or bed sheets. Germs such as "C. Diff" can live for many days on surfaces and can cause infections if they get into your mouth. All caregivers should clean their hands before treating you. About two-thirds of medical staff were unaware they should clean their hands with soap and water, because alcohol sanitizers don't kill this superbug.

12. Ask your doctor about monitoring your glucose (sugar) levels continuously during and after surgery, especially if you are having cardiac surgery. The stress of surgery often makes glucose levels spike erratically. When blood glucose levels are tightly controlled, heart patients resist infection better. Continue monitoring even when you are discharged from the hospital, because you are not fully healed yet. [12]

13. Avoid a urinary tract catheter if possible. It is a common cause of infection. The tube allows urine to flow from your bladder out of your body. Sometimes catheters are used when busy hospital staff don't have time to walk patients to the bathroom. If you have a catheter, ask your caregiver to remove it as soon as possible. [13]

14. If you must have an IV, make sure that it's inserted and removed under clean conditions and changed every 3 to 4 days. Your skin should be cleaned at the site of insertion, and the person treating you should be wearing clean gloves. Alert hospital staff immediately if any redness appears.

15. If you are planning to have your baby by Cesarean section, follow the steps listed above as if you were having any other type of surgery. [14]

*listed on Save the Patient with the approval of the author



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