Staying safe in the hospital: Avoiding hospital infections

When you're treated in the hospital, the last thing you probably expect is that you'll contract a life threatening infection in that supposedly sterile environment. Of course hospitals are not sterile, amassing people who are vulnerable due to sickness, injury, disease, or a recent operation creates a nirvana for pathogens. In the US alone, about 2 million people fall victim to healthcare associated infections (HAIs), resulting in some 90,000 deaths and an additional $4.5 billion in costs. They are so common,some US states now report infection rates publicly.

You might think that great technical skill and innovation is required to prevent such infections, but that's not so. A November 2009 paper on hand washing notes that "hand hygiene is widely regarded as the most effective preventive measure for healthcare?associated infection." Unfortunately, healthcare workers (HCWs) can be uncooperative: According to another recent review, numerous studies report that HCWs wash their hands on average about to the time they should, and perhaps more disturbing, "HCWs have reported that they don't believe hand hygiene can significantly reduce hospital-acquired infections."

Also of concern is the growing number of infections from drug resistant infections such as the staph infection MRSA and acinetobacter. There have been several hospital outbreaks of MRSA reported recently, and the past 10 years have seen over a 300% increase in cases of drug-resistant acinetobacter.

Other factors also contribute to growing number of infections: Overuse of antibiotics breeds drug-resistant bugs, and a new study from Ireland found that disinfectants used in hospitals can mutate strains of bacteria to resist both the disinfectant and some types of antibiotic. Miss-use of antibiotics is also a problem. For example, surgical procedures such as joint replacement require the administration of antibiotics in the hour or so before making the incision. What is sometimes forgotten is that optimum treatment requires stopping the antibiotic shortly after the operation (often 24 to 48 hours). And catheters, a prime entryway for pathogens into the human body, are often left in much longer than necessary.

So what can the patient do to help keep themselves safe? Several things:

1. All healthcare providers who attend to you should wash their hands first. If you don't see them doing it, ask if they have. A support person can be helpful here. One clever trick that well known author and physician Mehmet Oz suggests is to say something like: "I'm doing a survey of hand washing, did you just wash your hands with soap and water, or did you use that alcohol-based stuff?"

2. If you are undergoing surgery, make sure to ask if you'll need antibiotics before the operation starts, and when it should be discontinued. Again, a helpful reminder from you or a loved one can help remind busy hospital staff when they need to stop the drug.

3. If you receive a catheter, make sure to ask when it can be removed. Continue asking, if necessary, if you are in the hospital for an extended period of time.