As the pandemic subsides, people who put off elective surgery, such as a hip or knee replacement, are now scheduling these procedures that typically require hospital stays. If you or someone in your family is heading to the hospital, there are important steps you need to take to ensure safety.
According to the Centers for Disease Control and Prevention, healthcare-acquired infections (HAIs) ― those that occur in hospitals, ambulatory clinics, and long-term care facilities ― account for an estimated 1.7 million infections and 99,000 associated deaths annually. Infections contracted in the hospital kill more people than AIDS and breast cancer combined. Nearly all of these deaths are preventable.
Reduce Infection Deaths (RID), a non-profit educational campaign, helps you prepare before your surgery date and explains what precautions you should take while in the hospital, so that you can avoid infection. Whether you’re going in for surgery or for the happiest reason of all, to have a baby, review RID’s 15 Steps brochure that lists precautions that are important to take to prevent infection.
1) Print out and bring the 15 Steps list to your doctor’s appointment. Review the precautions with your surgeon at least one week before your surgery.
2) Ask your surgeon to have you tested for methicillin-resistant Staphylococcus aureus (MRSA) at least one week before you head to the hospital. This bacterium found on the skin can lead to serious infection that can be difficult to treat due to its resistance to some antibiotics. If you have it, extra precautions can be taken to protect you from infection.
3) Beginning three to five days before surgery, shower or bathe daily with chlorhexidine cleanser. A variety of brands are available in drugstores without a prescription. Washing with this antiseptic soap will help remove any dangerous bacteria you may be carrying on your skin that could cause infection at your surgical site.
4) Stop smoking well in advance of your surgery. Patients who smoke are three times more likely to develop a surgical site infection than nonsmokers.
5) On the day of your operation, remind your doctor that you may need to take an antibiotic one hour before the first incision. For many types of surgery, a pre-surgical antibiotic is the standard of care.
6) Ask your doctor about keeping you warm during surgery. This can be done with special blankets, hats, and booties, and warmed IV liquids. According to studies, patients kept warm resist infection better.
7) Do not shave the surgical site yourself. Razors can create small nicks in the skin, through which bacteria can enter. If hair must be removed, ask that clippers be used.
8) Ask your doctor about monitoring your glucose (sugar) levels continuously during and after surgery, especially if you are having cardiac surgery. When blood glucose levels are tightly controlled, heart patients resist infection better.
9) Ask that hospital staff clean their hands before treating you, and ask visitors to clean their hands too. And wash your own hands often. The best way to wash is with warm water and soap but if you can’t get to the bathroom, make sure to have hand sanitizer within reach. 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.
And don’t be falsely assured by gloves. If you don’t see healthcare workers wash their hands before pulling on their gloves, the gloves could be contaminated. You can explain nicely that you trust them, but since you did not see them wash their hands you would like them to do it again.
10) Beware of C. diff ― nickname for Clostridium difficile ― the most commonly reported hospital infection. C. diff germs invisibly contaminate virtually everything in the hospital, including bedrails, bed linens, call buttons, and doorknobs. These are all commonly touched surfaces, and the C. diff germs are easily picked up on your hands. To protect yourself from getting a C. diff infection, avoid touching your hands to your mouth and do not set foods or utensils on any surface except a clean plate. You don’t want those C. diff germs to enter your mouth. Infection with this bacterium can result in diarrhea, abdominal cramping and pain, nausea, and fever. Severe infection can lead to intestinal inflammation, colon enlargement and potentially deadly sepsis.
11) Ask your doctor if you can forgo a urinary catheter. It is a common cause of infection. If you do need one, ask your caregiver to remove it as soon as possible. It’s mostly hidden under the sheet, so you’ll have to remind your nurse it’s even there. Male patients can request a condom catheter, which is safer and sometimes also more comfortable.
12) Keep your IV site clean. If you must have an IV, make sure that it’s inserted and removed under sterile conditions and changed every three to four 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.
13) Avoid pneumonia. Ask for an extra pillow to keep your head elevated while in bed. Also ask for a spirometer ― the apparatus that measures how well you exhale and inhale, and how to use it. And/or ask for deep breathing exercises. Another way to reduce your risk of getting pneumonia is to have your mouth cleaned every day. Often in the hospital, busy caregivers don’t offer to help you brush your teeth. A buildup of bacteria can be aspirated into your lungs, causing infection.
14) If you need a “central line” catheter ― sometimes used if you need large amounts fluids, or medicines, such as chemotherapy, that can’t be administered through a regular IV ― ask your doctor about the benefits of one that is antibiotic-impregnated or silver-chlorhexidine coated to reduce infection risk.
15) Tell your visitors to skip the candy and flowers. Instead, they could bring a canister of bleach wipes. Wiping down surfaces around the bed, including bedrails, the call button, television controls, and your cellphone, will remove dangerous bacteria that could cause an infection. That simple step could save your life.
Betsy McCaughey, Ph.D., former Lieutenant Governor of New York State, is chairman of the Committee to Reduce Infection Deaths.
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