Protecting Yourself from Infection in the Hospital

Most of us will have to be treated in a hospital some day.  When it happens, get out as quickly as possible. Getting out fast is the one goal you and your insurance company will agree on. Trust your doctors and other care givers, but do not trust blindly.  Here are specific suggestions to prevent the hospital from actually making you sicker.

1. Ask that hospital staff clean their hands before treating you.

This is the single most important way to protect your health in the hospital. If you’re worried about being too aggressive, just remember that your life could be at stake.  If there is no sink in your room, keep a container of hospital-approved alcohol hand gel on your bedside table.  Alcohol-based hand rubs are even more effective at removing bacteria than washing with anti-microbial soaps.[1] Don’t be falsely reassured because caregivers are wearing gloves.  Gloves more often protect the staff than the patients, and can spread germs once they are contaminated. 

2. If you need surgery, choose a surgeon with a low infection rate.

Surgeons know their rate of infection for various procedures. Ask for it. If they won’t tell you, choose another surgeon. You also should be able to compare hospital infection rates. Unfortunately the industry has made it impossible to get that information.

3. Double-check to make sure you actually are given a preventive dose of antibiotics within an hour before surgery.

That is the standard for infection prevention, but it is often overlooked when staff is busy.[2]

4. Avoid a urinary tract catheter if possible.

These catheters, also called Foley catheters, are a common cause of infection.  A hospital staff member will thread the tube into your urethra, a passage which is in a man’s penis and just in front of a woman’s vagina.  The tube allows urine to flow from your bladder out of your body.  Left in long enough, an infection is almost inevitable. Usually the catheter is needed for medical reasons, but if it is only to prevent you from wetting the bed because you can’t get up yet, request a diaper or bed pan instead.

5. If you must have an I.V., make sure that it is inserted and removed under sterile conditions, and changed every three days.

Intravenous catheters, or I.V. s, are a common source of infection and are not always necessary.  Some places they are used automatically, because it makes it easier to get the insurance company to O.K. a patient’s hospitals stay.  The first question some insurers ask is: Does the patient need an I.V.? Ask your doctor if you really need one. If so, you have a right to insist on sterile conditions, which means that your skin is cleaned at the site of insertion, and the person treating you is wearing a sterile gown and gloves.

That should always be the routine, but it is not.  When I was in the hospital last year, the nurse who had been very kind to me during my stay came into the room holding a band aid in her bare fingers and announced it was time to remove my I.V. I said to her, “I’m writing a book on hospital infection, so for the heck of it, let’s do it the sterile way.”  “O.K.,” she said, and returned to my room a few minutes later wearing gloves and holding materials to clean my skin. “I would have done it this way,” she explained, “but you looked so young and healthy, that I thought if you got an infection, we could always give you an antibiotic.”

Many hospitals that once had specially-trained I.V. teams to insert and remove all I.V. s no longer do. “That went by the way side with budget cuts,” explains Dr. Beth Raucher, an infection control expert at Beth Israel Medical Center in New York City.   Trinitas Hospital New Jersey eliminated specially-trained I.V. teams 10 years ago. “I fought it tooth and nail,” says the head of infection control, “and showed them the data that I.V. teams lower infection rates.”   

6. Ask your surgeon to limit the number of medical students in the operating room.

Every increase in body count adds to your risk of infection.[3]

7. Do not shave any part of your body before surgery.

The razor can create small openings in the skin through which infection could enter.  If hair must be removed from the surgical site, it is better to use clippers than a razor.