My client, Kimberly-Clark Healthcare, has required that I learn all about healthcare associated infections (HAIs) — both how to treat them as well as how to prevent them.  There’s a renewed interest in MRSA and other super-bugs that are making people sicker than they were when they initially entered the hospital in the first place. RID and MyOptumHealth have stellar lists on what patients can do to reduce their risks before and during a hospital stay.  Most of these are perfectly normal, reasonable requests even though the hospital staff might not be readily happy to comply, they should be doing these things anyway! Also, if you’re interested in this, NPR had an amazing show on a recent Talk of the Nation called Bacterial Infections Defy Treatment that you need to listen to.

Here’s a great and comprehensive list from Betsy McCaughey over at RID

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.

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.

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.

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

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.

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.

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.

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.

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.

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. [11]–>

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.

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.

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.

Ideally, you would choose a hospital with a low infection rate. Good luck getting that information. It’s impossible. Many states collect data on infections that lead to serious injury or death, but nearly every state-with the exception of 6-has given into the hospital industry’s demands to keep the information secret. The federal Centers for Disease Control and Prevention also collect infection data from hospitals across the nation, but refuse to make it public. Government is too often on our backs, instead of on our side.

What’s the answer? Hospital infections report cards. Hospitals object that comparisons would be unfair because hospitals that treat sicker patients, such as AIDS, cancer, and transplant patients who have weakened immune systems, will have a higher infection rate. True, but the data can be risk adjusted to make comparisons fair. What is unfair is preventing the public from knowing which hospitals have infection epidemics. Keeping infection rates secret may help hospitals save face, but it won’t save lives.

Here’s another quite good list of things that we patients and consumers of medical care can use to do our best to keep safe, healthy, and to best survive our hospital stays without getting sick from a super bug or MRSA or any of that other stuff — at least to prevent it — via MyOptumHealth’s article Protect Yourself From Infection in the Hospital

Before you enter the hospital:

• Stop smoking. Smokers are three times more likely to develop an infection than nonsmokers.
• Have your blood sugar under control if you have diabetes.
• Ask about the hospital’s infection control program. Choose a surgeon and hospital with a low infection rate.
• Shower with chlorhexidine soap one week before surgery. This can be bought over the counter.
• Ask your doctor if you need a vaccine for flu or pneumonia.

In the hospital:

• Remind all staff and visitors to wash their hands before touching you.
• Discourage visits from people who are ill. Ask friends and relatives not to visit if they are sick.
• Avoid getting a urinary catheter if possible. Diapers or bedpans are safer. If you have a catheter, ask if it can be removed after two days. That is when the infection risk rises.
• Ask if the stethoscope was cleaned with alcohol.
• Ask for hair clippers – not a razor – to be used if hair needs to be removed before surgery.
• Make sure you receive an antibiotic within one hour of surgery.
• Move around to prevent bedsores, which can become infected.
• Call a nurse if your catheter is uncomfortable or loose.

Tell a nurse if your dressing or IV line is loose or wet, or if your gown or linens are soiled.