How to Help Prevent Hospital-Acquired Infections

Tuesday, September 25, 2007

Any surgery poses a risk of infection, but patients can help reduce those risks. Here are some steps recommended by the Committee to Reduce Infection Deaths, a nonprofit devoted to safer hospital care. This advice comes from the group's Web site.

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

2. Before your doctor puts a stethoscope to your chest, ask that the diaphragm (flat surface) be wiped with alcohol.

3. If you need a "central line" catheter, ask your doctor to use one that is antibiotic-impregnated or coated with the antimicrobial silver/chlorhexidine.

4. If you need surgery, choose a surgeon with a low infection rate. If your surgeon won't tell you his infection rate, consider choosing another surgeon.

5. Beginning three to five days before surgery, shower daily with 4 percent chlorhexidine soap, available without a prescription.

6. Ask your surgeon to have you tested for methicillin-resistant staphylococcus aureus (MRSA) at least a week before you enter the hospital.

7. Stop smoking well in advance of your surgery. Smokers 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.

9. Ask your doctor about keeping you warm during surgery. For many types of surgery, patients who are kept warm resist infection better.

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

11. Ask that your surgeon limit the number of people (including medical students) in the operating room. The more people who are present, the higher your risk of infection.

12. Ask your doctor to monitor your glucose (sugar) levels during and after surgery, especially cardiac surgery. Research shows that when blood glucose levels are kept between 80 and 110 mg/unit, heart patients resist infection better.

13. Avoid a urinary-tract catheter if possible.

14. If you must have an IV, make sure that it is inserted and removed under clean conditions and changed every three to four days.

15. If you are planning to have a baby by Caesarean section, follow the same steps above.

Adapted with the permission of Betsy McCaughey, chairman, Committee to Reduce Infection Deaths.

© 2007 The Washington Post Company