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Hospital Germs: How you can reduce the risk
Hospital germs, super germs, you, me and our loved ones.
A must read by anyone who is going
As a healthy person, the germs may not effect you, but to someone with a compromised immune system, they can be deadly. Weakened immunity can be caused by any number of factors including another illness, simply the length of time in hospital, or a general antibiotic treatment which destroys some of the immune system defenses (Talk to your doctor about reduction of non-specific antibiotics. For more details on this, see below General Medical Procedures).
What are the rules?
Washing of Hands By Everyone
Perhaps the most basic protection is simply the proper washing of hands. You may think you know how to do it and when. Think again. Take a look at Steps to proper hand washing or view the CDC video.
Before kissing, touching, feeding of loved ones, wash your hand and if you leave the room or bedside and then return, re-wash. Visitors coming to patients - touching, caring for and feeding them - are doing so without washing their hands even though they have just pushed elevator buttons, parking machines, opened doors, used a public phone (or even their own cell phone), or touched other surfaces touched by many others some of whom may have carried one of the germs.If the patient you are visiting is contagious, also wash your hands before leaving the room.
Repeatedly emphasized by health authorities as the most effective preventive measure against a number of the hospital germs and yet visitors and staff continue to ignore it.
Measures you can take before and during your stay in the hospital
15 Steps You Can Take To Reduce Your Risk of a Hospital Infection - published by RID
Do not insist on antibiotics if attending doctor advises otherwise. Antibiotics which are not specifically targeting the infection you have may reduce your immunity. For more information, see below under General Medical Procedures.
Do not borrow the utensils, apparatus, combs, brushes, books, etc. of another patient
Contagion signs - Understand the meaning of contagious signs on certain rooms or sections of the hospital.
In rooms marked as contagious do not borrow chairs, tables which are in rooms marked as contagious.
Wash hands when leaving room if visiting an infected person, for any reason what-so-ever even if it is only to get a chair, a cup of water any thing which might entail the touching of surfaces which others will touch, and of course re-wash hands when returning so as not to add another infection.
Use soap provided by the hospital for the purpose and wash hands as prescribed.
Protective garments - If patient is contagious, adhere to the rules for protective garments and when finished visiting or on going out of the room, throw away garments.
Rental equipment - TVs and other equipment on loan or for rent. The controls put previous patient's germs into the hand of the new subscriber. Be sure that parts handled are wiped clean with an antiseptic.
Food kept in communal refrigerator Do not keep food for your loved one in the refrigerator. The food of patients who are contagious is also kept there. If you do, be sure that hands touching the refrigerator door, kitchen door, the food parcels of others, as well as your own parcel which may have been handled by as many as 10-20 others in the course of a day (moved aside, looked at to find if theirs, etc) , are washed before feeding patients. If you think about it, the task is almost impossible.
Other measures to reduce risk taken by hospital staff and management include
Wear a new set of gloves for each patient treated. Nurses often do not put on fresh gloves after each patient and carry the germs of one patient to the next. Use gloves or antiseptic gel between each patient even in non-contagious wards because the lab tests are not always up-to-date or take too long to often effectively serve as a warning.
Wash hands before putting on gloves. See article: Gloves - the unwashed hand that puts them on touches the surfaces
Make sure that visitors are strictly following the rules for protective garments and the washing of hands upon leaving the room.
Make sure that bathrooms used by patients and visitors are adequately stocked and that anti-bacterial soap is available in all bathrooms.
Make sure that patients who are infectious know what to do and not do to reduce the likely spread of contagion.
When rounding up chairs to put them back into circulation, do not take chairs from contagious rooms unless they are sterilized.
Use disposable cuffs on blood pressure machines.
Keep doors open during visiting hours to provide unimpeded access by staff, patients and visitors
Toys passed around from child to child or held in a communal setting should be cleaned between patient handling.
Hospital badges may be a source of contagion says a study Germs Coat Hospital Badges, Says Study Discovery News March 19, 2007
Admittance and Release
Prescreening swabs on admission to screen out and alert staff to contagion brought into hospitals by new patients.
Give all first time visitors a verbal and a written list of precautionary measures and the possible dangers.
If patient is released to home care with continuation of the antibiotic treatment before full recovery from an infection by one of the germs, patient and family should be warned of the dangers still facing the patient and make active arrangement for follow-up, retesting at the end of a prescribed series of antibiotics, what symptoms meant a relapse, and the necessary procedures to be taken with in indication of the time period within which to accomplish procedures, re-admittance, etc.
If infected by one of the hospital germs, the release forms should state clearly the fact that the patient has been infected, the seriousness of the disease, and the treatment given so that the family doctor and care givers are fully aware that the person may still be in an unstable condition thus alerting them to possible signs of relapse or continued infection.
General Medical Procedures return top ways reduce risk
Non-use of broad spectrum antibiotics where not absolutely necessary. See studies related to use of Narrow spectrum antibiotics in combating Clostridium difficile to reduce destruction of anaerobic flora in intestinal tract.
Use of antibiotic one hour before surgery and stopped within the 24 hour period afterwards.Administration
Do follow-up to make sure that staff, nursing, technical, and doctors know the rules and follow them regarding reducing the spread of infection.
Supply the necessary supplies, machines, etc which will provide for the safe and separate handling of infected and non-infected patients
Make sure that the general public and visitors know what they must do to reduce the spread of contagion to their loved ones.
Wheelchairs or beds used for transport - all parts of wheelchairs and beds in contact with patients should be cleaned between transports. All handlers should wash hands after each transport, and wear a new pair of gloves between patients.
Provide the necessary supplies of basic materials, make them available and instruct nursing staff to distribute as needed if depleted outside of cleaning staff hours.
Make sure that hospital personnel do not carry infected material, instruments, etc. from one patient to another.
Provide full and open documentation of all infections contracted by individuals while in the care of the hospital.
Provide instructions to all patients released as to what to do if any of the symptoms occur or reoccur within a 2-4 week period after release.
Provide detailed instructions to those who have undergone treatment for one of the infectious diseases as to what procedures they must go through in the course of treatment continuation, periodic lab checks, and the signs and symptoms involved in detection of reoccurrence or continuation of the infection.
Provide active follow-up by the hospital and not just "let the family doctor take care of the patient once the hospital doors close behind them".
Make sure that family doctor or those caring for the patient know of the risks, the signs of continuance, reoccurrence, necessity for follow-up checks, etc. (to the depth needed by each level of caregiver ).
Print out instructions and be sure that they are disseminated to applicable individuals as well as to the patient.
Make sure that all dishes, trays, utensils are sanitized, and provision and instructions made for this procedure along with follow-up to be sure that this is accomplished.Related Articles
What Can Be Done By the Insurance Groups
Medicare ends coverage for hospital errors New incentive for better care, August 12, 2007 Carol Ann Campbell, Star-Ledger Staff "Beginning next year, Medicare will stop paying for hospital mistakes." Under rules issued last week, the government insurance program will no longer pay extra to treat certain infections that patients pick up in the hospital."
What Can Be Done Through Legislation
Hospital Infection Disclosure Laws Listing of states which have passed state hospital infection disclosure laws or are considering such legislation that will give their residents important information about hospital infections. New law aims to wipe out deadly staph infection Hospitals must screen and isolate patients to fight antibiotic-resistant bacteria By Carol Ann Campbell Star-Ledger Staff "Gov. Jon Corzine yesterday signed a law requiring all New Jersey hospitals to create similar "screen and isolate" programs to fight this antibiotic-resistant bacteria, which is on the rise in hospitals around the nation."
Hospital Infection Reporting Bill Approved by Washington Senate Thursday, April 12, 2007 ConsumersUnion.org Bill Would Require Washington Hospitals to Report Patient Infections to the Public "The Washington Senate approved a bill that requires hospitals in the state to disclose the rate at which patients acquire certain infections during treatment. HB 1106, sponsored by Representative Tom Campbell, is designed to spur hospitals to improve care and reduce infections. Hospital infections kill 90,000 Americans every year according to the Centers for Disease Control and Prevention The Department of Health would be required to publish a report on its web site that compares the health care associated infection rates at individual hospitals in the state using the date reported in the previous calendar year."
Committee to Reduce Infection Deaths
Wealth of information on the problem and what can be done to reduce it.
Stop Hospital Infections.org updated references to what is being done and current status in the U.S.
LIST OF SOME OF THE MAJOR GERMS RESPONSIBLE
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A league of superbugs 25/10/2006
The cost of doing it well is minimal against the cost of caring for patients who contract these diseases while in the hospital. In many cases, hospitals are being partially reimbursed for the extra time and cost in a number of ways so that the hospitals are not really being forced to do what is necessary to reduce the number being infected and even dying as a result.
Time spent in hospital and costs Thursday, April 12, 2007 ConsumersUnion.org An example in one state of the U.S.: "Pennsylvania has produced the most extensive reports to date based on data submitted by its hospitals. In November 2006, the state revealed that hospitals identified 19,154 patient infections during 2005 and detailed infection rates for each of the states 168 hospitals. The mortality rate for patients with a hospital acquired infection was 12.9 percent compared to 2.3 percent for patients without infections. Patients with infections stayed in the hospital 16 more days, on average, than patients without infections. On average, insurers paid nearly $46,000 more for patients with infections than for patients without infections."
Unnecessary Deaths: The Human and Financial Costs of
Table of Contents:
Third World Hygiene in Our First Class Medical System
The Major Problem: Poor Hygiene
MRSA Screening Is Essential
Preventing Infections Makes Hospitals More Profitable
Hospital Infection Is the Next Asbestos
Shouldnt Medical Students Be Taught Hygiene?
Success Stories: Infections Can Be Eradicated
15 Steps You Can Take to Reduce Your Risk of a Hospital Infection
The Importance of Hospital Infection Report Cards
Screening patients for MRSA makes hospitals more profitable "Preventing MRSA infections costs far less than treating them. For example, in a medical intensive care unit at the University of Pittsburgh, screening tests, gowns, and other precautions cost $35,000 a year and yielded over $800,000 a year in avoided infection costs. No capital outlay was required. "Virtually all published analyses" reach similar conclusions, according to the medical journal, Lancet, in its September 2006 issue. Screening patients for MRSA makes hospitals more profitable. Most importantly, it saves lives."
SUGGESTIONS IN DEVELOPMENT OF A MODEL FOR LEGISLATION
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First, it specifies the method of risk-adjustment for surgical site infections used by the CDC, rather than leaving the risk-adjustment method to be determined by committee
Secondly, the bill imposes civil penalties on hospitals that fail to report or flagrantly underreport their infections
Thirdly, the model bill ensures that hospital infection reporting will benefit the public, not enrich trial lawyers
STUDIES, SIDE ISSUES AND INFORMATIVE MATERIAL
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Intensive Insulin Reduces ICU Morbidity and Mortality PulmonaryReviews.com, Jan 2002
LEUVEN, BELGIUMA study of 1,548 mechanically ventilated adults in an ICU (intensive care unit) given intensive insulin treatment to keep blood glucose levels in normal range (80 to 110 mg/dL) significantly reduced morbidity and mortality. The alternative may predispose patients to "complications, such as severe infection, polyneuropathy, multiple organ failure, and death".