Healthcare-acquired infections (HAIs) are far more common than you might think, and a major threat to patient safety. Causing tens of thousands of Americans to lose their lives each year, these infections end up costing billions of dollars. More than a million of these infections occur in the United States each year, reports the Agency for Healthcare Research and Quality. Your doctor may not necessarily tell you everything you need to know about HAIs before you’re admitted to the hospital. Here are facts you should know to safeguard your health — and maybe even save your life.
1. Healthcare-associated infections are alarmingly common.
About 1 in 25 hospital patients has at least one healthcare-associated infection, according to the U.S. Centers for Disease Control and Prevention. Some 722,000 of these infections occurred in U.S. acute care hospitals alone in 2011. And 75,000 hospital patients with an HAI died while hospitalized, the CDC says. The most common infection patients pick up in the hospital is pneumonia, followed by gastrointestinal illness, urinary tract infections, primary bloodstream infections, surgical site infections, and other types of infections.
2. You could come down with an infection that’s resistant to antibiotics.
Many infections that you could contract while in a hospital are very serious. Yet they often don’t respond to antibiotics. One of the most common bacterial infections, Clostridium difficile (C. diff), causes fever and life-threatening diarrhea. The biggest risk for getting this infection is the overuse of antibiotics. Another deadly bacteria known as MRSA (Methicillin-resistant staphylococcus aureus) caused more than 80,000 invasive infections and 11,000 deaths in 2011, the last year for which CDC figures are available.
3. You could be a carrier of a drug-resistant bug and not even know it.
If you are a carrier for the drug resistant bug MRSA, chances are you may not even have any symptoms. Still, you’re at an increased risk for an actual MRSA infection after surgery, explains Kevin Kavanagh, MD, board chairman for Health Watch USA, a non-profit, patient advocacy organization based in Somerset, Kentucky. You can lower your infection risk by getting a screening test for MRSA before a risky operation. “If you are a carrier, you can be treated and cleared before surgery,” Dr. Kavanagh says. Unfortunately, many doctors don’t order a pre-op MRSA screening for their patients, he says. Testing to see if you are a MRSA carrier is important before certain surgeries such as joint replacement, believes Bruce Farber, MD, chief of infectious diseases at North Shore University Hospital in Manhasset, and Long Island Jewish Medical Center in New Hyde Park, New York. “You should be tested for risky procedures and procedures where a foreign body will be placed,” he says. “If you are a carrier you will be given medications to get rid of the carrier state before elective surgery.”
4. Hospital-acquired infections don’t only develop in patients who have surgery.
One of the easiest ways for infection-causing bacteria to enter your body is through your skin, which is the body’s biggest defense against infection, says Daniel Saman, DrPh, MPH, Research Scientist at Essentia Institute of Rural Health, Duluth, Minnesota, and Chief Epidemiologist at Health Watch USA. If you get a central line or central catheter, a tube is placed into a large vein that is used to administer fluids of medications or to draw blood. A bloodstream infection may develop if bacteria or another type of germ enters the bloodstream via the central line. These infections, which can be serious, typically are treated with antibiotics. It’s possible to reduce the incidence of these infections by having medical personnel follow certain protocols such as hand washing, cleaning the area of the body where the line will be inserted, and removing the catheter as soon as possible. “There are proven interventions that can reduce the risk of HAIs,” Dr. Saman says. “But the biggest threat is a lack of adoption of the protocols by hospitals.”
5. Taking antibiotics when they’re not needed increases your risk of a future healthcare-associated infection.
Antibiotics won’t cure a virus. So if you have a cold or the flu, which are caused by viruses, don’t coax your doctor into prescribing an antibiotic. In the long run, unnecessary use of antibiotics can put your health at risk in the future, Saman says. “It increases your risk of developing an infection in the future that we may not be able to treat,” he warns. “Whether or not to take an antibiotic should always be an informed decision made between the patient and the provider.” The bacteria C. diff is in the food supply too these days, Farber explains, but most people don’t develop the infection since they don’t take antibiotics. But if you’re asking for an antibiotic every time you have a virus like a sinus infection or upper respiratory infection, you can increase your risk for getting C. diff — in or out of the hospital. “Your question to your doctor should not be, ‘Can I have an antibiotic,’ but, ‘Do I need the antibiotic that you just prescribed to me,’ ” Farber says.
6. You can find out how your hospital’s infection rate compares with others.
Share your concerns about infections with your doctor before you go into the hospital, Saman advises. Ask what the hospital’s infection rate is and what protocols are in place for reducing it. You can also go to Medicare’s Hospital Compare site to learn a variety of facts about hospitals you are considering, such as rates of healthcare-associated infections and surgical complications.
7. Common objects in a hospital can be contaminated with disease-causing germs.
Stethoscopes, doctor’s white coats, and doctors’ ties can all carry disease-causing bacteria, Saman says. “One of the things a hospital can do to promote hygiene is to not have doctors wear ties,” Saman says. In other countries, the rate of HAIs decreased when doctors wore scrubs rather than white coats, and when they stopped wearing ties, explains Sean Elliott, MD, medical director of infection prevention at the University of Arizona Health Network in Tucson. “It’s a matter of great debate,” he says. “But interventions like these have been known to drop the infection rate.”
8. Surfaces like bed rails and hospital elevator buttons need to be kept clean, too.
Your doctor probably won’t tell you to wipe down surfaces in the hospital room with bleach or alcohol wipes. Yet high-touch areas like bed rails and elevator buttons can harbor the pathogens that cause infections. Karen Curtiss, whose father contracted several HAIs in the hospital following a lung transplant, including MRSA and C. difficile, spent weeks in the hospital with her dad. She was never told to wipe down any surfaces with bleach or alcohol, or even to wash her own hands. “We had no idea how easy it is to bring germs into the patient’s room,” says Curtiss. Her father died at the age of 71 from these untreatable infections — without ever leaving the hospital. RELATED: Just Bad Luck? One Family’s Tragic Story of Preventable Medical Error
9. Many hospital-associated infections are preventable.
You can take steps to help protect yourself or a loved one in the hospital. Since the biggest culprit when it comes to the spread of infection is unwashed hands, the first thing you can do is to wash your hands thoroughly with soap and water. If you are visiting, wash your hands every time you enter the hospital room. Make sure that you see doctors and nurses washing their hands, too. If not, insist that they do. Ask where you can find alcohol or bleach wipes and disinfect areas of the room such as the TV remote, telephone, and bedside chair. For a list of more ways to keep yourself and a loved one safe, check out the list that is published by Campaign ZERO, a patient advocacy group founded by Curtiss after her father passed away.
10. Hospitals make a concerted effort to lower the rate of HAIs among their patients.
In fact, many types of hospital-acquired infections have declined, according to a report released by the Department of Health and Human Services. From 2010 to 2013, hospitals saw a 28 percent decrease in urinary catheter infections, which saved over 4,000 lives. Infections of large central treatment lines went down by 49 percent, saving another 2,000 lives. MRSA decreased by 23 percent. But not all the news is good, C. Difficile infections increased by 17 percent. “One concern is that we do not have a coordinated healthcare system and uniform improvement or adoption of protocols has not taken place,” Kavanagh explains.” Some hospital systems, such as the Veterans Administration, may have very low rates of MRSA, and others may be much higher. Kavanagh stresses, “One cannot over emphasize the importance of checking with your doctor and Hospital Compare before choosing an inpatient facility.”
