AVOIDING INFECTION IN THE HOSPITAL
Be alert on any stay
In hospitals, there is considerable risk of contracting an infection during one's stay, since sick people have weakened immune systems. Knowing what kinds of procedures and precautions hospitals use to prevent and control infection is essential: an educated caregiver is more likely to notice and report ominous signs and risky practices.
A Clean Environment
The Hospital Setting
If at all possible, caregivers should assess the condition of a hospital before their patient-to-be is admitted. "As a rule of thumb, the hospital should be reasonably clean and organized, with its employees well-dressed and well-kept," says Steven F. Harwin, MD, FACS, Chief of Adult Reconstructive Surgery of the Hip and Knee at Beth Israel Medical Center in New York City.
Infection-Prevention Protocols
Staff Hand Care
Liquid Cleansers
Check that, both outside and inside every room in the hospital, there is a waterless cleaner dispenser. "Anyone or anything that comes in contact with a patient should be clean, or cleaned," says Dr. Harwin. "Every time I come into or go out of a patient's room, I take the pump and put cleanser on my hands," he says. "Caregivers should check that everyone on the staff complies with hand-washing rules."
Gloves and Gowns
"Ifa doctor or nurse is performing a procedure on a patient," notes Dr. Harwin, "they should put on gloves beforehand. If you're penetrating any part of a patient's body, the gloves must be sterile, but latex gloves can be used (unless, of course, you're allergic to latex) if you're removing rather than inserting something." Wearing a gown is not required, he notes, unless a patient is in isolation.
Instruments
Noninvasive
Make certain that, if a doctor is using a stethoscope to listen to a patient's heart, the physician cleans off the stethoscope with a sterile cleanser before and after use, notes Dr. Harwin. Thermometers should also be sterile or sterilized before and after use.
Invasive
Ifa staff member is inserting a device like a urinary catheter or a tube into a patient, check that the professional cleanses the genital area with an antiseptic like chlorhexidine soap to remove bacteria. "The catheter should also be sterilized with a sterile lubricant before insertion," says Dr. Harwin. Removing a catheter is less problematic, "but generally one cleans around the area after the removal," he says.
Visitors' Health
Unpredictable situations can arise when visitors who are not caregivers enter the room to see a patient, or a patient's roommate. If a visitor is unwell, perhaps coughing or sneezing, he should not come near the patient. But if he merely suspects that he may be catching cold, for example, the caregiver could request masks for herself and her patient-although usually it's the hospital staff who wear masks (and gowns) to protect themselves from patients with contagious diseases. "It's almost impossible to protect against this kind of situation," says Dr. Harwin. "But people should be aware that most hospitals do have an air-conditioning system that filters the air to a degree.The chance of a cough causing a communicable disease is quite rare, however, even if a patient has pneumonia," he says.