THE DETAILS: Investigators for Extending the Cure, a project that focuses on antibiotic resistance, analyzed 69 million hospital discharge records from hospitals in 40 states. They focused on two common conditions caused by hospital-acquired infections: sepsis and pneumonia. These conditions are often caused by dangerous microbes, including antibiotic-resistant bacteria like MRSA. “In many cases, these two conditions could have been avoided with better infection control in hospitals,” says Ramanan Laxminarayan, PhD, principal investigator for Extending the Cure. Sepsis is a serious condition that develops when the bloodstream is overwhelmed with bacteria. In hospital-derived infections, this is often the result of faulty sterilization techniques during surgery. Pneumonia is a severe respiratory infection that, when it is contracted in the hospital, is usually caused by contaminated respirators.
Researchers found that among patients who developed sepsis after surgery, 20 percent died. The condition also resulted in 11 extra days in the hospital on average, and an additional $35,000 in hospital costs for each patient. Hospital-acquired pneumonia resulted in two extra weeks in the hospital and nearly $50,000 in additional costs per patient. In 11 percent of the pneumonia cases, the patients did not survive. "These so-called superbugs are increasingly difficult to treat and, in some cases, trigger infections that ultimately cause the body’s organs to shut down," Malani says.
Read on to learn about specific things you can do to reduce your risk of getting sick while in the hospital.
WHAT IT MEANS: Hospital infection rates represent a significant health threat, one that's not getting the attention it deserves. But there are ways to reduce your risk of acquiring an infection in the hospital. Here's what you can do to protect yourself and your loved ones:
• Lobby for commonsense solutions. "This is a problem that healthcare providers have to take on,” says Malani. “The hospital isn't on the hook to pay when they infect you." Rather, taxpayer-funded Medicare foots a huge portion of these bills, except in instances when the hospital is blatantly in the wrong, such as when an operating-room instrument is left inside a patient during surgery.
Malani also contends that Medicare and private insurance companies should refuse to pay for all hospital-acquired infections. He urges people to contact their elected officials, telling them you don't think doctors and hospitals should see any financial gain from infecting patients with deadly conditions. "We need to align incentives to make sure that what is in hospital's financial interests is also best for the patient," he says.
• Make inquiries. It isn’t mandatory in all states for hospitals to report infection rates, but it's still worth asking your state's health department or the hospital itself for that information before you have an elective procedure. The Centers for Disease Control and Prevention National Health Safety Network is another resource for the information. Based on what you find out, don’t be hesitant to shop around. You should ask whether the hospital uses the “bundle” system, a series of evidence-based preventive strategies that, when taken together, can greatly reduce infection rates, says Stephen Streed, MS, CIC, board member of the Association for Professionals in Infection Control and Epidemiology.
• Get clean ahead of time. Before you schedule an elective surgery, ask your doctor if he or she can give you a take-home antiseptic agent that you can bathe with the night before and morning of the surgery. Also, request a nasal swab to check to see if you're carrying MRSA. If you are a carrier, doctors may use suppression protocols to reduce risk of an infection after surgery. Finally, ask if your doctor plans to prescribe prophylactic antibiotics to lower your risk of infection.
• Stick up for yourself. Be willing to ask a doctor, nurse, or aide to wash his or her hands or sanitize them before touching you, or put gloves on. When internists, dieticians, quality-of-life aides, and therapists make their rounds to your room, question what they are doing. For example, ask if it's necessary at that point to keep the IV in your arm. "The longer any device is in place, the more likely there will be complications associated with it," says Streed.
If a loved one is on a ventilator, perhaps because of a trauma or sepsis, ask for what’s called a “sedation vacation,” which allows the patient to come out of sedation long enough to see whether he or she can breathe independently. This could shorten the amount of time spent hooked up to the machine, which may lower the risk of infection.
• Be a good visitor. Visitors are not the primary contaminators at a hospital, but they should take steps to reduce the risk of infecting a patient. If you're visiting someone, don't touch or tinker with any tubes or IVs, and don't allow the patient to show off his or her new surgery wound, as cool as this may seem.
• Don't go under the knife sick (if you can help it). It’s very important to postpone an elective procedure if you are feeling ill. "You need to be candid with your surgeon if you have an infection or have done so recently," explains Streed. "An infection in another area of the body increases the risk of postoperative infection at the surgical site," he says. And while it's always a good idea to eat well in order to stay healthy, it's imperative to get plenty of immune-boosting foods in the days leading up to and following a hospital visit.