Stop Deadly MRSA with a Few Simple Questions

Knowing what to ask may get you out of the hospital without a dangerous infection.

April 2, 2009

Show of hands: If you didn't see your doctor wash up, ask him about it.

RODALE NEWS, EMMAUS, PA—They travel on everything from paper gowns to hospital gurneys and cost the U.S. up to $4 billion a year in added health-care costs. But research presented at a recent conference of the Society for Healthcare Epidemiology shows that drug-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), can be kept under control if hospitals make simple improvements to their cleaning methods. And patients can take their own steps to protect themselves.


THE DETAILS: A study funded by the Centers for Disease Control and Prevention (CDC), found that improved cleaning methods and educational campaigns for hospital cleaning staff reduced intensive care patients’ risk of acquiring MRSA from 3.5 percent to 1.9 percent, and reduced risk of infection by other strains of drug-resistant bacteria from 4.5 percent to 3.5 percent. Another paper presented at the conference showed that hospitals that engaged in “best practices” saw a 16 percent reduction in MRSA cases. Best practices include contact precautions—keeping MRSA from spreading by direct or indirect contact with an infected patient—staff education programs, a program to detect and track patients with MRSA, and monitoring hand washing.

MRSA, which can cause a potentially fatal skin infection that does not respond to standard antibiotics, has been found on surfaces in hospitals and health-care facilities ranging from bed rails and bedsheets to gowns, lab coats, and even doctors’ neckties. MRSA can thrive for up to 3 weeks on dry surfaces, says Christine Nutty, RN, MSN, CIC, president of the Association for Professionals in Infection Control and Epidemiology. “Other [drug-resistant] bacteria can live even longer,” she adds. Which is why the British National Health Service has instituted a “bare below the elbows” rule, prohibiting doctors and other health-care professionals from wearing ties and long sleeves. There’s no similar law in the U.S.

WHAT IT MEANS: Preventing infection can’t be limited to removing lab coats, cleaning dirty bed railings, or even just washing one’s hands—patients have to do their part too. “It takes a lot of things all together to fight infections,” says Nutty. “You need everything working together.” One of the best protections: “Patients need to be informed and ask questions.”

Here are a few questions that Nutty recommends every patient ask before going to a hospital, either for routine checkups or major surgery:

• What is your infection rate? Hospitals are under economic strain nowadays and may not thoroughly monitory all kinds of infections, but it doesn’t hurt to ask, says Nutty. And doing so encourages transparency, something she thinks hospitals could use more of in this country.

• Have you washed your hands? This is a big one. Patients may feel intimidated to ask a doctor or nurse this question, but it’s becoming more common. If the doctor hesitates to answer, ask him or her to wash up in front of you. The Centers for Disease Control and Prevention has an online podcast that offers suggestions about how to ask this of a doctor or nurse. (You can watch the video, but listening to the audio track is almost as informative.)

• Will you use a razor? This applies if you’re having surgery. Razor blades can cause microscopic nicks that open the skin to infection. Nutty recommends asking the nurse or surgeon to use clippers with a disposable blade to remove hair from the site of your incision.

• Am I clean and healthy? This is a question to ask yourself. “The patient plays a great role before they come to hospital,” says Nutty. Taking a shower or bath before you come in for surgery can go a long way in preventing infections when you go under the knife. It’s also important to eat a healthy diet, which boosts your immune system’s ability to heal itself and fight off postsurgery infection.