I cruise the newswires daily in search of all infection prevention-related news to post on our Web site and to feature in our weekly e-newsletters, and I was encouraged by a press release issued by University of Kansas Hospital that discussed the right questions a patient should ask about how hospitals prevent infections. I commend Nina Shik, RN, an infection control professional at the U of K hospital in Kansas City, Kan., for coming up with these questions and for no doubt helping to spearhead this press release. The six suggestions Shik encourages patients to follow to determine if a hospital is doing enough to ensure patient safety, are:
1. Talk to your physician: Ask your doctor or surgeon about possible risks of infection associated with a particular procedure or test and what specific steps will be taken to reduce the risks of infection.
2. Adopt a good reporters tactics: Watch before and after an examination, do doctors wash their hands? If not, ask them to do so. Look around, is the hospital environment clean? Signs of unclean hospitals include dirty floors, dirty countertops, clutter, and healthcare workers who dont look professional.
3. Comparison shop: Compare the hospitals infection rate with the national rates published by the CDC. Low rates are good, and a rate below the CDC 10 percentile rate is considered very low. Ask how many trained and certified infection control practitioners are employed. The appropriate number of ICPs per occupied hospital beds is about 1 per 100, especially for acute-care medical centers, based on a recent study.
4. Query the nursing staff: Inquire if hospital beds, especially intensive-care beds, are elevated at 30 degrees for patients requiring a ventilator, to help prevent ventilator-associated pneumonia.
5. After any procedure, be persistent about cleanliness: If a catheter is in place, inquire if its still needed since bacteria can enter the device and quickly spread through the body. Ask if incisions are dressed appropriately and if any sign of infection has appeared.
6. Ask the unobvious questions: The CDC advocates isolation to prevent transmission of germs in high-risk patients. If placed in isolation, ask questions about how aggressive the hospital is with infection control strategies in isolation rooms and floors. Does the hospital screen high-risk patients? What kinds of patients are considered high risk? Does it carry out cultures on them to see if they carry antibiotic-resistant bacteria and should be isolated? Does the physician or staff check whether a patient is up to date with vaccines? Are hospital employees who are sick told to stay at home or go home if theyre at work? Ask about the hospitals procedure for identifying infection and dont forget to ask about custodial services. The infection control team should make regular rounds to examine the environment and ensure all appropriate disinfection methods are followed.
Dont shy away from being nosy and inquisitive, warns Shik. As a consumer, you want to feel someone is listening to you and being forthright with you especially about a life-and-death matter. The press release adds, Infection control is a constant challenge. Thats why its necessary for a hospital to retain a contingent of qualified, trained and enthusiastic sleuths with good science skills to be on continual alert. These personnel are essential to ensure that infection control ranks as a priority for everyone at the hospital. I couldnt have said it better myself.
Until next month, bust those bugs!
Kelly M. Pyrek
Group Editor, Medical Division