The Patient’s Role in Preventing Infections

An estimated 100,000 patients will die this year from infections they get while in the hospital. According to the Centers for Disease Control, last year in Massachusetts there were 2,500 reported cases of MRSA (methicillin-resistant staphylococcus aureus), a strain of bacteria resistant to antibiotics that can be fatal. Beneath these tragic numbers lies an empowering fact: each of us can dramatically reduce the chances of becoming one of them.

Infections are not just in hospitals, but also in other places, like school or the gym, where germs tend to flourish. With school in session and sports teams practicing, the number of so called ‘community-acquired infections’ increases. Steps as simple as washing hands properly or keeping exercise equipment clean can prevent a vast array of infections that could otherwise become serious medical problems.

It’s especially important that we tackle this challenge here in Massachusetts. Our state is correctly proud that we deliver world-class health care, but when it comes to preventing infections, we aren’t keeping up. In a 2006 study by Health-Grades, a national health care ratings organization, Massachusetts’s rate of hospital-acquired infections was higher than the national average and more than double that of Wyoming, the state with the lowest rate of infection.

Hospitals bear a responsibility to their patients to change that. At my hospital, for example, we’re conducting a wide-ranging campaign to reduce infections, including educational outreach to both patients and clinicians. We’re also posting on our Web site our rate of infections — as well as other measures of how well we deliver health care — so patients can know how we compare to other hospitals and can hold us accountable. Many other hospitals are beginning similar efforts.

Patients, too, have an important role to play in preventing infections, and the Partnership for Healthcare Excellence, a coalition of Massachusetts health care organizations, is playing a key role in educating people on how they can become informed, empowered patients and ensure the care they receive is of the highest quality.

What can patients do to prevent infections? Wherever you are — whether it’s at home, school, the gym, or someplace else — washing your hands regularly is the most powerful thing you can do to prevent infection. Our hands are the vehicles for transferring many germs from the outside world to the inside of our bodies. The brief amount of time it takes to wash them is nothing compared to the costs — in time, money, and suffering — of an infection. Materials on handwashing, including a brochure, poster, and coloring book for children, are available from the Mass. Medical Society at www.mmsalliance.org.

It’s also important to cover your mouth and nose if you sneeze, and to wash your hands afterward, for your own health, and for that of people around you. Take care of cuts, scratches, and wounds. If your skin gets dry or cracked, use moisturizer to heal it. Your skin’s job is to keep germs out, and an open cut or crack invites them in.

Many of those steps will also help prevent infections if you’re in the hospital. But hospitals, of course, are places where germs present special risks — and require special precautions.

If you go to the hospital, ask every worker with whom you come into contact — a doctor, nurse, technician, or whomever else — whether they’ve washed their hands. Don’t worry about insulting them. Good caregivers appreciate patients who take an active role in their health. Visitors should wash their hands when they come to see you as well.

If you’re going in for surgery, shower first so that you bring fewer germs into the hospital with you. If your caregiver wants to shave part of your body before surgery, ask them to use clippers instead of a razor; shaving creates tiny nicks and cuts that allow germs into the body. Before surgery, talk with your doctor about preventing infection. Often it’s appropriate to take antibiotics before surgery, not just afterward.

Visit www.partnershipforhealthcare.org for more information and links to other resources on preventing infections at medical facilities, at home, and in the community. You have the power to take charge of your health care just like you do for other aspects of your life. That’s your right — and it’s your responsibility, too.-

Dr. Ronald B. Goodspeed is executive vice president of Southcoast Health System, formerly president of Southcoast Hospitals Group, and president of the Mass. Coalition for the Prevention of Medical Errors.

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