The Health Care System Blog

How to Avoid Hospital Acquired Infections

Brent Aleshire — Sun, 22 Jan 2012 14:56:30 +0000

The Health Care Encounter

“Don’t touch me!” That’s probably what George should have said to his doctor but he didn’t. Most patients don’t. I was in George’s room to assist with the completion of a health care power of attorney document. George was in isolation due to an infection. Anyone could tell he was in isolation as a result of the “big” sign outside of his room that alerted all those who entered of the proper precautions. The precautions included putting on a hospital gown and wearing protective gloves.

The gloves and hospital gown that I had on did not interfere with my conversation with George. What stopped us was George’s physician who came into the room to join the conversation without his gloves or gown. George’s doctor preceded to touch everything including the patient, bedrail and my nerve!

Yes, I understand that physicians can be very busy. The problem is that bacteria and germs do not care who they attach themselves to. My thought immediately turned to “who” was the unsuspecting patient he would see next?

Health Care Consumers at Risk

“Gowning and gloving” as they call it in the hospital is time consuming but essential to stop the spread of infection. Health care acquired infections kill as many as 90,000 people annually in the United States, according to the Centers for Disease Control and Prevention. Another 1.9 million people nationwide who develop such infections endure longer stays in the hospital. Approximately 5 to 10 percent of all hospital patients develop infections.

More Americans die each year from hospital acquired infections than from auto accidents and homicides combined. Even though the problem is well documented, the risks of getting a hospital infection have steadily increased.

The good news is that health care facilities can reduce infection rates significantly by proper implementation of infection control practices, especially hand washing. Unfortunately, many hospitals have not done so. According to the National Quality Forum, most studies report hand washing compliance rates that are generally less than 50 percent.

Safety Strategies

With these frightening statistics in mind, here are several action steps that an empowered health care consumer can do to decrease the likelihood of a hospital acquired infection.

o Use anti-bacterial wipes to clean the telephone, TV remote and bedrails. Studies show that many patients’ rooms are contaminated with MRSA (methicillin-resistant Staphylococcus aureus) and VRE (Vancomycin-resistant Enterococci).
o Request that all hospital staff wash their hands or use an alcohol-based hand sanitizer before touching you.
o Wash your hands frequently.
o Be sure that all intravenous tubes and catheters are inserted under sterile conditions.
o Choose a surgeon with a low infection rate.
o Ask your doctor if you need to take an antibiotic prior to surgery.

The Committee to Reduce Infection Deaths http://www.hospitalinfection.org offers a comprehensive guide to reduce your risk of acquiring a hospital infection. Arm yourself with as much information as possible. Remember, prevention works, and don’t be afraid to say, “don’t touch me!”

Personal Medical Journal – Take Charge of Your Health Care

Brent Aleshire — Sun, 09 Oct 2011 13:20:57 +0000

Research suggests that patients who take a more active role in visits with their physician may have a greater sense of control and much better health outcomes.

Participation in your own health care can be dramatically increased through the use on a personal medical journal. Here are several additional benefits of using this powerful management tool.

Better Health Status – It has been observed that more effective gathering by patients, and more conversation by patients with their physician during office visits was related to better health status.
Avoiding Duplication of Tests – Keeping track of all tests and treatment history will save your time and money by avoiding duplication of tests and procedures. Repeating tests and procedures are not only costly but they can also expose you to potential medical errors.
Increased Partnership with Physician – A personal medical journal will be your personal tool to effectively enter into a full partnership with your physician and many other health care professionals. A good partnership with your doctor begins with open communication. Keeping a complete and accurate record of your history will strengthen communication with your physician as you can provide them with useful information.
Become Empowered – Information is the key to patient empowerment. As you gather information about your condition you will become more informed about treatment options. This will allow you to manage your condition more effectively and increase your sense of well being. You will then become empowered rather than victim to your condition.
Improve Chance of Correct Diagnosis – According to the American Society of Internal Medicine, 70% of a correct diagnosis depends on what the patient tells the doctor. The use of a personal medical journal will help you share vital information with your physician about your symptoms. Having more data available will help your physician make better decisions. With this information-rich data at hand you may be able to provide your treatment team with the one crucial item of information that helps secure a correct diagnosis.

Take charge of your own health care with the use a personal medical journal. This will allow you to “collect and share” valuable health information with all of your providers. Use this powerful tool to help you get the best of what our health care system has to offer.

Hospital Discharge – How to Plan For a Safe Discharge

Brent Aleshire — Tue, 09 Aug 2011 20:43:51 +0000

Be aware that all unplanned, rushed or poorly coordinated discharges from hospitals are very dangerous! A recent study in the New England Journal of Medicine concluded that one in five Medicare patients are readmitted to the hospital within 30 days. One in three are back within 90 days. The author suggests that many of these problems are related to inadequate coordination of care and poor discharge planning.

Why This Happens

Discharge planning is not always given the care and attention necessary for a smooth transition from the hospital. All patients should receive detailed care instructions in their language and at their health care literacy level. Unfortunately, this does not always happen.

Hospital staff members are under intense pressure to release you as soon as they can. Those in the health care industry have coined the term “quicker and sicker” when they describe how patients are now discharged from hospitals. As a direct result of such early hospital discharges:

41% of patients are discharged with test results still pending.
13% of these tests are of an urgent nature.

What’s worse, at the time of discharge, one half of adults have trouble understanding their prescriptions or discharge instructions. In addition, less than one-half of patients know their diagnosis, treatment plan or side effects of prescribed medication.

The results of poor care coordination at the time of a hospital discharge can jeopardize your health and safety. Here is my recommendation; don’t allow this to happen to you or a loved one.

Take Active Role in Your Discharge Plan

You must insist on a well planned and coordinated hospital discharge plan. At the very least, be sure to:

Receive the necessary discharge education about the condition that brought you to the hospital. Take full advantage of the expertise of the hospital staff. Ask as many questions as necessary to gain a full understanding of your condition, diagnosis, and treatment plan. Ask for written information as well.
Request to meet with the hospital pharmacist to review all of your discharge medications. Be sure to discuss any changes, additions or deletions of medication that you were taking before your hospitalization. This process is called “Medication Reconciliation” and is essential to a safe discharge. It has been found that between 20 and 30% of all hospital readmissions within 30 days are the direct result of medication issues.
Find out when you need to follow up with your medical team such as your primary care physician, surgeon or specialist. This is critical as a well coordinated discharge plan will involve timely follow up care.
Be sure that your primary care physician receives copies of your discharge medication list and instructions. Take your copy with you to your follow up appointment.

These are just a few of the items that need to be contained in your official discharge plan. Remember, this may not happen unless you request it. You will increase the likelihood of a safe discharge when you are an active participant in discharge planning.