6 Tips for Patients to Avoid Healthcare-Associated Infections
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When a loved one is hospitalized, the last thing anyone wants is for them to get an infection while receiving care. Yet, according to the Centers for Disease Control and Prevention (CDC), on any given day, about 1 in 31 U.S. hospitalized patients has a healthcare-associated infection (HAI).
An HAI is an infection that develops during or soon after receiving health care or being in a healthcare setting, such as a hospital, clinic, doctor’s office, surgery center, or nursing home. Common HAIs include bloodstream infections, surgical site infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia.
Follow these 6 tips to help you and your loved ones prevent HAIs:
1. Speak Up and Ask Questions
Advocate for yourself and your loved ones by talking with the healthcare professionals caring for you. When a specific treatment is recommended, such as an IV or urinary catheter, ask why it is needed, what the risks are, and when it can be removed. Write down your questions in advance to help remember details. You should feel empowered to ask questions and share any concerns.
2. Keep Your Hands Clean
Make sure that everyone around you, including healthcare professionals, caregivers, and visitors, clean their hands with soap and water or with alcohol-based hand sanitizers when they enter or leave your room and just before touching you or your devices, dressings, or equipment. If you do not see a healthcare professional clean their hands, simply remind them to “please clean your hands, thank you.” If everyone routinely washed their hands, countless deaths could be prevented. This video shows the right (and wrong) way to wash your hands: How to Wash Your Hands (nfid.org).
3. Be Antibiotics Aware
Antibiotics do not treat respiratory infections caused by viruses, like colds, flu, and COVID-19. Never demand an antibiotic if it isn’t prescribed. When antibiotics aren’t needed, they won’t help you, and the side effects can be harmful. Even when they are needed, antibiotics can still cause side effects and contribute to antimicrobial resistance. Talk with a healthcare professional about the best treatment for your illness.
4. Recognize the Signs and Symptoms of an Infection
Learn how to recognize early symptoms of an infection, such as a fever. If you have recently had surgery, look out for redness, pain, or drainage where the incision was made in your skin, without touching the site directly. Never touch IV lines. Keep cuts and wounds clean and covered until healed. If you had a urinary catheter, look for signs of a urinary infection, such as pain or burning when urinating. Talk with a healthcare professional about what signs and symptoms you should look for and what to do to ensure prompt and proper treatment if you do get an infection. If an infection isn’t stopped, it can cause sepsis, a life-threatening medical emergency. Healthcare professionals should immediately evaluate and treat people who might have sepsis.
5. Stay Up to Date on All Recommended Vaccines
Staying up to date on all recommended vaccines can help you stay healthy, avoiding the need for health care in the first place. Everyone ages 6 months and older should get an annual flu vaccine and stay up to date with their COVID-19 vaccines. Talk with a healthcare professional about other vaccines you may need.
6. Don’t be a Dreaded Spreader
Don’t share your germs when visiting someone in a hospital, nursing home, or other healthcare facility. Do not visit a healthcare facility if you don’t feel well. Wash your hands often. Stay home when sick and use precautions, such as wearing a mask where and when required. Masks can help reduce the spread of some germs.
All of us—patients, caregivers, loved ones, and healthcare professionals—play a role in preventing HAIs. Follow these tips to help protect yourself and those you love. To learn more, visit National Foundation for Infectious Diseases (www.nfid.org).
Author:
Patricia (Patsy) A. Stinchfield, RN, MS, CPNP is president of the National Foundation for Infectious Diseases (NFID). A pediatric nurse practitioner specializing in vaccine-preventable diseases, she currently has an affiliate faculty position in the School of Nursing at the University of Minnesota. Prior to her retirement, she served as senior director of infection prevention and control at Children’s Minnesota, where she remains on professional staff.
6 comments on “6 Tips for Patients to Avoid Healthcare-Associated Infections”
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This blog post was absolutely stellar!!
Patient Safety is very important. However, little or no progress has been made in HAIs in the last twenty five years, when To Err is Human was published. In addition, the increase in complexity of procedures and outpatient facilities providing medical care has increased. Infections in these outpatient facilities are not as carefully monitored as hospitals. How can prevention of HAIs in hospitals and health systems, including outpatient sites, be improved?
It would be nice if the comment software would retain linebreaks instead of running all the sentences together.
CDC needs to start seriously considering public comments, expert opinions, and expert reviews of evidence. Please listen to and discuss the input from nonvoting members on advisory committees. Please use Regulations.gov, instead of blog responses, to solicit public comments.
My comments focus on airborne infectious diseases.
Please model respirator use in public settings; it is the most visible layer of protection against the transmission of airborne viruses [1].
CDC guidance should be assertive and authoritative, such as using “should” instead of “consider”. The COVID-19 pandemic has revealed that my personal healthcare providers take the language literally and interpret any equivocation to mean the recommendation is entirely unnecessary.
As the healthcare workers look to the CDC for authoritative information, the public looks to healthcare workers for cues about how seriously to take precautious measures. The dropping of precautions and blogs such as this one that ignore airborne transmission have translated to the public that the pandemic is over [2], COVID-19 is not a threat [2], and there are no serious consequences to getting COVID-19 [2]. In fact, the pandemic continues [3], COVID-19 is still common and has surges [4], and there are still serious consequences (death [5], long Covid [6], increased risk from other infections [7]) to having COVID-19.
In addition to the CDC’s impact on domestic health care and public practices, for decades, the world looked to CDC for authoritative information and guidance. The COVID-19 has shown the world that government agencies, including CDC, can get away with disseminating misinformation and weak versions of facts. Repairing the resulting breaches in trust by scientists and science-based public agencies around the world needs to begin. This blog, by putting the onus on patients rather than healthcare providers, and giving patients inadequate guidance, to boot, wastes a crucial opportunity to make repairs by demonstrating a scientific base and precautionary (“do no harm”) stance.
Your blog should state:
A. Based on current scientific evidence, masks (less than N95 quality) are inadequate controls for airborne pathogens. Now that we know that tuberculosis, measles, influenza, chicken pox, etc, in addition to COVID-19, are airborne [8], respirator use should be universally consistent in all healthcare spaces (direct care, backroom, support, and administrative). Many people are in ubiquitous healthcare spaces (waiting areas, hallways, diagnostic testing areas, initial assessment areas) before test results are obtained. The air in those spaces circulates in the entire areas and into other areas [9-10] and we know viruses can remain viable in the air for hours [11]. Furthermore, about half of people who are spreading SARS-CoV-2 have no symptoms and are unaware that they are infectious [12-13]. Therefore, we need to take precautions (act like everyone is infectious), especially in settings attended by vulnerable people who may be invisibly vulnerable.
B. CDC communications should validate that people want to avoid infection from both well-established and new pathogens. Health care settings must act as if dangerous viruses are in the air if they don’t actively take precautious measures to prevent that state.
C. Healthcare organizations should mandate universal consistent use of respirators. They should provide fit testing with a variety of respirators and provide for each employee the model that fits best with the most comfort. Patients and visitors should be greeted with an offer to fit test a wide variety of disposable N95 masks and either mandated or asked to consistently wear the best fitting respirator while they are in the facility. Every person should be allowed to voluntarily wear an even higher level of protection.
Patients who enter rooms that are incompatible with typical N95 masks should be offered and encouraged to wear a compatible alternative, such as RediMask that has no metal.
Patients and their medical advocates who cannot wear a respirator for medical reasons should: be encouraged to wear the most effective type of mask they can tolerate, be isolated from other patients and visitors in a private room, and be in the presence of their own or a facility-owned operating portable HEPA filter.
D. In addition, there needs to be effective control of healthcare worker sources. Over half of COVID transmission occurs from people who don’t know they are infected [12-13]. Infectious people should isolate. Therefore, healthcare workers (direct care, backroom, support, and administrative) should be required to test positive before each shift. They should receive full pay to isolate while they either test positive or have symptoms. Each facility should hire enough staff to cover duties when employees are out sick during surges.
REFERENCES
1. Stop transmission with the five pillars of prevention. World Health Network. 2023 Mar 27. https://whn.global/stop-transmission-with-the-five-pillars-of-protection/.
2. Tyson A, Pasquini G. How Americans View the Coronavirus, COVID-19 Vaccines Amid Declining Levels of Concern: Continued decline in share of U.S. adults with up-to-date vaccination. Pew Research Center. 2024 Mar 7. https://www.pewresearch.org/science/2024/03/07/how-americans-view-the-coronavirus-covid-19-vaccines-amid-declining-levels-of-concern/.
3. Provisional COVID-19 new hospital admissions, by week, in the United States, reported to CDC. CDC. Accessed 2024 Mar 14. https://covid.cdc.gov/covid-data-tracker/#trends_weeklyhospitaladmissions_select_00.
4. Paris F. We Are in a Big Covid Wave. But Just How Big? Wastewater data has become perhaps the best metric to track the spread of the virus in the U.S., but it’s an imperfect tool. New York Times. 2024 Jan 10. https://www.nytimes.com/2024/01/10/upshot/covid-pandemic-wave.html.
5. Provisional COVID-19 deaths, by week, in the United States, reported to CDC. CDC. Accessed 2024 Mar 14. https://covid.cdc.gov/covid-data-tracker/#trends_weeklydeaths_select_00.
6. Table 8. Duration of COVID-19 Symptoms and Ability to Carry Out Everyday Activities, by Select Characteristics. Phase 4.0 Cycle 01 Household Pulse Survey: January 9 – February 5. US Census Bureau. 2024 Feb 22. https://www.census.gov/data/tables/2024/demo/hhp/cycle01.html.
7. Severe COVID-19 may cause long-term immune system changes. NIH COVID-19 Research. 2023 Oct 27. https://covid19.nih.gov/news-and-stories/severe-covid-19-may-cause-long-term-immune-system-changes.
8. Pietrangelo A, Weatherspoon D. What are airborne diseases? Healthline. 2023 May 19. https://www.healthline.com/health/airborne-diseases.
9. Mingotti N, Grogono D, dello Ioio G, et al. The Impact of Hospital-Ward Ventilation on Airborne-Pathogen Exposure. Am J Respir Crit Care Med. 2021 Mar 15; 203(6): 766-769. DOI: 10.1164/rccm.202009-3634LE.
10. Prather KA, Marr LC, Schooley RT, et al. Airborne transmission of SARS-CoV-2 [letter]. Science. 2020 Oct 5; 370(6514): 303-304. DOI: 10.1126/science.abf0521. https://www.science.org/doi/10.1126/science.abf0521.
11. Indoor Air and Coronavirus (COVID-19). US Environmental Protection Agency. 2023 Jun 7. https://www.epa.gov/coronavirus/indoor-air-and-coronavirus-covid-19.
12. Ma et al. Global Percentage of Asymptomatic SARS-CoV-2 Infections Among the Tested Population and Individuals With Confirmed COVID-19 Diagnosis: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021 December 1; 4(12): 22137257. DOI: 10.1001/jamanetworkopen.2021.37257.
13. Mugglestone MA, Ratnaraja NV, Bak A, et al. Presymptomatic, asymptomatic and post-symptomatic transmission of SARS-CoV-2: joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance. BMC Infectious Diseases. 2022; 22: 453. DOI: 10.1186/s12879-022-07440-0.
Hilariously incongruous article, considering that by removing isolation guidance for COVID-19 the CDC has just further increased the risk of hospital-acquired COVID-19 infections. The fact that N95s aren’t required in the healthcare setting in the middle of a deadly airborne pandemic just because people don’t like wearing them is simply embarassing. I’m more likely to get a COVID-19 infection from my annual colonoscopy, during which I cannot wear an N95 and no healthcare providers wear any kind of respirator, than I am from going to the grocery store. Contagious individuals should not be allowed to return to work regardless of if they wear a respirator. The CDC has truly let the American people down.
“mask”, as in surgical mask, only “where and when required.” Can you please elaborate as to where and when masks– let alone respirators– are required? Are masks required in oncology? When visiting a loved one in the ICU? And please address whether surgical masks are adequate to prevent transmission of airborne (ie aerosol-spread) viruses? Thanking you in advance for sound public education which may result from answering these questions.