How to stay safe and avoid other infections while Hospitalized
Patients who are admitted to hospitals may not always achieve expected outcomes. While this does not happen to everyone, chances are that it could happen to you. Knowing what to expect , how to stay safe, and appropriate questions to ask health care providers are key to successful recovery while hospitalized.
Patients who are hospitalized should expect the following: High quality care, a clean and safe environment, involvement in their care, protection of their privacy.
High Quality Care:
All patients deserve high quality health care when they get admitted to a hospital. High quality care means care from people who are adequately trained to treat your condition, or people who are adequately trained to perform a surgical intervention required to make you better.
Ask caregivers to explain their qualifications. For example; what is the difference between an Intern or a Resident? Are you Registered Nurse or a Licensed Practical Nurse and what is the difference? What are the functions of a Certified Nurses Assistant?
An intern is a physician who has recently graduated from medical school and is undergoing supervised training before beginning his residency program. A Resident is a physician receiving specialized clinical training in a hospital after completing his internship. You have a right to refuse a procedure that will be performed by an Intern especially if you are his first patient.
A Registered Nurse is a nurse who has undergone extensive training, passed a state registration examination and is licensed by the State to practice Nursing. A LPN is a Nurse who has completed a practical Nursing Program, most often at a technical vocational high school and is licensed by the state to perform patient care under the direction of a Registered Nurse.
Do not assume that a Licensed Practical Nurse (LPN) is qualified to perform the same activities as a Registered Nurse (RN). An LPN may not have the same assessment skills as a RN and may misinterpret signs that are significant in diagnosing certain conditions. For example, a LPN may not have the ability to differentiate between a pericardial friction rub from wheezing within the lungs. A friction rub is rubbing of the outer layer or the sack that encloses the heart. This may lead to a delayed diagnosis of Pericarditis (inflammation of heart).
LPNs are also not qualified to give certain types of IV drugs without supervision.
CNAs are unlicensed personnel who work under the supervision of a nurse. CNAs assist patients with activities of daily living such as; feeding, bathing, toileting, grooming, repositioning and changing of bed linen. CNAs are not allowed to give medication, perform dressing changes or conduct patient assessments.
As a patient, you should also learn the identity of your caregivers. Nurses and doctors are required to wear identification badges so that patients in their care can easily identify them. If a care giver does not have a name tag you should remind him or her that the name tag is missing and immediately get a name.
In one case, several Certified Nurses Assistants (CNAs) in a health care facility decided to identify themselves by the same name to a patient who was slightly confused. The patient could not understand why she was being cared for by so many different “Suzies.”
A Clean and Safe Environment
Many patients acquire infections in hospitals that they did not have prior to being admitted. These may include a host of urinary tract infections, gastrointestinal tract infections or blood stream infections. It is very common to see several rooms in the Intensive Care Unit (ICU) and telemetry Units of hospitals marked with signs such as: “Do not enter before speaking with Nurse.” These signs usually indicate that the patient is being isolated due to some infection that they were diagnosed with.
MRSA & C. Diff
The most common types of infections that are acquired in the hospital setting are bacterial infections. The two most common types of bacterial infections are Methicillin Resistant Staphylococcus (MRSA) and Clostridium Difficile (C. Diff). MRSA is a bacterium that is resistant to many antibiotics. Patients with these conditions need to be isolated from other patients as these diseases are very contagious.
Patients diagnosed with MRSA may initially notice a skin abscess with draining pus. MRSA may cause pneumonia, serious blood stream infections and surgical site infections in the hospital. . MRSA may also affect bones and organs. MRSA is very difficult to treat. Patients with MRSA need to be isolated because MRSA is easily transferred from one patient to another. MRSA is treated with antibiotics.
C. Diff is a bacterial infection that is also spread by hand to hand, or hand to body contact in hospital settings. C. Diff may cause diarrhea, inflammation of the colon  loss of appetite, fever, weight loss and other symptoms. C. Diff is treated with antibiotics.
The patients in units such as telemetry and ICU do not walk around and socialize, yet multiple patients on these units are contaminated with MRSA and C. Diff caused by the very people entrusted with their care.
General Safety Tips:
1. Hand Washing
Make sure that care givers are washing their hands. Check to see whether care givers are going from room to room in the same gloves. MRSA and C. Diff are transferred by the hands of nurses, doctors, CNAs and other care givers in then hospital. Do not be afraid to ask care givers if their hands are clean or to instruct them to wash their hands before they touch you. The hand soap and hand sanitizers that are used in the health care setting contain chemicals that kills bacteria.
IV catheters and Foley catheters (urinary catheter) should be inserted using sterile technique. Sterile means free from germs. This means that your nurse should not be pulling a pair of gloves from a box on the wall to insert these devices. The gloves used for these procedures should be individually wrapped and labeled sterile. Most facilities have IV insertion kits and Foley catheter insertion kits that contain all sterile equipment for insertion of these devices. Prior to inserting a Foley catheter or an IV, nurses should wash their hands. All the supplies should be placed on a sterile towel. There should be no touching of objects that are not on the sterile field during the insertion process. Use of a sterile technique during insertion of an IV will help prevent blood stream infections. Use of Sterile gloves during a Foley Catheter insertion will help prevent Urinary tract infections.
3. Look at your surroundings. Check to see if the floors and side tables look clean.
4. Check to see if trays get left at the bedside until the next meal is brought in.
5. Ensure that your call bell is within reach at all times.
6. Do not get out of bed unassisted in a semi darkened room.
7. Do not walk unassisted while taking narcotic medications.
8. Do not try to sit up or get out of bed if you are feeling dizzy.
9. Do not try to disconnect your IV tubing by yourself. Do not make any adjustments to medical equipment without assistance. Do not try to adjust dressings or handle catheters without help from a nurse.
10. Have all needed supplies within reach before you go to sleep in the hospital.
11. Do not take pills that are sitting by the bedside.
12. Ask your nurse or Aide to ensure that your side table is within reach.
13. Ask you Aide to ensure that your urinal or bed pan is easily available, especially if you are unable to walk and need to urinate frequently.
14. Ask the Aide to set up a toileting schedule for your loved one is unable to move or toilet himself. A nurse may establish a toileting schedule by taking you or another patient to the bathroom every two hours. The nurse may also offer you a bed pan or commode routinely within the same time frame.
Be Involved In your Care
Be involved in your care. The success of your care requires your cooperation and knowledge. Ask about the course of therapy and your prognosis. Your Prognosis is the likely outcome of your treatment. Will there be a full recovery? Will I require in -patient physical therapy while hospitalized? How many days per week will I be required to go to therapy? Will there be any outpatient therapy needed after discharge? Will my limb be fully functional after my surgical wound heals? Will plastic surgery improve the appearance of my post surgical scar? Are there side effects to a particular medication? Are there alternative pain medications with fewer side effects? Do I need to see other specialists while hospitalized?
Ask about the frequency of IV tubing changes. These are usually changed every 72 hours. How often will an Aide or nurse make rounds? A nurse or aide should make round a minimum of every hour. Can I expect my family member who is unable to move, to be turned and repositioned every two hours as promised?
Can I have administer my own pain medication via a Pain Controlled Analgesia Pump (PCA)? A Pain Controlled Analgesia pump allow patients to deliver their own pain medications when they feel that they need them without having to wait for a nurse. Can my family member help me with my bath and other activities of daily living while hospitalized? Can I bring my loved one ethnic food from home if he or she does not want to eat the food that the hospital prepares? Patients who are involved in their care, and who have family support usually do better in health care settings.
High Quality Care
A clean and safe environment
Involvement in your care
Protection of your privacy
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that ensures the privacy of individual health information. This means that people who are unrelated to your care should not have access to your information while you are in the hospital. Nurses and doctors should not be discussing your care in a hallway where they can be overheard by others. No one unrelated to your care should have access to your chart.
A nurse in one hospital was reprimanded after she wrote a patient's diagnosis on the patient's bed sheet while taking report from another nurse in the emergency room. The patient became traumatized when other patients and visitors passing by where able to read her diagnosis.
The Hospital requires your signed authorization before it can disclose information related to your care to others. For example, hospitals need a signed authorization before it can release your records to an attorney. However, the hospital can disclose your care to other specialist and facilities for treatment purposes without an authorization.
The hospital is not always a safe place. The care received in a hospital may not be what you expected. Stay involved in you care and carefully observe the hygiene practices of the individuals entrusted with your care. Keep the abovementioned tips in mind when admitted. Know your rights, ask questions and demand privacy at all times.
 CDC. Methicillin Resistant Staphylococcus. CDC. Available at : http://www.cdc.gov/mrsa/
 Mayo Clinic Staff. C. difficile Infection. Available at: http://www.mayoclinic.org/diseases- conditions/c-difficile/basics/definition/con-20029664