After being ignored too long, the prevalence of hospital infections and how to prevent them has achieved transparency. Medical professionals and patients alike are aware that being in the hospital raises one’s chances of contracting an infection that wasn’t part of the reason for being there in the first place.
Insurance companies and Medicare have imposed financial penalties on facilities that don’t address or can’t control their rates of infection, but practitioners and patients also must be aware of how to minimize the chances of a health-care acquired infection (HAI). Not only do these infections impede your ability to recover, they’re expensive – see our recent blog, “The Costs of Catching an Infection in the Hospital.”
The Association of Professionals in Infection Control and Epidemiology (APIC) recently issued a consumer alert specifically about contracting pneumonia in a hospital setting. Although many different infections can be acquired in the hospital, pneumonia is common and relatively easier to avoid.
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses and/or fungi. You’re more likely to catch it if you’re older than 65; younger than 5; have a chronic medical condition such as diabetes, heart disease or asthma; smoke cigarettes.
Being hospitalized puts you at a higher risk of developing pneumonia because certain situations disrupt normal breathing – for example, if you’re completely bedridden, take certain medications or if you need a ventilator and endotracheal tube. That machine aids breathing by supplying oxygen through a tube inserted into the patient’s mouth, nose or through a hole in the front of the neck.
But anybody is at risk, so here are nine ways to minimize it:
1. Wash your hands and make sure the patient’s health-care providers and visitors do so as well.
Clean your hands after using the bathroom; after sneezing, blowing your nose, or coughing; before eating; when visiting someone who is sick; or whenever your hands are dirty.
Doctors, nurses, technicians, orderlies … anybody who works with patients should clean their hands before and after contact with a patient who has a breathing tube, and before and after contact with any respiratory device a patient uses, whether or not they wear gloves. They should clean their hands before and after touching a patient, before a procedure, after being exposed to a patient’s fluids and after touching a patient’s surroundings, whether or not the patient has a breathing tube.
2. Ensure proper use of breathing tubes.
The patient or family member/advocate should ask what measures will be taken to reduce the chances of needing a breathing tube, or to reduce the time the patient needs one. If you’re having surgery, ask the anesthesiologist if it can be done with a regional or spinal anesthesia instead of through the mouth.
Family members/advocates should ask health-care providers to check on the patient’s ability to breathe on their own every day so that if there is a breathing tube, it can be removed as soon as possible.
3. Watch what you wear.
Caregivers should wear gowns, gloves, masks, or face shields when performing procedures such as suctioning the patient’s secretions and inserting a breathing tube. They should change them if they get soiled with respiratory secretions. Protective coverings keep germs from moving from provider to patient.
If you or the patient you’re looking out for is having such a procedure, ask the caregiver to don a clean protective covering first.
4. Take deep breaths and get moving.
If you have been prescribed breathing exercises using an “incentive spirometer” (a device you blow into that moves plastic balls in a tube), do the exercises as often as directed. If you’re urged you to get up and walk around, it’s not just your muscles providers are seeking to build, it’s you’re your lung function. Taking deep breaths and moving around as much as you can also help reduce your chances of acquiring pneumonia.
5. Raise the head of the bed.
Ask the health-care providers if the head of the hospital bed should be elevated (to an angle of 30-45 degrees) to reduce the chances of breathing in secretions.
6. Take a break from sedating medications.
For patients who are sedated, family members or advocates should ask the health-care team if the drugs can be stopped to determine of the patient is alert enough to begin the process of removing the breathing tube.
7. Get vaccinated.
If you or your loved one is at high risk for pneumococcal disease, get vaccinated before your hospital stay. Pneumococcal disease is an infection caused by Streptococcus pneumoniae bacteria, sometimes referred to as pneumococcus. It can cause many illnesses, including pneumonia, blood infections, ear infections and meningitis.
The pneumococcal vaccine is recommended for all adults 65 and older and for anyone 2 and older who’s at high risk for disease. That includes smokers, people with chronic illnesses or conditions that weaken the immune system, or who live in a nursing home or other long-term care facility. Other vaccines that can help prevent diseases that cause pneumonia are Haemophilus influenzae type b vaccine (Hib), pertussis, varicella, measles and influenza.
8. Keep your mouth clean.
Good oral care is important in preventing pneumonia. Patients or family members/advocates should ask the caregivers how often they will clean the inside of the patient’s mouth. This should occur regularly with a toothbrush or antiseptic rinse.
9. Stop smoking.
Smoke is not lung-friendly. Smoking increases the risk of pneumonia and other health conditions. If you are a smoker, try to stop. And don’t expose yourself to someone else’s secondhand smoke, which also compromises lung function.