Hospital-acquired infections are infections that develop during the course of a patient's hospitalization. They may develop because the patient’s medical condition makes them susceptible to infections; because they had a surgical procedure; because they have a catheter in their urinary tract, nose, mouth or blood vessels; or because they have aspirated (inhaled) material from the nose or mouth into the lungs. Some of these infections can be prevented by utilizing best practices.
What is hand hygiene?
- Hand hygiene is the most effective way to prevent the spread of infections.
- Hand hygiene means washing with soap and water or using waterless, alcohol-based hand rubs.
What are we doing to promote hand hygiene?
- Positioning hand sanitizers throughout the hospital in easy-to-access locations.
- Performing hand hygiene prior to and after touching a patient and their surroundings.
- Observing hospital staff to make sure hand hygiene is happening every time it should be.
- Educating staff on the importance of hand hygiene.
- Meeting regularly with an active group of staff to focus on hand hygiene practices.
What can the patient do?
- Cleanse hands often.
- Use soap and water or an alcohol-based hand rub to clean your hands.
- Know that it is always okay to ask your caregiver if they have washed their hands before touching you.
- Ask your visitors to either wash their hands or use an alcohol-based hand sanitizer.
- Ask to have the area in your room or equipment being used on you cleaned if it appears in need.
When to wash your hands
- Before eating.
- Before preparing food items.
- After contact with any body fluids such as blood, urine or vomit.
- After changing infant or adult diapers.
- After touching animals and pets.
- After using the restroom.
- After blowing your nose, coughing or sneezing.
- Before and after touching a sick or injured person.
- Before and after visiting a hospital unit.
Surgical Site Infections
What is a surgical site infection?
A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. Some of the common symptoms of a surgical site infection are:
- Redness and pain around the area where you had surgery
- Drainage of cloudy fluid from your surgical wound
What is the health care team doing to prevent surgical site infections?
- Cleaning their hands and arms up to their elbows with an antiseptic agent just before the surgery.
- Cleaning their hands with soap and water or an alcohol-based hand rub before and after caring for each patient.
- If necessary, removing some of your hair immediately before your surgery using electric clippers if the hair is in the same area where the procedure will occur. They should not shave you with a razor.
- Wearing special hair covers, masks, gowns, and gloves during surgery to keep the surgery area clean.
- Giving you antibiotics before your surgery starts. In most cases, you should get antibiotics within 60 minutes before the surgery starts and the antibiotics should be stopped within 24 hours after surgery.
- Cleaning the skin.
- For select procedures, bathing with a disinfectant solution called chlorhexidine the day before and the morning of surgery.
What you can do to help prevent surgical site infections
Before your surgery:
- Tell your doctor about other medical problems you may have. Health problems such as allergies, diabetes and obesity could affect your surgery and your treatment.
- Quit smoking. Patients who smoke get more infections. Talk to your doctor about how you can quit before your surgery.
- Do not shave near where you will have surgery. Shaving with a razor can irritate your skin and make it easier to develop an infection.
- Ask your provider if you need any shots or vaccines
- Bathe with Chlorhexidene prior to coming to the hospital if instructed to.
At the time of your surgery:
- Speak up if someone tries to shave you with a razor before surgery. Ask why you need to be shaved and talk with your surgeon if you have any concerns.
- Ask if you will get antibiotics before surgery.
After your surgery:
- Make sure that your health care providers clean their hands before examining you, either with soap and water or an alcohol-based hand rub.
- Do not allow family and friends who visit touch the surgical wound or dressings.
- Ask family and friends to clean their hands with soap and water or an alcohol-based hand rub before and after visiting you. If you do not see them clean their hands, ask them to clean their hands.
Monitor for signs of an infection:
- Acquiring a fever is often the first sign of infection. Other symptoms and signs of an infection after surgery include:
- Increasing swelling and redness of the skin around the incision site.
- Increasing tenderness and pain in the surgical area.
- Increased drainage or pus from the incision site.
- Separation and bleeding of a previously sealed incision.
- If you notice any signs listed above or anything else out of the ordinary, contact your doctor immediately.
Central Line Infections
What is a central line infection?
A “central line” or “central catheter” is a tube that is placed into a patient’s large vein, usually in the neck, chest, arm or groin. The catheter is often used to draw blood, or to give fluids or medications. It may be left in place for several weeks. A bloodstream infection can occur when bacteria or other germs travel down the “central line” and enter the blood. If you develop a catheter-associated bloodstream infection, you may become ill with fevers and chills or the skin around the catheter may become sore and red.
What the health care team is doing to prevent central line infections
- Choosing a vein where the catheter can be inserted safely and where the risk for infection is small.
- Cleaning their hands with soap and water or an alcohol-based hand rub before putting in the catheter.
- Wearing a mask, cap, sterile gown and sterile gloves when putting in the catheter to keep it sterile. The patient will be covered with a sterile sheet.
- Cleaning the patient’s skin with an antiseptic cleanser before putting in the catheter.
- Cleaning their hands, wearing gloves and cleaning the catheter opening with an antiseptic solution before using the catheter to draw blood or give medications. Healthcare providers also clean their hands and wear gloves when changing the bandage that covers the area where the catheter enters the skin.
- Deciding every day if the patient still needs to have the catheter. The catheter will be removed as soon as it is no longer needed.
- Carefully handling medications and fluids that are given through the catheter.
What the patient can do to help prevent central line infections
- Ask your doctors and nurses to explain why you need the catheter and how long you will have it.
- Ask your doctors and nurses if they will be using all of the prevention methods discussed above.
- Make sure that all doctors and nurses caring for you clean their hands with soap and water or an alcohol-based hand rub before and after caring for you.
- If your bandage comes off or becomes wet or dirty, tell your nurse or doctor immediately.
- Inform your nurse or doctor if the area around your catheter is sore or red.
- Do not let family and friends who visit touch the catheter or the tubing.
- Make sure family and friends clean their hands with soap and water or an alcohol-based hand rub before and after visiting you.
What do I need to do when I go home from the hospital?
Some patients are sent home from the hospital with a catheter in order to continue their treatment. If you go home with a catheter, your doctors and nurses will explain everything you need to know about taking care of your catheter.
- Make sure you understand how to care for the catheter before leaving the hospital. For example, ask for instructions on showering or bathing with the catheter and how to change the catheter dressing.
- Make sure you know whom to contact if you have questions or problems after you get home.
- Make sure you wash your hands with soap and water or an alcohol-based hand rub before handling your catheter.
- Watch for the signs and symptoms of catheter-associated bloodstream infection, such as soreness or redness at the catheter site or fever, and call your healthcare provider immediately if any occur.
What is ventilator-associated pneumonia?
A pneumonia is an infection of the lungs. A ventilator is a machine that helps a patient breathe by giving oxygen through a tube. The tube can be placed in a patient’s mouth or nose, or through a hole in the front of the neck. The tube is connected to a ventilator. A ventilator-associated pneumonia, or VAP, is a lung infection or pneumonia that develops in a person who is on a ventilator.
What we are doing to prevent ventilator-associated pneumonia
To prevent ventilator-associated pneumonia, we:
- Keep the head of the patient’s bed raised between 30 and 45 degrees unless other medical conditions do not allow this to occur.
- Check the patient’s ability to breathe on his or her own every day so that the patient can be taken off of the ventilator as soon as possible.
- Clean our hands with soap and water or an alcohol-based hand rub before and after touching the patient or the ventilator.
- Clean the inside of the patient’s mouth on a regular basis.
- Clean or replace equipment between use on different patients.
What the patient or family can do to help prevent ventilator-associated pneumonia
- If you smoke, quit. Patients who smoke get more infections. If you are going to have surgery and will need to be on a ventilator, talk to your doctor before your surgery about how you can quit smoking.
- Family members can ask about raising the head of the bed.
- Family members can ask when the patient will be allowed to try breathing on his or her own.
- Family members can ask doctors, nurses and other health care providers to clean their hands.
- Family members can ask about how often health care providers clean the patient’s mouth.
Catheter-Associated Urinary Tract Infections
What is a catheter-associated urinary tract infection?
A catheter-associated urinary tract infection (CAUTI) occurs when germs (usually bacteria) enter the urinary tract through the urinary catheter and cause infection. CAUTIs have been associated with increased morbidity, mortality, healthcare costs, and length of stay. The risk of CAUTI can be reduced by ensuring that catheters are used only when needed and removed as soon as possible; that catheters are placed using proper aseptic technique; and that the closed sterile drainage system is maintained.
What the healthcare team is doing to prevent CAUTIs
- Inserting a catheter only when medically necessary.
- Removing catheters as soon as possible.
- Educating staff on the care of the catheter.
- Continually evaluating catheter products.
What you can do to help prevent CAUTIs
- Understand why the catheter is needed and ask the healthcare provider frequently if the catheter is still needed.
- Clean your hands before and after touching the catheter.
- Check the position of the urine bag; it should always be below the level of the bladder.
- Do not tug or pull on the tubing.
- Do not twist or kink the catheter tubing.
If you will be going home with a catheter, talk with your doctor or nurse to make sure you know everything you need to know to properly handle your catheter.
How we are doing in preventing catheter-associated urinary tract infections?
HospitalCompare reports date on catheter-associated urinary tract infections.