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How not to die in hospital

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Alex View Drop Down
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  Quote Alex Quote  Post ReplyReply Direct Link To This Post Topic: How not to die in hospital
    Posted: 16 Feb 2010 at 09:48

Your hospital survival guide: The ingenious tricks that can save you from superbugs and other hospital disasters


A trip to the hospital - whichever side of the sheets you're sat - is not meant to be fun, but the prospect of ending up ill as a result of your visit is enough to make anyone afraid.

Hospital-acquired infections are still a major concern. A recent Parliamentary report warned that the NHS has become so focused on MRSA and c.difficile - responsible for just 15 per cent of hospital-acquired infections - that there is a risk of ignoring much more common dangers, such as e.coli, which soared by 33 per cent between 2003 and 2007, to around 22,000 cases.

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Keeping yourself safe: When you are seriously ill, your body is more prone to infections that healthy people are able to fight off

'The best available evidence is that other - equally deadly, but also avoidable - infections, such as surgical site infections and pneumonias, have increased,' said the report committee chairman Edward Leigh.

But it's not just infections that pose a danger to hospital visits - in 2008 more than 8,000 patients were more malnourished leaving hospital than when they went in.

'Malnourished patients have 30 per cent more complications and a 40 per cent higher mortality rate,' says Dr Mike Stroud, consultant gastroenterologist at Southampton University Hospital.

'This is because when you're seriously ill, your body often needs more energy in the form of calories and vitamins than a healthy person to recover.'

So if you have to venture through those swinging doors, what can you do to make sure you leave in a better state than when you went in?

DOSE UP ON ASPIRIN

Swallowing 300mg daily for three days prior to surgery can halve your risk of developing a deadly infection, according to research from Dartmouth College in the U.S.

It won't help once you've got one of the Staphylococcus infections (which can include MRSA) it can help prevent it in the first place. It works by stopping the bacteria multiplying.

However, you should avoid aspirin if you're already taking any anticoagulant drugs - as aspirin also thins the blood - or if you have a stomach ulcer as it can further irritate the stomach lining, says Sean Woodward, of the Royal Pharmaceutical Society.

'In high doses it can prevent blood clotting, so don't take any on operation day, without your surgeon's consent.'

It also shouldn't be given to under 16s, as it can cause Reye's syndrome, a rare brain and liver condition, or to asthmatics as it can trigger attacks. 

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Hazard: While visitors sitting on your bed can be a comfort, it could help the spread of infections such as MRSA

KEEP VISITORS OFF THE BED

If they truly wish you a speedy recovery, your visitors should take a seat in a chair, not on your sheets.

In a study published in the British Medical Journal, researchers found that a combination of infection-control strategies that included eliminating visitor contact with a patient's bed was able to stop the spread of MRSA and reduce the number of infections by 70 per cent.

'Clothes can carry potentially dangerous bacteria and viruses, yet aren't washed like your hands as you enter a ward,' explains Dr Ron Cutler, microbiologist at Queen Mary University, London.

'Chairs are seldom properly cleaned, so can harbour millions of bacteria, which can be picked up by the hands when sitting down or getting up, so you then transfer those bacteria to sheets when you sit - avoiding contact with a patient's bed has to be at the top of anyone's list.'

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ASK FOR AN EARLY MORNING OPERATION

Patients whose procedures started near 9am were four times less likely to have anaesthesia complications - nausea, post-operation pain, fluctuating blood pressure - than those wheeled in around 4pm, according to an analysis of 90,000 operations by U.S. researchers.

Blame fatigue and overbooked doctors arriving late to the operating theatre, they suggest.

WASH YOUR HANDS

The infection risks from sharing a bathroom are obvious. What isn't so apparent is the risk you pose to yourself.

'More often, organisms that cause infections come from the patient's own home-grown bacteria,' explains Dr Ron Cutler.

Regularly throughout the day, as well as after every trip to the loo, wash your hands with antibacterial soap and hot water for a full minute.

'It won't kill bugs, but it will help dislodge them, so there's less chance of them entering your system,' Cutler says.

'Most importantly, always dry your hands completely after washing, as any lingering moisture can harbour harmful viruses and bacteria.'

While washing every hour is a sensible plan of action, be especially wary every time you've touched door handles or are about to eat, he adds.

TAKE A PHOTO OF YOUR DOCTOR

You will see countless doctors, nurses and other people during the course of a day, so it's important to know exactly who the doctor in charge of you is.

Grab your camera phone and take a picture of him. In a recent study published in The Lancet, researchers found that patients with a snapshot of their doctor were better able to identify them.

This, in turn, helped cut down on the number of medical mistakes caused by patients giving information to the wrong medical personnel, who might not spot relevant changes in your condition or give misleading advice.

'Make sure everyone who talks to you identifies themselves, and convey changes in your condition only to the doctors and nurses involved in your case,' says Gail Van Kanegan, an advanced practice nurse and author of How To Survive Your Hospital Stay.

DON'T TOUCH THE TOYS

Any children coming to visit need to be kept away from toys littering the waiting room.

When University of Nottingham researchers swabbed the surfaces of 12 toys in an intensive-care unit, they found half of them swarming with various strains of bacteria, including staphylococcus aureus (linked to everything from minor skin ailments to pneumonia and meningitis).

'Bacteria and skin cells from patients are easily transferred to objects like toys, magazines and books, which, unlike medical equipment, aren't cleaned frequently,' explains researcher Dr Jacqueline Randle.

'Just because it's not actually used during surgery, don't assume it's not a danger.'

DRINK PLENTY OF WATER

Hydration equals healing. 'In order for the body to heal, the cells must have sufficient amounts of water,' says Dr Ron Cutler.

'If you're dehydrated, you're at risk of infection, pressure sores, electrolyte imbalances in your blood that can leave you feeling nauseous and weaken your immune system, heart irregularities and other complications, especially if you're older. Dry airways also give harmful bacteria open access.'

Aim for two litres of fluids a day in the two weeks before your hospital visit and keep topped-up with the same intake during your stay.

COVER THE STETHOSCOPE

While your doctor's checking your heartbeat, millions of bacteria are going on to your body - so ask them to sanitise the stethoscope first.

Just as effective: a disposable latex glove over its round bit, or an antimicrobial coating called AgIon (ask - they'll know what you're talking about, as it is a standard product used in hospitals).

Similarly, while a small percentage of healthcare workers are compulsively clean, 'others wash their hands only when they think they've got them dirty,' says Gail Van Kanegan.

Ask for a pump dispenser of alcohol-based sanitiser for your bedside table - the staff will get the hint, as will your friends and family.

This is particularly important before any procedure that breaks your skin, from an injection to a minor operation, says Hugh Pennington, emeritus professor of bacteriology at Aberdeen University.

'Insist the GP or nurse cleans their hands with the sanitiser and check the equipment is sterilised.'

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Hydrated: You should try and drink two litres of fluids a day in the two weeks before your hospital visit

EAT MORE

If you've noticed any weight loss before or during your hospital visit - rings become loose, your belt needs to be tighter - increase your calorie intake with nutrient and energy-rich foods to avoid malnutrition.

'Your body needs more energy than usual to repair and fight off bugs, so opt for full-fat milk, butter, fill up on carbohydrate-rich foods such as pasta and always have pudding,' says Eileen Steinbrock, of the British Dietetic Association.

'Too many elderly people live off bread and butter and tea because they don't cook for themselves, which means they often enter hospital with a calorie deficit - it's much better to worry about your weight when you're fit and well than to take risks.'

Men should aim for at least 2,500 calories a day, and women at least 2,000 calories, including three main meals, snacks and plenty of fluids.

ASK FOR ANOTHER BLANKET

On the morning of your operation, clip all your nails short (minimising the chances of bacteria hiding underneath), then have a 15-minute piping-hot shower, using antibacterial soap to scrub every nook and cranny of your body, advises Derek Butler of the campaign group MRSA Action UK.

Try Boots Antibacterial handwash (99p), containing ticlosan, an antibacterial chemical used in many cleaning products.

Before you go under anaesthesia, ask for an extra blanket for your bed.

The combination of a cold operating room and anaesthesia can lead to mild hypothermia, which can slow the post-operation healing process.

TAKE AN APPLE (BUT REMEMBER TO WASH IT FIRST)

DO YOUR PREP
Before going under the knife, find out the infection rates of the hospital you’re being booked into, advises Derek Butler of the campaign group MRSA Action UK.

‘Under the new “Book and Chooseî system, it’s your right to choose any hospital in the country or, if you can’t get surgery in the required time, even to go abroad, with the NHS paying,’ he explains.

Find out all comparative infection data at NHS Direct, NHS Choices, or at mrsaactionuk.net which updates the latest figures monthly. ‘In my experience, GPs can be very reluctant for you to go anywhere other than the local hospitals where they trained, but don’t take no for an answer if you’re not satisfied,’ adds Butler.

GIVE UP SMOKING

Smoking reduces the amount of oxygen carried in your blood, which means you not only heal slower - so you’ll be stuck in hospital longer - but your immune system is weakened, leaving you more vulnerable to any nasty bugs around the ward.

In fact, according to one U.S. study, smoking just ten cigarettes a day in the two weeks preceding a hospital operation can increase your length of stay by up to a third.

Another study found that cigarettes also contain large numbers of bacteria linked to lung, blood and food-borne infections, which the authors believe can survive the smoking process to enter your system. Quit, and in just six months your blood will be restored back to its full healing potential. 

PACK WELL

‘Pack a bag with a change of clothing, two sets of pyjamas and slippers, all wrapped in clean carrier bags to keep them free of dirt, along with awash kit, two toothbrushes (one for pre-op use and one for post-op, to reduce the risk of infection), and plenty of washed fruit to keep your energy reserves up - don’t assume others will bring it for you,’ Butler adds. 


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Edited by Alex - 16 Feb 2010 at 09:49
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Rose View Drop Down
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  Quote Rose Quote  Post ReplyReply Direct Link To This Post Posted: 16 Feb 2010 at 11:16

Very sound advice to be honest ..
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James View Drop Down
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  Quote James Quote  Post ReplyReply Direct Link To This Post Posted: 17 Feb 2010 at 01:15
How about the hospitals start using some BLEACH around the place? Whatever happened to that stuff they used to use and all hospitals smelled of it? I really liked that and you never had all this nonsense then. Also, get shot of the contract cleaners and start employing professional cleaning staff directly. I have to deal with contract cleaning companies as part of my job and frankly, some of them will employ anybody. 
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