Washington Injury Law Blog

15 STEPS YOU CAN TAKE TO REDUCE YOUR

RISK OF A HOSPITAL INFECTION

 

Infections are dangerous these days especially with the untreatable MRSA floating around. Tennessee attorney Morgan Adams who authors the Truck Injury Lawyer Blog found a great article detailing ways to protect yourself from getting infections while admitted to a hospital.  If you have a family member going to or  in the hospital following a car accident, motorcycle accident or any other treatment requiring a hospital stay PLEASE read the article below.  For a link to the article see: www.hospitalinfection.org/protectyourself.shtml

 

Most of us will have to go into the hospital some day. Here are specific steps you can follow to protect yourself from deadly hospital infections:

 

1. Ask that hospital staff clean their hands before treating you, and ask visitors to clean their hands too. This is the single most important way to protect yourself in the hospital. If you’re worried about being too aggressive, just remember your life could be at stake. All caregivers should clean their hands before treating you. Alcohol-based hand cleaners are more effective at removing most bacteria than soap and water. Do not hesitate to say: “Excuse me, but there’s an alcohol dispenser right there. Would you mind using that before you touch me, so I can see it?” Don’t be falsely assured by gloves. If caregivers have pulled on gloves without cleaning their hands first, the gloves are already contaminated before they touch you. 1

 

2. Before your doctor uses a stethoscope, ask that the diaphragm (the flat surface) be wiped with alcohol. Stethoscopes are often contaminated with Staphylococcus aureus and other dangerous bacteria, because caregivers seldom take the time to clean them in between patient use. 2

 

3. If you need a “central line” catheter, ask your doctor about the benefits of one that is antibiotic-impregnated or silver-chlorhexidine coated to reduce infections. 3

 

4. If you need surgery, choose a surgeon with a low infection rate. Surgeons know their rate of infection for various procedures. Don’t be afraid to ask for it.

 

5. Beginning three to five days before surgery, shower or bathe daily with chlorhexidine soap. Various brands can be bought without a prescription. It will help remove any dangerous bacteria you may be carrying on your own skin. 4

 

6. Ask your surgeon to have you tested for methicillin-resistant Staphylococcus aureus (MRSA) at least one week before you come into the hospital. The test is simple, usually just a nasal swab. If you have it, extra precautions can be taken to protect you from infection. 6

 

7. Stop smoking well in advance of your surgery. Patients who smoke are three times as likely to develop a surgical site infection as nonsmokers, and have significantly slower recoveries and longer hospital stays. 7

 

8. On the day of your operation, remind your doctor that you may need an antibiotic one hour before the first incision. For many types of surgery, a pre-surgical antibiotic is the standard of care, but it is often overlooked by busy hospital staff. 8

 

9. Ask your doctor about keeping you warm during surgery. Operating rooms are often kept cold, but for many types of surgery, patients who are kept warm resist infection better. 9 This can be done with special blankets, hats and booties, and warmed IV liquids.

 

10. Do not shave the surgical site. Razors can create small nicks in the skin, through which bacteria can enter. If hair must be removed before surgery, ask that clippers be used instead of a razor. 10

 

11. Avoid touching your hands to your mouth, and do not set food or utensils on furniture or bed sheets. Germs such as “C. Diff” can live for many days on surfaces and can cause infections if they get into your mouth.

 

12. Ask your doctor about monitoring your glucose (sugar) levels continuously during and after surgery, especially if you are having cardiac surgery. The stress of surgery often makes glucose levels spike erratically. When blood glucose levels are tightly controlled, heart patients resist infection better. Continue monitoring even when you are discharged from the hospital, because you are not fully healed yet. 12

 

13. Avoid a urinary tract catheter if possible. It is a common cause of infection. The tube allows urine to flow from your bladder out of your body. Sometimes catheters are used when busy hospital staff don’t have time to walk patients to the bathroom. 13 If you have a catheter, ask your caregiver to remove it as soon as possible.

 

14. If you must have an IV, make sure that it’s inserted and removed under clean conditions and changed every 3 to 4 days. Your skin should be cleaned at the site of insertion, and the person treating you should be wearing clean gloves. Alert hospital staff immediately if any redness appears.

 

15. If you are planning to have your baby by Cesarean section, follow the steps listed above as if you were having any other type of surgery. 14

 

1] Studies show that, nearly three quarters of patients’ rooms are contaminated with MRSA and 69% with VRE. In one study, 42% of gloves worn by hospital personnel who had no direct patient contact but who touched contaminated surfaces became contaminated. Boyce JM et al., “Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications,” Infection Control and Hospital Epidemiology 18.9 (1997): 622-627. A Concensus Statement by a multidisciplinary group of experts asked by the American Medical Association to provide guidelines for infection control cautions that: “In some cases caregivers actually go from patient to patient without changing their gloves, apparently confusing self-protection” with patient protection. Goldmann DA et al., “Strategies to Prevent and Control the Emergence and Spread of Antimicrobial- Resistant Microorganism in Hospitals,” JAMA 275.3 (1996): 234-240.

 

[2] Routine disinfection of stethoscopes between patients is recommended by the American Medical Association. Salgado CD, Farr BM, “MRSA and VRE: Preventing Patient-to-Patient Spread,” Infections in Medicine 20 (2003):194-200; Marinella MA et al., “The stethoscope: a potential source of nosocomial infection?” Archives of Internal Medicine,157.7 (1997): 786-90; Zachary KC et al., “Contamination of gowns, gloves, and stethoscopes with vancomycin-resistant Enterococci,” Infection Control and Hospital Epidemiology 22.9 (2001): 560-564; Noskin GA et al., “Recovery of vancomycin-resistant Enterococci on fingertips and environmental surfaces,” Infection Control and Hospital Epidemiology 17.12 (1996): 770-772.

 

[3] The Agency for Healthcare Research and Quality recommends use of antibiotic catheters as one of its eleven patient safety practices. Making Healthcare Safer: A Critical Analysis of Patient Safety Practices. AHRQ Publication 01-E058, 2001. Also see: Darouiche RO et al., “A comparison of two antimicrobial-impregnated central venous catheters,” New England Journal of Medicine 340.1 (1999): 1-8; Raad I et al., “Central venous catheters coated with Minocycline and Rifampin for the prevention of catheter-related colonization and bloodstream infections,” Annals of Internal Medicine 127.4 (1997): 267-274.

 

[4] The following four studies support this suggestion : (1) Vernon MO et al., “Chlorhexidine gluconate to cleanse patients in a medical intensive care unit,” Archives of Internal Medicine 166 (2006): 306-312. (2) Hayek LJ et al., “Preoperative whole body disinfection – a controlled clinical study,” Journal of Hospital Infection 11, Suppl. B (1988): 15-19 This study showed that two chlorhexidine showers reduced total infection rate by 30% and Staph aureus infections by 50%. (3) Byrne DJ et al., “Rationalizing whole body disinfection,” Journal of Hospital Infection 15.2 (1990): 183-187. This study shows that a single shower does not maximize skin disinfection. The authors conclude that three showers should be recommended. (4) Daryl S. Paulson, “Efficacy Evaluation of a 4% Chlorhexidine Gluconate as a Full-Body Shower Wash,” published by the Association for Practitioners in Infection Control (1993). This study found that showering for five days with chlorhexidine yielded maximum results for reducing bacteria on the skin, and keeping it low for 24 hours or more. “A 1 or 2 day presurgical application period is simply too short to establish the necessary levels of residual antimicrobial properties to be of value in reducing post-surgical infection rates.”

 

[6] Worcester S, “Hospital system takes on MRSA,” Internal Medicine News 38.19 (2005): 1-2.

 

[7] Kurz A et al., “Perioperative Normothermia to Reduce the Incidence of Surgical-Wound Infection and Shorten Hospitalization,” New England Journal of Medicine 334.19 (1996): 1209-1215.

 

[8] The Institute for Healthcare Improvement guidelines for improving infection prevention state that: “Administration of prophylactic antibiotics beginning 0 to 1 hour prior to surgical incision decreases the risk of surgical infection. http://www.ini.org/IHI/Topics/PatientSafety/

SurgicalSiteInfections/ImprovementStories (accessed 10-14-02). See also: Burke JP, “Maximizing appropriate antibiotic prophylaxis for surgical patients: an update from LDS Hospital, Salt Lake City,” Clinical Infectious Diseases 33, Suppl. 2 (2001): S78-83.

 

[9] Ibid., the Institute for Healthcare Improvement Guidelines for improving infection state that “surgical patients with core temperatures greater than 36 degrees C./ 98.6 degrees F are less likely to get an infection.”

 

[10] Ibid., the Institute for Healthcare Improvement states that “clipping instead of shaving results in decreased infection rates,” and recommends that patients be told “not to shave the surgical site for 72 hours prior to surgery.”

 

[12] Pittsburgh Regional Healthcare Initiative, “PHRI Executive Summary,” (June, 2005).

 

[13] Urinary tract infections are the most common hospital-acquired infections. Limiting the use and duration of urinary tract catheters reduces risk of infection. See: Puri J et al., “Catheter Associated Urinary Tract Infections in Neurology and Neurosurgical Units,” Journal of Infection 44.3 (2002): 171-175; Stephan F et al., “Reduction of Urinary tract infection and antibiotic use after surgery: a controlled, prospective, before-after intervention study,” Clinical Infectious Diseases 24 (2006): 1544-1551.

 

[14] Killian CA et al., “Risk Factors for Surgical-Site Infections Following Cesarean Section,” Infection Control and Hospital Epidemiology 22.10 (2001): 613-7.

Over my three part series I have explained the Top 7 Errors to Avoid When Treating your Car Accident Injuries. All 7 errors to avoid are listed below.  Car accident victims often don’t have the information they need at the time of the accident when they start receiving medical care for injuries caused by the car accident. Hopefully by reading the below list you have gained some useful insight into how to protect your injury case.

 

It doesn’t matter whether you ultimately hire and attorney to help you on your injury case or not, the insurance companies will always look for these errors and use them against you when they find them. Everyone deserves to be treated fairly. It’s my hope to level the playing field a little for you by providing this information.

 

Here are the Top 7 Errors to Avoid when Treating your Car Accident Injuries:

 

1. Not seeking medical treated immediately.  When you have been injured and feel pain do not delay in  seeking medical care.  Not seeking medical treatment immediately often times leads to insurance companies arguing that you must not have been hurt very badly if you were able to wait days or weeks before first seeing a doctor.  Protect your health and your case by seeking medical treatment as soon as possible.

 

2. Not following the doctor’s instructions.  When your doctor tells you what to do to heal your injuries you need to follow through with what your doctor recommends.  Your doctor is the expert at diagnosing and fixing injuries, and your injury case will likely depend on his expert opinions.  The insurance company will minimize the severity of your injuries because you failed to do what was recommended by your doctor.

 

3. Not starting or completing therapy recommended by your doctor. If your doctor instructs you to go to 12 physical therapy treatments over the next six weeks, do it! Don’t let your busy schedule dictate when you’ll get the medical care you need. Delays in starting treatment and stopping before treatment is completed allows the insurance company to argue your injuries weren’t bad or you must have been healed earlier than expected. Protect your case and promptly seek treatment that’s recommended.

 

4. Self-referring to other types of treatment without consulting your doctor. An injury case is very often dependant on your primary doctor’s expert opinion regarding if you were injured and the severity of that injury. If you go to a chiropractor or other health care provider without first discussing it with your primary doctor it can look like you may be seeking unnecessary care. Keeping your primary doctor in the loop and in your corner protects your case.

 

5. Skipping treatment appointments or letting large gaps in time pass between treatment follow-ups. When you miss appointments or stop treating for long periods it implies that you are not suffering from your injuries. If your injuries were bad and very painful we would expect you to be very motivated to seek the treatment needed to stop the pain and suffering as quickly as possible. Life can get in the way of the best-laid plans, and you can learn to live with the daily discomfort, but it does a great disservice to your injury case when this happens.

 

6. Failing to disclose preexisting injuries. You need to be open and honest with your doctor. Failing to tell him about a prior injury to the same body part or any other body part can lead him to incorrect conclusions and opinions. Since your case is normally very dependent on your doctor’s expert opinion, you don’t want the facts that your doctor bases those opinions (part of which is your medical history including preexisting injuries) to be based upon inaccurate information and thus open to attack by the insurance company. It’s best if everything is out in the open, that way your doctor and attorney can deal with any complicating issues appropriately. Just because you have preexisting injuries does not mean you lose, Washington law still allows for such situations as do many other states laws.

 

7. Not having your car insurance or health insurance pay your medical bills. When the at-fault party or you pay your medical bills you hurt your injury case. There is a financial benefit to you when your car insurance or health insurance pays your medical bills for you. Don’t hurt your case by failing to take advantage of available insurance coverage. The reason for this is complex due to subrogation issues that may vary depending on the type of insurance coverage you have available to you.

 

Just because you were in a car accident that someone else caused that doesn’t mean that you should be made to feel guilty or defensive about getting medical treatment you need to heal. Being injured in a car accident is serious and may only happen once in your lifetime.  Don’t hurt your case by committing the above errors in the assumption everything will work out in the end. Nobody is going to take care of you except you. 

 

Insurance companies are in the business of making money and will generally only do the minimum required regardless of how long you’ve been a customer. However, that doesn’t mean just because you were in a car accident that someone else caused you should be made to feel guilty or defensive about getting medical treatment you need to heal. 

 

Healing from injuries suffered in a car accident can be time consuming, frustrating and stressful. But if you want to receive fair compensation for the injuries caused by the car accident you need to work at getting better by being diligent in your treatment, honest with your doctor and taking advantage of available insurance coverage. Doing these things and avoiding the top 7 errors when treating your car accident injuries will in most cases establish a solid foundation for your injury case, and help you maintain the full value of your case when it comes time negotiation a settlement or file a lawsuit.

Last time we discussed following through on the treatment your doctor recommends and keeping your doctor in the loop on all decision on what kind of treatment to seek after you’re injured in car accident.  In this post we’ll wrap up the series with the final three errors to avoid when treating your car accident injuries. 

 

These final three errors are big ones and can seriously damage the value of your case if they are committed.  By avoiding the below errors you can make sure the foundation of your injury case is solid.  Errors 5, 6 & 7 to avoid are:

 

5. Skipping treatment appointments or letting large gaps in time pass between treatment follow-ups. When you miss appointments or stop treating for long periods it implies that you are not suffering from your injuries. If your injuries were bad and very painful we would expect you to be very motivated to seek the treatment needed to stop the pain and suffering as quickly as possible. Life can get in the way of the best-laid plans, and you can learn to live with the daily discomfort, but it does a great disservice to your injury case when this happens.

 

6. Failing to disclose preexisting injuries. You need to be open and honest with your doctor. Failing to tell him about a prior injury to the same body part or any other body part can lead him to incorrect conclusions and opinions. Since your case is normally very dependent on your doctor’s expert opinion, you don’t want the facts that your doctor bases those opinions (part of which is your medical history including preexisting injuries) to be based upon inaccurate information and thus open to attack by the insurance company. It’s best if everything is out in the open, that way your doctor and attorney can deal with any complicating issues appropriately. Just because you have preexisting injuries does not mean you lose, Washington law still allows for such situations as do many other states laws.

 

7. Not having your car insurance or health insurance pay your medical bills. When the at-fault party or you pay your medical bills you hurt your injury case. There is a financial benefit to you when your car insurance or health insurance pays your medical bills for you. Don’t hurt your case by failing to take advantage of available insurance coverage. The reason for this is complex due to subrogation issues that may vary depending on the type of insurance coverage you have available to you.

 

Why reduce the amount you receive on your injury case by paying your own medical bills when insurance is available.  Keep the money in your pocket and let the insurance do what is was purchased to do.  Never feel guilty about using insurance that was purchased for the exact circumstance you are in after a car accident. 

 

I often here car accident victims complain about all the treatment appointments and time it takes to go to each treatment session.  But do your health and your case a favor and go to those appoints as scheduled and recommended.  Skipping treatments and failing to tell your doctor about preexisting injuries can cause major damage to the value of your case, and in some cases it can be fatal. 

 

By avoiding the 7 errors we’ve discussed in this series you can go a long way towards putting your injury case on a solid foundation.  You will have made it possible to defeat many of the most common arguments insurance companies love to use attack your case in an attempt to minimize the value of your injury case and pay you as little as possible for your injuries.

Last time we discussed seeking treatment immediately and following your doctor’s recommendations after you’re injured in car accident that was someone else’s fault.  The next two errors concern the importance of following though on the treatment recommended by your doctor and whether self referring to other types of treatment without first talking to your primary doctor is a good idea.

 

By avoiding the errors discussed below you take a major step toward eliminating many of the arguments that insurance companies commonly use to attack your case in an attempt to minimize the amount they are willing to pay you.  Errors 3 & 4 to avoid are:

 

3. Not starting or completing therapy recommended by your doctor. If your doctor instructs you to go to 12 physical therapy treatments over the next six weeks, do it! Don’t let your busy schedule dictate when you’ll get the medical care you need. Delays in starting treatment and stopping before treatment is completed allows the insurance company to argue your injuries weren’t bad or you must have been healed earlier than expected. Protect your case and promptly seek treatment that’s recommended.

 

4. Self-referring to other types of treatment without consulting your doctor. An injury case is very often dependant on your primary doctor’s expert opinion regarding if you were injured and the severity of that injury. If you go to a chiropractor or other health care provider without first discussing it with your primary doctor it can look like you may be seeking unnecessary care. Keeping your primary doctor in the loop and in your corner protects your case.

 

By following through on the treatment your doctor recommends and keeping your doctor in the loop on all decisions as to what kind of treatment to seek you continue to build the foundation of your injury case while defeating more of the arguments insurance companies love to make against you. 

 

In Part III we’ll look at what errors can happened when you skip treatment appointments, fail to disclose preexisting injuries, and don’t have your car or health insurance pay your medical bills.

Part I

 

When you’re in a car accident or other injury causing accident medical treatment is often required to heal your injuries.  If another person is responsible for causing the accident you may have an injury case to assert against that person. Over the next three posts I will be discussing the Top 7 Errors to Avoid when Treating Car Accident Injuries, so you can make sure you don’t inadvertently damage your case.

 

Your medical treatment is the foundation that your injury case is built upon. You need to be aware that someone (an insurance company adjuster) down the road may be looking at what medical treatment you received and the records generated by your doctors and other medical treatment providers.

 

There are some things to avoid regarding your medical treatment to give your injury case the best chance at success. This three part series will tell you the 7 most common errors that insurance companies will use to attack your case in an attempt to minimize the value of your injury case.  The first two errors to avoid are:

 

1. Not seeking medical treated immediately.  When you have been injured and feel pain do not delay in  seeking medical care.  Not seeking medical treatment immediately often times leads to insurance companies arguing that you must not have been hurt very badly if you were able to wait days or weeks before first seeing a doctor.  Protect your health and your case by seeking medical treatment as soon as possible.

 

2. Not following the doctor’s instructions.  When your doctor tells you what to do to heal your injuries you need to follow through with what your doctor recommends.  Your doctor is the expert at diagnosing and fixing injuries, and your injury case will likely depend on his expert opinions.  The insurance company will minimize the severity of your injuries because you failed to do what was recommended by your doctor.

 

Seeking treatment immediately and following your doctor’s recommendations will go a long way to putting your injury case on a firm foundation and defeating some of the arguments insurance companies love to make against you. 

 

In Part II we’ll look at the importance of following though on the treatment recommended by your doctor and whether self referring to other types of treatment without first talking to your primary doctor is a good idea.