Hospital infections: what can a patient's companion do?

Your father or mother is in hospital and you are staying with them. You may have heard that some infections are caught in the hospital itself. This article explains what simple things a companion can do and what to tell the nurse or doctor.

What is a hospital infection?

The CDC describes it as an infection a patient gets during or shortly after receiving medical care. Germs can move between patients, staff, employees and visitors through unclean hands, improper or reused equipment, and some treatment procedures.

The CDC names several types:

• Bloodstream infection linked to a central venous line
• Urinary infection linked to a catheter
• Surgical site infection
• Pneumonia linked to a ventilator

The names of these types show that each is tied to a device or a treatment: a central line, a catheter, surgery or a breathing machine. So if your patient has one of these devices or has had an operation, the questions in the later sections will be more useful.

Washing hands: the first thing

WHO writes that proper hand hygiene prevents up to 50 percent of avoidable infections acquired while receiving care. The CDC’s patient safety page says regular handwashing stops the spread of germs, even resistant ones. So there are a few practical things for a companion to do:

• When you enter the room, and before and after touching the patient or their wound, wash or sanitise your hands.
• After touching hospital surfaces such as bed rails, the bedside table, door handles, the TV remote or the phone, clean your hands too.
• Remind other visitors to do the same.
• Let the room be cleaned, and do not ask the staff to come back later. The CDC says this.
• If you have a cough, fever or diarrhoea yourself, put off the visit. For a viral respiratory illness, the CDC says to stay home and keep away from others.

Ask the care team to clean their hands

For most companions this is the hardest part. The CDC says it is fine to ask the care team to do this, and suggests wording:

• “Before you start the examination, could you clean your hands again?”
• “Could you clean your hands before changing the dressing?”

The CDC writes that wearing gloves alone is not enough, and that anyone who touches the patient or medical equipment should have cleaned their hands. The same guide asks patients and their companions to remind visitors to wash their hands.

When the patient has a catheter or an IV line

The CDC says that if the patient has a urinary catheter or a central line, ask every day when it can be removed. The longer a catheter stays, the greater the chance of infection. The CDC notes that syringes and needles must not be reused for more than one patient. If you have doubts about any of this, ask the nurse or doctor simply and respectfully.

Signs to look for

The CDC says some skin infections show themselves with redness, pain or discharge at the site of an IV line or surgery. For surgical site infection the CDC lists these signs: redness and pain around the surgery site, cloudy fluid draining from the wound, and fever.

If you see any of these:

• Tell the nurse or doctor straight away.
• Do not wait for the next visit.
• If you think the patient has an infection, the CDC suggests asking, “Could this be sepsis?”

Confusion, fast breathing, pallor or a rash that does not fade under pressure are also in the list of urgent signs.

If the patient is taking antibiotics

The CDC advises that antibiotics should be used only when the doctor thinks they are needed, and if a new medicine is prescribed, ask whether it is necessary. If the patient is taking a medicine, follow all instructions, and tell the doctor if a side effect such as diarrhoea appears.

On resistant germs, the CDC also suggests asking the care team what the hospital does to protect the patient and their family. Resistance means the germ blocks the usual medicines; it belongs to the germ, not to the patient’s body. More explanation is in resistant and recurring infections.

Dressings and wounds

The CDC says visitors should not touch a wound or dressing, and should wash their hands before and after the visit. Whoever cares for the wound must also clean their hands before and after. For patients being discharged, the CDC advises making sure before leaving that they understand wound care and know whom to call. So at discharge, ask:

• How do we care for the wound?
• Which signs mean we should come back?
• Whom do we call, and on what number?

How much is your share?

Preventing infection is shared work between the patient, the companion, the care team and the hospital, and not all of it is on you. If an infection happens despite all the care, do not blame yourself. Tell the doctor what you have seen and ask what needs to be done for the patient.

A reminder

This article is for information only and does not replace the care team’s opinion. If your patient has a particular condition, ask the doctor or nurse what other precautions are needed.