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Who's afraid of hospital infections?

india Updated: Jul 24, 2011 01:15 IST
Sanchita Sharma
Sanchita Sharma
Hindustan Times
Sanchita Sharma

There's some good news for those who fear flying. Despite crotch bombers and their ilk threatening air travel in imaginative ways with each passing day, planes remains far safer than hospitals.

More people die each year from medical errors and hospital infections than air crashes, said a patient-safety expert at the World Health Organisation (WHO). Statistics show that your chances of dying in a plane crash are one in a million, compared to your one in 10 risk of being subjected to a medical error, irrespective of the country you are admitted to hospital in. And your chances of dying of a medical error are 1 in 300, which is a frightening scenario considering hospitals are the places you go to be saved from your medical troubles.

Much as we hate them, hospitals cannot be avoided, so you may want to consider using WHO's suggestions for patients and doctors to lower risk of infection and death. At the risk of making you very unpopular with nurses and doctors, the the global health watchdog's Committee to Reduce Infection Deaths recommends that you: Ask hospital staff whether they have washed their hands or used an alcohol-based sanitiser before letting them touch you. Doctors should be asked to wipe the stethoscope with alcohol before use. And always, avoid putting your hands near your mouth.

Before surgery, quit smoking. Smokers are more likely to get infections and take longer to recover. And just to be sure, remind the nurse to give you an antibiotic before surgery.

For surgeons, the WHO recommends its 2-minute surgical checklist, developed by the US-based Dr Atul Gawande, associate professor of surgery at the Harvard Medical School. The checklist identifies 19 safety standards to avoid surgical complications and death related to major operations.

The list clearly works, with a New England Journal of Medicine study showing its use reduced death by 40% in eight hospitals across the world, including in India. Delhi's St Stephen's Hospital participated in the WHO-sponsored study, along with hospitals in Manila, Amman, Seattle, Toronto, London, Auckland and Ifakara in Tanzania. Serious complications fell from 11% to 7%.

With 234 million major operations done worldwide each year -- one for every 26 people - the reduction translates into tens of thousands of complications avoided and many lives saved. In some developing countries, 5% people die of surgical complications, with improper anaesthesia use alone causing death in one in 150 surgeries in sub-Saharan Africa. In developed countries, complications range between 3 and 16%, says the WHO.

Since even small errors can kill people, the checklist identifies three phases in a surgery, each corresponding to a specific period in the normal flow of work: before the induction of anaesthesia ("sign in"), before the incision of the skin ("time out") and before the patient leaves the operating room ("sign out"). In each phase, a checklist coordinator needs to confirm that the medical team has completed listed tasks before moving on.

Of course, the best way to save yourself is to avoid hospitals like the proverbial plague. Avoiding hospitalisation alone can save you from hospital infections, such as the MRSA and the NDM-1, which are resistant even to new-generation antibiotics such as carbapenem.

Yet, however hard you try, there is no escaping illnesses and accidents. So perhaps insisting doctors and nurses sanitise their hands and stethoscope before touching you is not such a bad idea.