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Your Role in Preventing Hospital Complications

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Recently Kevin Price, Host of the nationally syndicated Price of Business Show, welcomed Dr. Ann Hester to provide another commentary in a series.

The Dr. Ann Hester Commentaries

The Centers for Medicare and Medicaid Services, also known as CMS, lists 14 categories of hospital acquired conditions that can enormously impact patients. They range in severity, and some have the potential to be fatal. While we may not be able to help prevent all these conditions, we can help prevent some of them. For instance, urinary tract infections related to having a bladder catheter are common. We call these catheter-associated urinary tract infections or CAUTIs. While they are frequently curable, sometimes they become complicated. The infection can spill over into the bloodstream and causes septic shock and potentially even death.

Now, it’s easy to see why people may not want to get up and move around when they’re sick in the hospital. They may feel that having a catheter in the bladder will make it easier because they don’t have to get up and go to the bathroom. But there’s a lot of bacteria in that area of the body. Sometimes bacteria can creep along the walls of the catheter and set up an infection in the bladder.

So, when you’re in the hospital, know the activity level your doctor prescribed. If you can walk around at will, get up and go to the bathroom. If you’d rather have a bedside commode so you don’t have to walk as far, ask your doctor to order one. And if you’re feeling weak and want assistance, push the call bell and ask for help.

Another example is an infection associated with a particular type of IV called a central line. While most IVs are small and placed in the arm, others are larger and are positioned closer to the body’s central core, such as in the neck, chest, or groin. These are called central lines.

According to the CDC, infections related to central lines, known as central line-associated bloodstream infections, or CLABSIs, are responsible for thousands of deaths each year, yet they are preventable. Healthcare providers have a huge role in preventing CLABSIs, but you can also play an important role. First, try to keep the central line dry. If you notice redness or soreness around the catheter, notify your nurse immediately. And if the bandage gets wet or dirty or falls off, let your nurse know. Also, avoid touching the catheter tubing as much as possible.

Bed sores, called decubitus ulcers, are another central area of concern. While minor redness or skin breakdown may be more of a nuisance than a cause for concern, deeper ulcers can lead to significant complications, including infection of a bone. A surgical procedure could be needed to remove dead tissue, and healing could be challenging. If incapacitated, you must rely on others to turn you over in bed to decrease the risk of developing these ulcers. But if you are able, get up and move around. Don’t spend long periods lying on your back in bed if not required to do so. If you can’t get out of bed but can turn over, change positions regularly. Ask your nurse or doctor how often you should change positions. This can go a long way in decreasing pressure over any given body region, lowering your risk of ulcer development.And perhaps the most concerning condition that may arise during hospitalization is the formation of a blood clot. When a person is immobile, such as lying in bed for long periods, it increases the risk of blood clot formation, typically in a deep vein in a leg. If a portion of the clot breaks off and travels thru the bloodstream to the lungs, it could cause a fatal cardiac arrest. While most blood clots are not deadly, some are. So, it’s imperative to know your doctor’s plan to decrease your risk of blood clots. Her plan may be that you walk around the hospital ward or in your room a few times a day. Alternatively, your doctor may order leg pumps or injections. The important thing is to ask. The bottom line is systems fail. People make mistakes. So, whenever you are hospitalized, be a true partner in your healthcare to ensure the best outcome possible.

Ann M. Hester, M.D. is a board-certified internist with over 25 years of experience. She obtained her medical degree from the University of Tennessee in Memphis. Dr. Hester believes when patients are taught exceptional “patient skills,” they become empowered to play a previously unimagined role in optimizing their medical care and minimizing medical costs. Her mission is to share these critical skills by various means, thereby improving patient outcomes and strengthening the U.S. healthcare system. This mission started in medical school when she witnessed the tremendous gap between how patients and doctors think. Over the years, she has written various patient empowerment pieces online and through books. Her latest book is Patient Empowerment 101: More than a book, it’s an adventure! This unique work takes an unprecedented step in helping people think more like doctors and position themselves at the center of their healthcare team.

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