How to avoid infection

How to avoid infection

Credit: Claude Dagenais / Two Humans

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by Nancy Levenson / Contributor

Posted on March 4, 2010 at 6:00 AM

Updated Wednesday, Oct 30 at 7:13 AM

Happy Birthday to You!
Happy Birthday to You!
Happy Birthday to anyone who's listening ... 
Happy Birthday to You!

One more time!

This is the song I've been singing to myself each time I'm standing at the sink, washing my hands. That is, ever since I found out that having clean hands is the No. 1 way to prevent infection.

Granted, I work at home, and I'm not exposed to a lot of the bacteria and viruses that are floating around, but I figure it can't hurt. The hospital is, of course, a different story. Approximately 5 percent of patients admitted to hospitals contract a healthcare-associated infection (HAI).

In fact, hospitals are now putting teams in place to reduce these numbers. Jana Brott is the Manager of the Infection Prevention & Control (IP&C) Program at Legacy Health Systems in Portland, Ore. She and her team work with healthcare workers, volunteers and visitors to educate people and reduce the incidence of HAIs. "Over the past twenty months, our efforts have resulted in a thirty-nine point nine percent reduction in HAIs across our six hospitals," Jana reports.

Education is key for reducing infection. Jana Brott and her team focus on two seemingly simple--but crucial--messages: Having clean hands and practicing respiratory etiquette are hugely effective for infection prevention.

The Culprits
There are four major types of infections that hospitals such as Legacy are working to prevent:

  • Surgical site infection - Approximately 1 - 3 out of every 100 patients who have surgery develop an infection.
  • Ventilator associated pneumonia - Patients on ventilators are susceptible to lung infections called ventilator-associated pneumonia (VAP).
  • Catheter-associated bloodstream infections - If germs travel down a central line and enter the blood, a patient may get a bloodstream infection.
  • Catheter associated urinary tract infections - Patients with catheters are susceptible to urinary tract infections (UTIs), which affect the bladder and kidneys.

Squeaky-Clean Solutions
Reducing the incidence of bacteria such as Staphylococcus aureus, commonly known as staph, is one way to lower the risk for infection. These common bacteria normally live on the skin or the nasal passages of roughly 30 percent of the U.S. population. Staph can cause infection when they enter the skin through a cut or sore. Infection can also occur when the bacteria move inside of the body through a catheter or breathing tube. The infection can be minor and local (for example, a pimple), or more serious. With proper hand washing and respiratory etiquette, viruses and bacteria like staph are much less likely to spread.

So, what are the rules for proper hand washing? Below are some guidelines from the Centers for Disease Control:

  • Wet your hands with clean running water and apply soap. Use warm water if it is available.
  • Rub hands together to make a lather and scrub all surfaces.
  • Continue rubbing hands for 15-20 seconds. Need a timer? Hum "Happy Birthday" twice through.
  • Rinse hands well under running water.
  • Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.

If soap and clean water are not available, use an alcohol-based hand rub. These rubs work quickly and significantly reduce the number of germs on the skin.

When using an alcohol-based hand rub:

  • Apply product to the palm of one hand.
  • Rub hands together.
  • Rub the product over all surfaces of hands and fingers until hands are dry.

Respiratory etiquette guidelines are as follows:

  • Carry clean tissues and cover your mouth and nose with a tissue when you cough or sneeze.
  • If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.
  • Discard used tissues immediately.
  • Clean your hands after coughing, sneezing or blowing your nose.

Both the hand washing and the respiratory etiquette apply to anyone in a healthcare environment: workers, patients, visitors and volunteers.
And if you see someone not taking precautions, it's OK to say something. "We encourage patients to speak up. The single best thing you can do to decrease your risk of infection is to be engaged with your health care team," says Jana Brott. That could mean asking your doctor to wash her hands before examining you, or asking a member of your health care team what they're doing to prevent infection. It may seem uncomfortable at first, but it's much more comfortable than ending up with an infection.

About the Author

Nancy Levenson is a freelance writer based in Portland, Ore. Her work has been published online at and

and in magazines such as Cottage Living and Northwest Homes and Gardens. She is also a contributor to theBest Places guidebooks.