Top Docs: Avoiding hospital infections

People go to the hospital to get better, not sicker. But hospitals can be hospitable places for a variety of nasty germs -- an obvious problem for ill people, who are especially vulnerable to infections.

An estimated one in 20 people who are hospitalized develops an infection related to hospital care, according to the U.S. Centers for Disease Control and Prevention.

Here's what you need to know:

1. WHERE HOSPITAL-ACQUIRED INFECTIONS COME FROM

Why the abundance of germs in hospitals? One answer is simple: Because they're filled with sick people who bring them in.

But that's not the only explanation. The treatments people are given in a hospital can also expose them to infections, explained Dr. Michael E. Khalife, an attending surgeon at Winthrop-University Hospital in Mineola.

"Sometimes, it's because the method by which the infection is obtained is normally only found in a health care setting," Khalife said. "An example of this would be a urinary tract infection from a catheter in the bladder, or a pneumonia that is contracted due to prolonged use of a breathing tube and ventilator."

In some cases, germs in hospitals are difficult to vanquish with medication because they've developed resistance to drugs. The increased use of antibiotics in the hospital setting, he said, has allowed certain strains of bacteria to become more dangerous. "In fact, the increased use of antibiotics has led to an increase in the incidence of Clostridium difficile colitis, a serious infection of the colon by bacteria that thrive after other healthy bacteria in the colon have been wiped out by the use of antibiotics."

2. PATIENTS AND VISITORS SHOULD TAKE PREVENTIVE ACTION

"Patients can take some universal precautions to avoid certain infections, especially the type that is spread through contact," Khalife said. "This includes frequent hand washing, avoiding contact with sick visitors, limiting exposure to other sick patients and limiting the amount of contact with other floors of the hospital."

Visitors should stay away from the hospital if they're sick, he said, and they should always wash their hands both entering and when leaving a hospital room. "Leave the handling of soiled linens and other excrement to the hospital staff," Khalife said. "If you do have to handle these, wear gloves, which are usually readily available in most hospital rooms."

3. HOSPITALS ARE DOING THEIR PART, TOO

At Winthrop-University Hospital, as at many hospitals, "there are washing stations with antibacterial soap in all patient rooms and throughout the hospital," Khalife said. "There are also hand-sanitizer pumps throughout."

Also, he said that members of the hospital's health care team are trained in ways to prevent the spread of infection through things like gloves, gowns and masks. "Patients with known drug-resistant infections are isolated in their own rooms to prevent spread to roommates," Khalife said. "Signs are placed so everyone visiting the room is aware. Patients coming to the emergency room from nursing homes -- which have a higher incidence of resistant bacteria -- are screened appropriately to see if they carry any resistant bacteria."

4. IT'S OK TO SPEAK UP

If patients or visitors think hospital staff members aren't following proper procedures regarding the control of infections, Dr. Bradley Cohen urges that they speak up.

But Cohen, a surgical oncologist in Islip Terrace who's affiliated with Good Samaritan Hospital Medical Center, acknowledges that this can be difficult. "Questioning and trying to correct the actions of hospital staff members is awkward," he said. "There can be interpersonal repercussions, since people are people."

So how should patients or visitors point out concerns? "A friendly, forceful and non-accusatory attitude will work best," Cohen said.

"But this requires a maturity and insight that is hard to teach."

5. IT'S WISE TO MOVE OUT OF THE HOSPITAL AS QUICKLY AS POSSIBLE

With doctors and nurses on duty every minute of the day and emergency assistance just steps away, a hospital might seem like the perfect place to recover from illness. But lingering can boost the risk of a hospital infection.

"Many patients believe the hospital is a safe haven to recover in and are reluctant to go home," Khalife said, "when in reality, the home may be a much safer place to recover in."

SURGEONS

2035 Lakeville Rd., Ste. 206

1999 Marcus Ave.

206 W. Park Ave.

270 Pulaski Rd., Ste. A

Greenlawn; 631-423-1414

15 Park Ave.

Bay Shore; 631-581-4400

600 Northern Blvd., Ste. 111

North Shore-LIJ Health System

Dept. of Surgery

1999 Marcus Ave.

South Nassau Cancer Center

Surgical Oncology

1 Healthy Way

Oceanside; 516-632-3350

139 Plandome Rd.

516-627-5262

580 Union Blvd.

West Islip

631-321-6801

139 Plandome Rd.

516-627-5262

10 Medical Plaza

516-676-1060

300 Old Country Rd., Ste. 101

100 Hospital Rd., Ste. 106

Patchogue; 631-475-8846

310 E. Shore Rd., Ste. 203

175 Jericho Tpke., Ste. 201

Syosset; 516-682-4800

Dept. of Surgery

HSC T-18, Rm. 060

Stony Brook; 631-444-1795

Winthrop Surgical Assoc.

120 Mineola Blvd., Ste. 320

Mineola; 516-663-3300

2800 Marcus Ave., Ste. 204

Lake Success; 516-622-6120

173 Mineola Blvd., Ste. 401

Mineola; 516-741-6464

Surgical Oncology

650 Commack Rd.

37 Research Way

East Setauket

631-444-1045

10 Medical Plaza, Ste. 305

158 E. Main St., Ste. 7

Huntington; 631-271-1822

How they were picked

Castle Connolly Medical Ltd. is a health-care research and information company founded in 1991 by a former medical college, board chairman and president to help guide consumers to America's top doctors and top hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of top doctors and the medical leadership of leading hospitals.

Castle Connolly's physician-led team of researchers follows a rigorous screening process to select top doctors on both the national and regional levels. Its online nominations process -- located at castleconnolly.com/ nominations -- is open to all licensed physicians in America who are able to nominate physicians in any medical specialty and in any part of the country, as well as indicate whether the nominated physician is, in their opinion, among the best in their region in their medical specialty or among the best in the nation in their medical specialty.

Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in their paperback guides, national and regional magazine "Top Doctors" features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)

Physicians selected for inclusion in this "Top Doctors" feature may also appear as Regional Top Doctors online at castleconnolly.com or in one of Castle Connolly's Top Doctors guides, such as America's Top Doctors or America's Top Doctors for Cancer.

To see the whole list . . .

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com or call 800-399-DOCS.