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Before surgery, ask if you will need antibiotics. Usually, antibiotics are given shortly before surgery (and stopped within 24 hours) to reduce the risk of wound infections. But don't just assume you're getting antibiotics: ask if you are. If you aren't, ask why.
Before surgery, ask how hair will be removed at the surgical site. If hair needs to be removed, it should be done with electric hair clippers rather than a razor. A razor can result in tiny cuts that can become infected. And the CDC recommends that if hair is removed it should be done immediately before surgery. Shaving should not be the night before an operation, because that is associated with higher rates of surgical skin infections.
Ask everyone -- including doctors and nurses -- to wash their hands. This is a key way to prevent the spread of hospital-acquired infections. Don't let anyone touch you who has not washed his or her hands in your presence. "It's your health," says Peter B. Angood, MD, co-director, International Center for Patient Safety, "so you need to make sure that health care providers are washing their hands and protecting you." Although you might feel awkward about asking a doctor or nurse to wash, you need to speak up. Besides, most hospitals now have policies that staff should be washing their hands in front of the patient.
Tell family members to stay away if they're sick. It can be hard to keep some dedicated well-wishers away. But remind loved ones that if they are sick, even with a mild cold, they must stay away until you've fully recovered.
Know the signs of infection. Before you're discharged, make sure you understand what to watch for. How will you know if your incision is getting infected? What will it look like? How will it feel? If you don't know these things, you might assume that dangerous signs of a hospital-acquired infection are just normal postoperative pain. "There are so many stories of people just toughing it out when they should have gotten help," says Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality (AHRQ) in Rockville, Md.
SOURCES: Peter B. Angood, MD, vice president, chief patient safety officer, The Joint Commission, Oakbridge Terrace, Ill.; co-director, International Center for Patient Safety. Carolyn Clancy, MD, director, Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services, Rockville, Md. Fran Griffin, RRT, MPA, former director, Institute for Healthcare Improvement, Cambridge, Mass. Medicare Quality Improvement Community web site: "Surgical Care Improvement Project: Tips for Safer Surgery." Surgical Care Improvement Project (SCIP): SCIP Project information, MedQIC. Mangram AJ, Infect Control Hosp Epidemiol, 1999.