Doctor Office and Hospital Visit Manners

Public Health: Doctor Office Manners

Best Practices For Patient Hospital and Doctor Visits

Germs are everywhere. There are 10 times more microbes that live in and on our bodies than our own cells. At any given moment on our skin there are about 1,000 different species of organisms. The vast majority of these don’t make us sick, and in fact many are beneficial to us. But when people do pick up a pathological infection they go to a healthcare provider.

Healthcare settings are like a centralized meeting place for infectious organisms. If that wasn’t bad enough, there are increasing numbers of infectious organisms that are resistant to antibiotics –the Centers for Disease Control and Prevention (CDC) has uncovered more than 220 germs by the latest count– and the CDC says that staying in a healthcare facility is one of the biggest risks for acquiring one of these antibiotic-resistant bugs.

That’s the normal background for why it’s important to observe infection control best practices in a healthcare setting. Factor in a contagion like Covid-19 and the point is underlined in bold.

Every year the CDC estimates that about one out of every 25 hospital patients gets diagnosed with a healthcare-associated infection; an infection they picked up while staying in a hospital. You can get sick from viruses, bacteria, and other pathogens by breathing them in or transferring them to your body from things you touch. Taking the following steps will help you prevent this.

Hand Cleanliness: Washing vs Sanitizing

Germs thrive in warm and wet places. In humans we collect germs on our hands from everything we touch, and when we touch our warm wet places –eyes, nose, and mouth; our mucous membranes– we transfer germs to an ideal incubator. From there they can easily find paths to our respiratory, digestive, and blood circulatory systems.

You may not realize it but you touch your face about 23 times an hour, and nearly half of those times involve touching a mucous membrane. Your face, head, and hair are naturally oily, and every time you touch them you get some of that oil on your hands. Oil is sticky and perfect for catching all kinds of bacteria, germs, and dirt on your hands.

Washing with soap for 20 seconds is great for removing that oil from your hands, along with the dirt and germs that are stuck to it. Soap acts as an intermediary between water and oil; it can bind to oil while also dissolving in water. Soap itself doesn’t actually kill germs, it merely washes them off your hands and down the sink drain, which is just as good from your perspective. Heat does kill germs, so that’s why it’s good to use hot water when you wash your hands.

Hand washing is the best way to remove germs from your hands. When it’s not possible, using hand sanitizer is the next-best option. To be defined as a hand sanitizer by the US Food and Drug Administration (FDA), a product must contain either alcohol (ethyl or isopropyl) or benzalkonium chloride.

Alcohol is the most common active ingredient you’ll find in over-the-counter consumer products. It kills germs by destroying their cell walls and breaking apart proteins. The CDC recommends at least a 60% concentration of alcohol in hand sanitizer.

Hand washing and sanitizing will only keep your hands relatively clean until you touch something again. So when you’re in a healthcare setting it’s good to keep the things you handle to a minimum.

Face Masks vs Respirators

Until the Covid-19 pandemic it was rare to see people in the West wearing facemasks. Since then the face mask has become a common daily sight like it has been in Asian countries for the recent past.

Face masks –pieces of cloth, paper, or other fabric that fit over the nose and mouth– can help prevent airborne transmission of infectious diseases by the person wearing them. If you’re sick or suspect you’re sick –and many who have Covid-19 are asymptomatic– then it doesn’t hurt to wear a face mask.

It’s the same principle for why you’d cover your mouth when you sneeze or cough: it prevents you from spewing infectious droplets into the air. A face mask can work even better than an elbow or your hand for covering a sneeze, and you’re not going to touch a public door handle with your mask after you’ve sneezed on it.

However there’s not strong evidence that wearing a face mask does much to prevent you from breathing in someone else’s infectious disease once it’s already airborne. Airborne microbes are by definition microscopic and can easily pass through a face mask, even more so for a loose-fitting face mask.

If you want to effectively filter the air you’re breathing and keep out 95% of very small particles (0.3 microns), then you’ll need a properly-fitted N95 respirator. This looks similar to a face mask but it’s internal design is more intricate and includes a filtration system.

Social Distancing

Becoming infected is a two-variable process. First it depends how much of an infectious substance you’re exposed to. Second, it depends on how capable your immune system is at defeating intruders.

Social distancing is a way to reduce how much of an infectious substance you’re exposed to. The closer you are to a person infected by an airborne pathogen, the more infected droplets will fall on you.

Time is another factor in reducing your exposure. The less time you spend in an infected place, you’ll be exposed to a relatively lower amount of infectious particles.

Keeping a distance from people who may be infected and reducing the time you spend in a public place like a hospital or doctor’s office are two good strategies. They hold true whether you’re sitting in a waiting room or going to the pharmacy to pick up a prescription.

Immune System Prophylaxis

Prophylaxis steps, preventative healthcare, can maximize the strength of your immune system. While this gets a brief mention it’s by no means less important. You can keep your immune system healthy by:

  • Eating a balanced diet with healthy foods
  • Getting plenty of exercise
  • Getting enough good-quality sleep
  • Reducing stress in your daily life while increasing enjoyable activities
  • Avoiding an unhealthy diet, drinking alcohol in excess, or smoking

Use: A Multi-Pronged Strategy

It’s best practice to use all the effective strategies you have at your disposal. That means combining good hand hygiene with social distancing and face masks as appropriate. You will have heard a lot about this during the Covid-19 pandemic but it’s also good standard practice.

Teenagers might feel that face masks aren’t cool, but if they’re sick (and during Covid-19 times when testing isn’t widespread and it’s hard to know who is a carrier) and going to be around a vulnerable population like the elderly, it’s strategic to wear a face mask.

During epidemics or pandemics, parents who take their toddlers to the doctor’s office or hospital waiting room should be weary about toys for public use in a children’s area. Plan ahead and bring your own games. Instill good hand washing hygiene habits on your kids while they’re still young.

If you’re going to be in a public setting, especially a hospital or doctor’s office, there’s no way to eliminate the risk from infectious diseases by 100%, but following these best practices will give you the best shot at staying healthy.

Resources

https://www.cdc.gov/publichealthgateway/didyouknow/topic/hai.html https://www.cdc.gov/winnablebattles/report/HAIs.html https://pubmed.ncbi.nlm.nih.gov/25637115/ https://www.fda.gov/drugs/coronavirus-covid-19-drugs/hand-sanitizers-covid-19 https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/n95-respirators-and-surgical-masks-face-masks https://www.federalregister.gov/documents/2019/04/12/2019-06791/safety-and-effectiveness-of-consumer-antiseptic-rubs-topical-antimicrobial-drug-products-for
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