One in three hospitalized patients nationwide are harmed by medical error or hospital-acquired infection, according to a recent study published by the journal Health Affairs. While hospitals, private agencies and government groups try to reach consensus on the best way to reduce medical errors and infections, there are a number of steps patients and their families can take to protect their health and safety:

1. Maintain your own personal medical record, including current medications, and take it with you to all medical appointments and to the hospital if you are admitted. Always identify yourself to your caregivers if they do not ask your name first, so you do not receive medications or treatments intended for someone else.

2.  Have a living will and be sure your doctor has a copy.

3.  Be truly informed before consenting to treatment. Educate yourself about all your medications, any proposed surgeries and procedures, your hospital and your doctors. Look up your hospital and health care providers at the independent Health Grades website, the Medicare program’s Hospital Compare, the Maine Health Management Coalition’s site and the online records of the Maine Board of Licensure in Medicine.

4.  Avoid hospitalization if possible. Get any care you can at home or on an outpatient basis.

5.  Keep your original body parts if you can live with them. Getting surgical implants puts you at high risk for infection. Surgical implants are things like joint replacements, cardiac valves, orthopedic pins, rods and screws, etc.

6.  If you absolutely cannot avoid surgery or a hospital stay, get in and out of the hospital as quickly as possible.

7.  Ask your doctors about getting screened for Methicillin-resistant Staphylococcus aureus at least a week before your admission. MRSA is an opportunistic bacterium that may be present without causing any health problems, or it can cause a life-threatening infection that is easily spread in a hospital setting. If you test positive with a nasal swab, demand decolonization treatment. Even if you have a negative MRSA result, take a shower with Chlorhexidine antiseptic soap for a few days before the day of your surgery. Chlorhexidine is available without a prescription at your pharmacy and it will clean away bacteria from your skin and help you avoid an infection.

8. Pay close attention to what your roommate’s diagnosis is. If he or she has an infection, you may soon have it, too, since you share a room and bathroom. Your caretakers cannot legally tell you what anyone else’s diagnosis is, but your roommate or visitors can. Ask directly but respectfully if an infection is present, and if the answer is “yes,” demand that you be moved into a room without infection.

9.  If possible, keep an advocate at your bedside 24 hours a day. Your advocate can help keep you safe and clean, do simple tasks to assist you, alert the nurses if something goes wrong, and help you in walking, moving and getting out of the hospital as soon as possible. Your advocate can monitor nurses’ and doctors’ hand washing and medication administration. They can keep a diary of your care and about your caregivers.

10. Bring hand sanitizer and disinfecting wipes to the hospital. Clean your hands regularly and carefully before eating and after bathroom use. Have your advocate clean frequently touched surfaces, like television remotes, phones, faucets and door handles, bedside rails, toilet levers, over-bed tables, etc.

This is a pretty good starting list. Patients must go on the defensive when it comes to their care. Control what you can by taking available safety measures into your own hands.

Kathy Day of Bangor is a retired registered nurse and an advocate for improved patient safety.