Healthy Hospital Tips
September 29, 2009 Written by JP [Font too small?]At one point or another almost everyone ends up in a hospital. Or, at the very least, someone that you care about pays a visit to one. When that time comes, it’s vital to be aware of certain resources that can help ensure a healthier and safer stay. The suggestions presented today have been validated by recent scientific studies. I’m sharing them in the hope that they will be helpful for both the patients being treated and the nurses and physicians who provide such care.
Please note that the following information is not comprehensive in nature. These are simply a few isolated recommendations based upon new information contained in the medical literature. In some instances, these tips may not be appropriate. Therefore, I strongly suggest that you discuss these options with your health care team prior to applying them.
Long before the advent of apartment complexes and skyscrapers, humans were surrounded by deserts, forests and jungles. It seems that this deeply ingrained history of ours may still have something worthwhile to contribute. A study in the September issue of The Journal of Alternative and Complementary Medicine explored the connection between the presence of ornamental plants in hospital rooms and the recovery process. 90 patients who underwent minor surgery were placed in traditional hospital rooms or rooms that included living flowers and plants. The patients in the rooms with plants demonstrated several key benefits as compared to those in rooms without:
- Lower levels of anxiety, fatigue and pain
- A significant reduction in systolic blood pressure
- The treatment group also conveyed a more positive impression about the quality of care they received from hospital employees.
These findings are very promising because they indicate that this simple change could improve the healing and working environment for both caregivers and patients. The authors of this study concluded that, “health care professionals and hospital administrators need to consider the use of plants and flowers to enhance healing environments for patients”.
Something as basic as a hand massage can significantly reduce stress in patients receiving advanced cancer care. A recent experiment evaluated the effects of a “brief hand massage” on the salivary levels of a substance called chromogranin A (CgA) in a group of in-patients. Saliva samples were taken prior to and after a “5 minute massage to the upper extremity” of 34 cancer patients in a “palliative care unit”. Palliative care refers to the management of quality of life issues present in severe medical conditions. Reductions in CgA levels and improvements in “patient satisfaction” were reported in all of the participants receiving this form of treatment. (1)
Incorporating comedy films and TV shows into a hospital care setting may assist doctors and patients improve tolerance to treatment related pain. A recent study performed at UCLA involving 18 children (aged 7-16) found that viewing “humorous video tapes” during painful procedures could help improve pain tolerance – see table below. The application of this kind of “humor therapy” may promote better patient compliance to stressful and uncomfortable therapies and ultimately, bring about improvements in treatment outcomes. (2)
Listening to relaxing music prior to surgery may be a safer way of reducing anxiety than the use of conventional anxiolytic (anti-anxiety) drugs. 372 surgical patients were divided into two groups. Half were asked to listen to calming soundtracks prior to surgery. The remainder was given an anxiolytic pre-operative medication known as midazolam. A standardized test called the State Trait Anxiety Inventory was used to determine the relative effects of both treatments. Those listening to the calming tunes exhibited a greater reduction in anxiety than those receiving the medication. The Swedish scientists that helmed the study commented that, “higher effectiveness and absence of apparent adverse effects makes pre-operative relaxing music a useful alternative to midazolam for pre-medication”. (3)
Pain Appraisal and Tolerance by Trial |
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| Condition | Mean Pain Appraisal | Mean Pain Tolerance in Seconds |
| No Video (Trial 1) | 4.60 | 52.26 |
| After Humorous Video (Trial 2) | 4.24 | 58.74 |
| During Humorous Video (Trial 3) | 4.57 | 80.42 |
Avoiding hospital acquired infections is a primary objective in modern medicine. A natural strategy that may reduce this risk is to supplement with probiotics. Probiotics are healthy bacteria that are present in the digestive system and can be found in cultured and fermented foods such as sauerkraut and yogurt. A recent meta-analysis in the European Journal of Clinical Pharmacology examined 9 randomized controlled trials that involved probiotic use in 733 hospital patients. The authors of the review determined that the incidence of “postoperative pneumonia, cholangitis and any infections, as well as the duration of postoperative hospital stay and length of antibiotic therapy were lower among patients receiving probiotics”. (4)
It’s incumbent upon us all to be our own advocates while under any kind of medical care. This is all the more true if and when we’re admitted to a hospital. If we respectfully demand the most up-to-date treatment options and participate in our own recovery, it not only helps us, but also benefits the medical staff and their other patients. It is the challenging and well informed patients that help doctors and nurses to improve performance. This, in turn, can have a positive “domino effect” that may lead to better care for countless others and is yet another way in which we can all help to reform health care.
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Hospital, Music, Probiotics
Posted in Alternative Therapies, Mental Health, Nutritional Supplements
September 30th, 2009 at 6:26 pm
Great article. I have been in and out of the hospital for the past week and a half. Between me and my newborn baby.
September 30th, 2009 at 6:48 pm
Thank you! Congratulations on your new baby!
I hope you both enjoy the best of health in the days to come.
Be well!
JP
April 14th, 2011 at 1:57 pm
This is awesome man!
I’m gonna go buy another plant for my room and turn on some comedy shows as soon as I get home!
(Seriously!)
July 30th, 2016 at 6:22 pm
Updated 07/30/16:
http://onlinelibrary.wiley.com/doi/10.1111/apt.13740/full
Aliment Pharmacol Ther. 2016 Jul 28.
Randomised clinical trial: a Lactobacillus GG and micronutrient-containing mixture is effective in reducing nosocomial infections in children, vs. placebo.
BACKGROUND: Nosocomial infections are a major public health issue and preventative strategies using probiotics and micronutrients are being evaluated.
AIM: To investigate the efficacy of a mixture of Lactobacillus GG and micronutrients in preventing nosocomial infections in children.
METHODS: A randomised, double-blind, placebo-controlled trial was conducted in hospitalised children. Children (6 months to 5 years of age) received Lactobacillus GG (6 × 109 CFU/day) together with vitamins B and C and zinc or placebo, for 15 days, starting on the first day of hospitalisation. The incidence of gastrointestinal and respiratory nosocomial infections after discharge was determined by follow-up telephone call at 7 days. After 3 months, another telephone call estimated the incidence of further infections during follow-up.
RESULTS: Ninety children completed the follow-up. Of 19/90 children with a nosocomial infection (20%), 4/45 children (9%) were in the treatment group and 15/45 (33%) in the placebo group (P = 0.016). Specifically, 2/45 (4%) children in the treatment group vs. 11/45 (24%) children in the placebo group (P = 0.007) presented with diarrhoea. The duration of hospitalisation was significantly shorter in the treatment group (3.9 days ± 1.7 vs. 4.9 ± 1.2; P = 0.003). At the follow-up, a total of 11/45 (24.4%) children in the treatment group had at least one episode of infection compared to 22/45 (48.9%) in the placebo group (P = 0.016).
CONCLUSION: A mixture containing Lactobacillus GG and micronutrients may reduce the incidence of nosocomial infections, supporting the hypothesis that this may represent a valid strategy to prevent nosocomial infections.
Be well!
JP
September 27th, 2016 at 10:28 pm
Updated 09/27/16:
http://iopscience.iop.org/article/10.1088/0967-3334/37/10/1872/meta;jsessionid=8372B3A652E37461CC983F9CEA652E57.c1.iopscience.cld.iop.org
Physiol Meas. 2016 Sep 21;37(10):1872-1884.
Walking in hospital is associated with a shorter length of stay in older medical inpatients.
Evidence suggests that inactivity during a hospital stay is associated with poor health outcomes in older medical inpatients. We aimed to estimate the associations of average daily step-count (walking) in hospital with physical performance and length of stay in this population. Medical in-patients aged ⩾65 years, premorbidly mobile, with an anticipated length of stay ⩾3 d, were recruited. Measurements included average daily step-count, continuously recorded until discharge, or for a maximum of 7 d (Stepwatch Activity Monitor); co-morbidity (CIRS-G); frailty (SHARE F-I); and baseline and end-of-study physical performance (short physical performance battery). Linear regression models were used to estimate associations between step-count and end-of-study physical performance or length of stay. Length of stay was log transformed in the first model, and step-count was log transformed in both models. Similar models were used to adjust for potential confounders. Data from 154 patients (mean 77 years, SD 7.4) were analysed. The unadjusted models estimated for each unit increase in the natural log of step-count, the natural log of length of stay decreased by 0.18 (95% CI -0.27 to -0.09). After adjustment of potential confounders, while the strength of the inverse association was attenuated, it remained significant (β log(steps) = -0.15, 95%CI -0.26 to -0.03). The back-transformed result suggested that a 50% increase in step-count was associated with a 6% shorter length of stay. There was no apparent association between step-count and end-of-study physical performance once baseline physical performance was adjusted for. The results indicate that step-count is independently associated with hospital length of stay, and merits further investigation.
Be well!
JP
November 20th, 2016 at 7:32 pm
Updated 11/20/16:
https://www.ncbi.nlm.nih.gov/pubmed/27863609
Complement Ther Clin Pract. 2016 Nov;25:42-51.
The impact of listening to pleasant natural sounds on anxiety and physiologic parameters in patients undergoing coronary angiography: A pragmatic quasi-randomized-controlled trial.
OBJECTIVE: This study aimed to investigate the impact of listening to pleasant natural sounds on anxiety and physiological parameters in patients undergoing coronary angiography.
METHODS: The present pragmatic quasi-randomized controlled clinical trial was conducted on 130 patients undergone elective angiography. The participants were randomly divided into two groups, including a pleasant natural sounds group, and a control group (n1/2 65 per group). Spielberger’s state/trait anxiety inventory was used to assess levels of anxiety. The patients’ anxiety level and physiological parameters were measured at baseline, before, during, immediately after, and 20 min after coronary angiography.
RESULTS: The mean level of anxiety was similar in both arms at baseline (t = 1.317, df = 128, p = 0.190). The intervention arm displayed significantly lower anxiety levels than the control arm during the intervention (Wilks’ lambda 0.11, Pillai’s trace 0.89, P 0.001, F 2.05). The physiological parameters (systolic and diastolic blood pressure, mean arterial pressure, heart rate, and oxygen saturation) of both groups showed statistically significant differences (p < 0.05) over time and in group-by time interactions.
CONCLUSION: As an effective nursing intervention presenting no side-effects, listening to pleasant natural sounds can be helpful in the management of anxiety.
Be well!
JP
December 15th, 2016 at 1:30 am
Updated 12/14/16:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107231/
Pain Res Manag. 2016;2016:9147279.
Effect of Intravenous High Dose Vitamin C on Postoperative Pain and Morphine Use after Laparoscopic Colectomy: A Randomized Controlled Trial.
Background and Objective. Vitamin C has antioxidant, neuroprotective, and neuromodulating effects. Recently, it showed antinociceptive effect as a result of the antioxidant properties. Therefore, we designed this study to assess the effect of intravenous vitamin C on opiate consumption and pain in patients undergoing laparoscopic colectomy. Methods. A total of 100 patients were enrolled and allocated to receive 50 mg/kg vitamin C or placebo by intravenous infusion immediately after induction of anesthesia. Morphine consumption and scores of pain were assessed at 2, 6, and 24 h after completion of surgery. Results. There were 97 patients included in the analysis. Patients who received vitamin C had higher plasma concentrations of vitamin C at the end of surgery, significantly lower morphine consumption at the 2 h after end of surgery, and significantly lower pain scores at rest during first 24 h postoperatively. There was no significant difference between groups in side effects, fatigue score, or pain score during cough. Conclusion. This study shows high dose vitamin C infusion decreased postoperative pain during the first 24 h and reduced morphine consumption in the early postoperative period. Additional research needed to examine whether higher doses of vitamin C and longer infusion times can amplify these effects.
Be well!
JP
September 4th, 2017 at 7:00 pm
Updated 09/04/17:
https://www.ncbi.nlm.nih.gov/pubmed/28866140
Clin Nutr. 2017 Aug 10.
Perioperative supplementation with a fruit and vegetable juice powder concentrate and postsurgical morbidity: A double-blind, randomised, placebo-controlled clinical trial.
BACKGROUND & AIMS: Surgical trauma leads to an inflammatory response that causes surgical morbidity. Reduced antioxidant micronutrient (AM)a levels and/or excessive levels of Reactive Oxygen Species (ROS)b have previously been linked to delayed wound healing and presence of chronic wounds. We aimed to evaluate the effect of pre-operative supplementation with encapsulated fruit and vegetable juice powder concentrate (JuicePlus+®) on postoperative morbidity and Quality of Life (QoL)c.
METHODS: We conducted a randomised, double-blind, placebo-controlled two-arm parallel clinical trial evaluating postoperative morbidity following lower third molar surgery. Patients aged between 18 and 65 years were randomised to take verum or placebo for 10 weeks prior to surgery and during the first postoperative week. The primary endpoint was the between-group difference in QoL over the first postoperative week, with secondary endpoints being related to other measures of postoperative morbidity (pain and trismus).
RESULTS: One-hundred and eighty-three out of 238 randomised patients received surgery (Intention-To-Treat population). Postoperative QoL tended to be higher in the active compared to the placebo group. Furthermore, reduction in mouth opening 2 days after surgery was 3.1 mm smaller (95% CI 0.1, 6.1), the mean pain score over the postoperative week was 8.5 mm lower (95% CI 1.8, 15.2) and patients were less likely to experience moderate to severe pain on postoperative day 2 (RR 0.58, 95% CI 0.35, 0.95), comparing verum to placebo groups.
CONCLUSION: Pre-operative supplementation with a fruit and vegetable supplement rich in AM may improve postoperative QoL and reduce surgical morbidity and post-operative complications after surgery.
Be well!
JP
December 19th, 2017 at 2:53 pm
Updated 12/19/17:
https://www.ncbi.nlm.nih.gov/pubmed/29252150
J Nutr Gerontol Geriatr. 2017 Oct-Dec;36(4):149-165.
Whey Protein Supplementation Improves Rehabilitation Outcomes in Hospitalized Geriatric Patients: A Double Blinded, Randomized Controlled Trial.
Whey protein supplementation (WPS) has been shown to improve functional outcomes in populations that are able to participate in high-intensity resistance training. The purpose of the study was to evaluate the efficacy of WPS on rehabilitation outcomes in a frail, hospitalized elderly population. Men and women (n = 47) were randomly assigned to either a control group or WPS group for the length of their hospital stay. Several functional and serum measures were determined pre- and post-intervention. WPS significantly increased average daily protein intake and was well tolerated. The WPS group exhibited significant improvements in grip strength and knee extensor force over the control group, and a significant positive correlation was found between change in prealbumin and percent-increase knee extensor force. These findings support the use of WPS to improve protein nutritional status and rehabilitation outcomes in a clinical setting involving a frail, elderly population.
Be well!
JP