Working in a hospital requires you to pay special attention to hygiene practices because the spread of germs happens quickly and without much prompting. As a result, some 687,000 patients experience a healthcare-associated infection (HAI) every year, 72,000 of whom die. What’s more, HAIs may be on the rise. From 2016 to 2017, the Centers for Disease Control and Prevention reported a 1 and 13% increase in HAIs nationwide.

It’s not clear what exactly is behind this shift, but it is clear that hospital employees play a significant role in both widening and preventing the spread of germs. Below are a few evidence-based sources of bacteria driven by healthcare workers.

• Hands

According to the CDC, studies show that healthcare workers wash their hands less than half of the number of times per day that they’re supposed to. Depending on how many patients you’re treating, you might need to wash your hands up to 100 times during a 12-hour shift.

For optimal hand-washing results, the CDC recommends:

• Using an alcohol-based hand sanitizer
• Wearing gloves whenever you’re treating a patient with C. difficile because alcohol-based hand sanitizer does not kill it
• Cleaning your hands before and after every patient interaction

You should also take the time to clean easily skipped areas, such as cuticle beds, and between your fingers. Because healthcare workers’ dry skin on their hands can also contribute to HAIs, regularly apply a CDC-approved lotion throughout your shift. If your hospital doesn’t stock it, you should advise them to do so. Regularly remind your patients to wash their hands, as well.

• Clothing

Multiple studies have shown that hospital workers’ clothing can contribute to infections, especially scrubs and white coats. That’s why multiple governments, including those in the UK and Australia, have issued a “bare below the elbow” recommendation.

In an October 2017 study, a simulation found that 25% of clinicians wearing long-sleeved white coats had contaminated sleeves and wrists compared to 0% of clinicians in short sleeves. Similarly, a 2016 study found nurses’ scrubs become contaminated with bacteria after roughly 10 percent of shifts. The authors noted clinicians should be more conscious of wearing protective clothing during interactions with patients with infections.

• Incorrect Protocol When Removing Protective Clothing

Many benefits of wearing protective clothing are lost if clinicians don’t follow the appropriate procedures when taking it off or “doffing.” A May 2019 study found 39% of healthcare workers make doffing errors and, as a result, were more likely to have contaminated clothes following a patient interaction. Always follow the CDC guidelines for personal protective equipment.

• Stethoscopes and Other Medical Tools

A 2018 study found stethoscopes are often loaded with diverse bacteria, such as Staphylococcus, which can cause deadly staph infections. Making matters worse, many clinicians don’t clean their stethoscopes. Littman offers some recommendations for doing so:

• Wipe your stethoscope with a 70% isopropyl alcohol solution.
• Do not use hand sanitizer as a cleaning agent, as there are additives that may damage parts of the stethoscope.
• Do not immerse your stethoscope in any liquid or subject it to any sterilization process.
• Keep your stethoscope away from extreme heat, cold, solvents, and oils.
• Tunable diaphragms can be removed from the chest piece and their surfaces wiped with alcohol or soapy water. Dry all parts thoroughly before reassembly.
• Ear tips can be removed from the ear tubes for thorough cleaning.

Healthcare workers frequently carry other known fomites, including badges, blood pressure cuffs, and pens.

• Shoes

Hospital floors often carry dangerous bacteria. According to a 2014 study, 22% of floors tested positive for methicillin-resistant Staphylococcus aureus, 33% had vancomycin-resistant enterococci, and 72% had C. difficile. Naturally, your shoes come in the most contact with the floor, so be sure to practice good hand hygiene after touching your shoes.

• Cell phones

Some 40% of nurses’ cell phones are contaminated with bacteria, MedPage Today reported in June 2019. Consider sterilizing your device regularly with bleach or alcohol to eliminate the most enduring bacteria, such as C. difficile. Dr. Dubert Guerrero, an infectious disease specialist at Sanford Health in Fargo, North Dakota, told The New York Times. While a certain degree of bacteria is inevitable in healthcare settings, revisiting best practices for cleaning your hands, scrubs, and your personal equipment can mitigate these effects.