As long as she knows she has protections in place, Rita Hubbard will clean any room at the Wyoming Medical Center.

The environmental services coordinator said she is not too worried about contracting infectious diseases, such as methicillin-resistant Staphylococcus aureus (MRSA), while she strips the sheets from beds and wipes down equipment.

"It's one of the most important jobs in the hospital," Hubbard said. "The reason I came here was to make a difference."

Hubbard spends about 35 minutes to an hour cleaning a room from top to bottom. She cleans the walls, disinfects the bathroom and mops the floor.

Housekeeping at the Wyoming Medical Center is just one part of the hospital's large commitment to infection control.

"We work with almost everyone in the hospital. It's a department-wide process," said Alice Lynch, an infection control nurse who coordinates doctors, nurses, housekeepers, dieticians and other hospital employees in preventing infections.

Hospital infections include surgical-site infections, hospital-acquired pneumonia and even urinary tract infections. According to the Centers for Disease Control and Prevention, more than two million hospitalized Americans contract infections each year. The infections are fatal for about 90,000.

Up to 50 percent of hospital-acquired infections are preventable, said Dr. Dale Bratzler, an expert on surgical-site infections and medical director of the Oklahoma Foundation for Medical Quality.

Because of this, the Wyoming Medical Center has adopted an aggressive program to control infections within its walls:

* Hand washing: This is the most important act to control hospital infections, Lynch said. The hospital has installed hand sanitizer dispensers on the outside of every patient room and in waiting rooms. The dispensers are even in the Support Services building where patients are not allowed.

Lynch passes out pocket-sized bottles of hand sanitizer to staff and does education on the importance of washing. She makes rounds in the hospital to ensure people are washing their hands and she does on-the-spot lecturing about it.

Emily Jennings, a registered nurse in the progressive care unit, tries to always wash her hands before and after putting on gloves. She also cleans her stethoscope and blood pressure cuffs with alcohol pads in between patients.

* Patient attention: Keeping patients warm in operating rooms and keeping ventilator patients' heads elevated at a 30 to 45 degree angle can also prevent infections. Something as easy as checking a ventilator patients' oral care can help reduce pneumonia.

"These are simple things that we can do that don't cost a lot of money," Lynch said.

* Timely post-operative care: The hospital is starting a program to remove urinary catheters more quickly after surgery, said Dr. Mark Dowell, an infectious disease physician and head of infection control at the Wyoming Medical Center. The longer the catheter is in, the greater chance the patient has of contracting a urinary tract infection.

The hospital also has "a very good IV team" that works to remove IVs quicker, Lynch said.

* Monitoring antibiotics. Patients must receive the correct antibiotic an hour before their surgery, Dowell said. The hospital displays lists of the types of antibiotics that should be used before various surgeries and alternatives if a patient is allergic.

"We know the antibiotics we are using and we rotate them," Dowell said. "We have a very aggressive program."

Rotating antibiotics helps prevent infection-causing organisms from becoming antibiotic resistant.

* MRSA screening: The hospital now screens all patients who come through the intensive care unit for MRSA, an antibiotic-resistant skin infection. Health care providers swab patients' noses and culture the samples.

If a patient comes back positive for MRSA, he or she is put on "contact precaution," Lynch said. Nurses must wear gloves and full gowns every time they enter the patient's room.

Thursday morning, Jennings had to gown up before entering several of her patients' rooms. It takes longer, but it is worth it to protect herself and her patients, she said.

"There has been a dramatic decrease in MRSA after we implemented the ICU screening two years ago," Lynch said.

Proactive infection control is good for patients. It's also good for the financial well being and reputation of a hospital.

A hospital infection can increase the patient's length of stay and can cost the hospital $5,000 to more than $20,000, depending on the infection, Dowell said.

"If we can cut down on hospital infections, it may help us stay in the black," Dowell said. "If I can just prevent a few infections a year, it may make the difference between a financially stable hospital or not."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@casperstartribune.net.

For more on this story, click here to read about the issue of health infections at hospitals, and click here to find out how to protect yourself during surgery. Also, click here to learn how the rise of antibiotics has hindered infection control.