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Hospital Facilities

Hospitals & facilities

What to know about hospital hazards

Hospitals can be hazardous. Here’s how to avoid harm.

Hospital-acquired conditions

  • Harm in the hospital, or “hospital-acquired conditions (HAC),” includes medication errors, falls, pressure ulcers, blood clots, obstetric adverse events and healthcare-associated infections
  • A recent study of 11 hospitals in Massachusetts found that serious preventable harm occurred in about 1% of hospital admissions
  • A “National Scorecard” on HAC details how often each type of problem occurs

Healthcare-associated infections

  • Hospital patients are sicker than other people and hospital germs are more resistant to treatment than germs outside healthcare facilities
  • Surgical sites, urinary catheters, “central lines” and ventilators all provide ways for germs to enter the body
  • As a result, hospitalized patients are especially vulnerable to infection and to sepsis, a life-threatening response to infection

Controlling infections

  • Patients and families can take steps to control infections such as enforcing staff and visitor handwashing; disinfecting surfaces, especially high-touch surfaces; and seeking prompt removal of urinary catheters
  • Patients and families should also be alert for signs of infection or sepsis, a life-threatening response to infection
  • A mnemonic for detecting sepsis is TIME: Temperature, Infection, Mental decline and Extremely ill

Medication errors

  • Errors involving medication are one of the most common types of inpatient errors, with children at significantly higher risk than adults
  • Patients and families can help ensure the “rights” of medication administration (right medicine, dose, patient, time, route, documentation, reason and response)
  • “High-alert” medications such as blood thinners, insulin and narcotic pain medicines require special vigilance


  • Patients are more likely to fall in the hospital than at home
  • Reasons for an increased risk include drugs that cause dizziness, drowsiness or confusion and dizziness when standing up after an extended period in bed
  • Patients can take steps such as being extra careful getting out of bed, asking for help if dizzy or unsteady, and wearing slippers with nonskid soles

Blood clots

  • Blood clots are the leading cause of preventable death in hospitals
  • Signs of a clot include swelling, pain and tenderness in a leg, increased warmth in a swollen or painful area of a leg, and red or discolored skin on a leg
  • Signs that a clot has broken free and traveled to the lungs include shortness of breath, chest pain, a racing heart and unexplained coughing
  • Devices to improve blood flow and medications to thin the blood can help prevent clots

Pressure ulcers (bed sores)

  • Bed sores can form when skin is under pressure, for example when a person is bedridden
  • They can become infected and/or take months or years to heal
  • Bed sores can be prevented with inspection, repositioning, padding, and care of the skin

Complications of labor & delivery

  • The US has high rates of maternal injury and death compared to other developed countries
  • Patients and families can help protect themselves by checking in advance whether a hospital has recommended procedures in place to detect and manage hemorrhage (excessive blood loss), severe high blood pressure and blood clots
  • Starting in Fall 2023, patients and families will be able to check whether a hospital qualifies as “Birthing Friendly” under a new quality and safety initiative from the Centers for Medicare and Medicaid Services

Rapid decline

  • Signs of a rapidly declining patient include changes in mental status, shortness of breath, acute pain, and the patient stating that something is wrong
  • In this situation patients and families should ask to see a physician immediately
  • If necessary patients and families can call the hospital operator and ask for the administrator on call

Risks with hospital discharge

  • Discharge from the hospital involves risks such as confusion about whether to continue pre-hospitalization medications and gaps in care between discharge and the next appointment with a physician
  • Patients and families can speak up if a discharge seems unsafe and appeal any decision by Medicare or another insurer to stop paying for care
  • Medicare’s Care Compare can help locate and evaluate nursing homes, home healthcare, inpatient rehabilitation and long-term hospitals
  • Medically reviewed August 2023