As a patient, or as the loved one of a patient, you are a part of the care team. Your role is to speak up whenever you don’t understand something or if you see or hear something that doesn't seem right – even if you’re not a medical professional – so you’ll know what to expect before, during and after care.
Here are some tips on what to watch for, ask and do.
Before Going to the Hospital
Some hospitalizations occur suddenly while others are planned in advance. If the situation allows you to plan ahead, consider the following:
1. Arrange for someone to be at the hospital with you. Make sure they understand why you are going to the hospital and are aware of any other health concerns you may have. This person will be your eyes and ears if you are sedated or recovering. Make sure that person is included in your HIPAA information so the medical team can talk directly with them about your condition.
2. Make a list of all your medications, or bring them with you. Include any over-the-counter medications, like aspirin; these medications can be as important to your doctor as your prescription medications.
3. Ask if you need medications after surgery and get them filled prior to the operation. Also, if you typically require antibiotics before dental work, tell your doctor.
4. Ask about mobility. Will you be able to walk on your own or do you need crutches, a wheelchair or other device? If you have to climb stairs to get to your home or if your bedroom is not on the main level, create a temporary recovery area in a convenient place.
5. Ask if you will get to leave the hospital the same day or if you will need to stay overnight. If staying at the hospital, ask if you can bring a small bag with toiletries and a change of clothes.
6. Ask if you will need home health services and make arrangements
7. Call the number on the back of your member ID card to talk to a customer service representative about your upcoming surgery. You can ask questions about what your policy covers and how you will be billed. You also can learn more about your doctor and hospital by searching online.
8. If you smoke, try to quit at least two weeks before the hospitalization. If you can't quit, let the hospital staff know. They may be able to provide support to help with withdrawal symptoms.
9. Tell your doctor if you have an addiction to alcohol or drugs. Your doctor may be able to help you with withdrawal, and not letting the doctor or hospital know could create a serious health situation for you.
10. Tell your doctor if you have allergies to medications, food, latex or tape adhesive.
11. Plan to wear loose clothing to the hospital. Do not wear makeup or lotions, body spray, perfume and other scented items.
12. Plan to leave your jewelry and other valuable items at home.
At the Hospital
At the hospital, it’s important to watch for possible risks of falls and infection. If you are an advocate for the patient, speak up when he or she can’t.
As a patient:
13. Ask if the hospital has adopted a surgical checklist. If not, ask what your surgeon and anesthesiologist will do to be sure the requirements are met.
14. Ask for the surgical site to be marked before you are sedated so you know it is the correct location. Make sure your advocate knows the location as well.
15. Do not shave the surgical site yourself. The hospital staff should use clippers, not razor blades, to prepare the site.
As a patient advocate:
16. Ask how long the patient will be in surgery and recovery and when you can expect an update.
17. Wash your hands frequently and be sure others (family, nurses, doctors) wash theirs every time they come in the room. If someone doesn't, say something. Be sure the doctors and nurses wear gloves when doing wound care, dressing changes, IV site changes etc.
18. Politely tell sick visitors they should wait to visit when they — and the patient — are better.
19. Keep a record of all activities and conversations. Include times and names of all people involved. What medicine was given? Was there a change? Which doctor came by? Which tests or procedures were done? Did the results get back to the doctor?
20. If a medication is new, ask what it does and find out if there could be side effects.
21. If the stay in the hospital is lengthy, be sure the staff keeps your loved one from developing bedsores by frequently turning him or her.
22. Report any broken or malfunctioning equipment, including call lights, wheelchairs, bedside tables, hand-sanitizer dispensers or bathroom handrails. If something is not working, it may cause problems.
23. Falls are frequent in hospitals because of sickness, age, incontinence, medication effects and being in a strange environment. Talk to each nurse at shift change about what can be done to prevent falls.
- What changes have occurred in your loved one that may increase the risk of falling?
- Is the room cluttered or too dark?
- Are wheels locked on wheelchairs and other equipment?
- Are the toilet seat and the bed at the appropriate height?
- Would a regular bathroom schedule be safer than waiting for an urgent call of nature?
- Is the call-light working and reachable?
- As your loved one improves, is the activity level expanded so that muscle strength and conditioning improves?
24. Watch any wound dressings; if they come off or need to be changed, tell someone.
25. If there is an IV line inserted into the neck or near the heart (called a central line) watch for signs of infection. Pay strict attention to hand washing and gloves. Talk to the doctor daily regarding how long the central line should stay in place.
26. Be sure urine catheter bags are below your loved one's center of gravity. Discuss with the doctor and nurses what can be done to prevent infections from the urinary catheter and make sure it happens.
27. If your loved one is on a ventilator, ask about bed elevation and how often his or her mouth should be cleaned.
28. Watch your loved one's intake at meals. If the patient is not eating consistently, tell the doctor.
Before Leaving the Hospital
29. Once again, it is important for the patient and advocate to listen, ask questions and take notes. Too often, patients do not follow their doctors' discharge instructions and end up being re-admitted to the hospital. You may be able to avoid re-admittance by asking the following:
- Are there special instructions for any catheters, surgical incision sites, dressings or IV sites?
- What are signs of infection?
- How should pain be managed?
- What medications are necessary?
- When is the follow-up appointment?
Being part of the care team when someone needs medical attention is a huge responsibility, but by watching and listening intently, and speaking up when you have a concern, you can be sure you or your loved one gets the best care possible.------
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