Hospital stay safety
Posted by michellemoquin on May 2nd, 2008
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I always said that I should have been a doctor because my handwriting was so bad. ‘Chicken scrawl’ is what I call it. No matter how hard I try, my handwriting is just no good. I always wanted to write gracefully but unfortunately my mind moves much quicker than my hand. Therefore my hand is continually playing ‘catch-up’ leaving me with handwriting very similar to Michael Jackson. You know the look; cursive mixed with printing and throw in a few caps now and then – basically a mish-mash of well-intended words having a party (a pretty intoxicated one) on my paper. Well…I have been told that sloppy left handers are very creative. I can live with that.
What I can’t live with is mixed up prescriptions. This happened to me a long time ago with an allergy med that I was prescribed. And luckily I discovered it before it was popped into my mouth. This mistake pill was not even for allergies! I rarely take drugs but I needed this one at the time. You can be sure that I check everything thoroughly now before I ingest it.
I found this article on-line and I found it to be very helpful not only in regards to prescription meds being misinterpreted but other medical errors that could be very detrimental. Check this out:
As many as 195,000 patients die each year in US hospitals because of medical errors, according to a recent study by HealthGrades, a leading health-care rating company. Here’s how to stay safe next time you’re in the hospital. If you’re too incapacitated by your illness or injury to do these things for yourself, a family member can do many of them for you.
1. Keep a list of prescribed medications with dosages. You can get this list from the attending physician (the doctor in charge of your case), an intern, resident or nurse. Receiving the wrong medication is one of the most common — and dangerous — hospital errors. When a hospital staff member hands you a pill or starts to hook an intravenous (IV) bag to your arm, ask what you’re being given. If the drug isn’t on the list of medications you have been prescribed…
Ask “What does this treat?” If the answer isn’t a condition that you think you have, double-check that the drug provider knows your name and birthday, to confirm you’re the patient he/she thinks you are.
Make sure it’s not a drug with a similar name. If you’ve been prescribed Zantac and someone’s trying to give you Xanax or you take Celebrex but the nurse shows up with Cerebyx, someone may have misheard the instructions and provided the wrong medication.
Also, if it is a drug you’ve been prescribed but you previously received a different dosage, make sure the change was intentional.
2. Label yourself. If you’re in the hospital for an operation on a limb, a lung or anything else that you have more than one of on or in your body, use a marker or ballpoint pen to write “this arm,” “this leg” or just “yes” on the side that should go under the knife, so there is no confusion in the operating room. (At some hospitals, your surgeon will sign his initials to the body part in advance of your operation.) Don’t use an “X” to mark the spot, because an “X” is ambiguous — it could be misinterpreted as “not here.”
If you’re allergic to any medications, make a sign to this effect and post it over your hospital bed. Example: “Allergic to Penicillin.”
3. Schedule your hospital stay wisely. New interns, residents and medical school students begin assignments at teaching hospitals in early July. If possible, postpone elective procedures until a different time, when young medical professionals have more experience.
If you can’t avoid a July stay in a teaching hospital, be wary about what you let interns and medical students do. If one wants to draw blood, insert a catheter or perform another common hospital task, ask how many times he/she has done it before. If the answer doesn’t fill you with confidence, insist that a nurse or resident take over.
Also, at any time of the year, try to schedule your surgery for early in the day. By the end of a long day, even the most skilled surgeons aren’t at the top of their game. Also, because patients aren’t allowed to eat or drink before surgery, a late operation means extra hours of hunger, thirst and worry.
4. Get to know the staff. A wide range of doctors, nurses, physician’s assistants, interns, residents, orderlies and others might be involved in your care. Whenever a new face arrives, politely ask his name and what his role is, unless his name tag makes this obvious, then engage in some friendly conversation.
If you make a personal connection with everyone involved in your care, it reduces the odds that you’ll be mistaken for a different patient with potentially dangerous results. It also increases the odds that you’ll get prompt care. Because most hospital patients are preoccupied with their health problems, the few who remain composed, personable and interested in the hospital staff often are treated more favorably.
5. Know who should do what. Find out when you can expect your attending physician to visit your bedside, and save any questions you have until then. Answers you receive from anyone else might not be definitive.
Don’t let a UAP (also known as unlicensed assisting personnel or nurse assistant) insert an IV or catheter, change a sterile dressing, give you a shot or feed you through a tube. Such tasks should be handled by trained medical staff, such as a registered nurse. Check the person’s name tag. If there’s no designation, such as RN, ask what his training is.
6. Select the right surgeon. Unless it is an emergency, you shouldn’t necessarily settle for the first surgeon you’re sent to. When you meet with a surgeon for a consultation, ask…
Are you board-certified in this specialty? Or check this on the Web site of the American Board of Medical Specialties (www.abms.org or call 866-275-2267). You will have to register on-line, but it is free.
How many times have you performed this exact procedure? You want someone who has done it hundreds or even thousands of times. If the procedure is rare, you at least want a surgeon who performs it dozens of times per year.
7. Find the right hospital. If your surgeon has privileges at more than one hospital in your area, the annual “America’s Best Hospital Guide” of US News and World Report (www.usnews.com and click on “Best Hospitals” at left) can help you decide which facility is best for a given procedure. Be aware that your health insurance might limit you to a particular hospital or restrict your choice of surgeons.
8. Plan for the unexpected before you wind up in a hospital. Ask your doctor now which emergency room in your region he considers the best, assuming that there’s more than one. (Of course, in situations where every second counts, the closest ER is almost always the best choice.)
9. Speak up. Make no effort to conceal your pain in a crowded emergency room — the ER staff might equate a quiet patient with a low-priority medical problem and treat others ahead of you. If you must wait, let the staff know if the pain gets worse… you have trouble breathing… feel increasingly lightheaded… or lose feeling in, or control over, part of your body.
10. Encourage bedside visitors. Visitors don’t just keep you company in the hospital. They can keep an eye on the quality of your care when you’re unable to do so yourself. And because hospital employees know that family members keep an eye on what’s going on, more visitors tend to mean more attention from the staff.
11. Warn your anesthesiologist of any loose teeth. A loose tooth could be knocked out during intubation (when a breathing tube is placed in your windpipe), causing a potentially serious infection if the tooth reaches your lungs. Also, ask your doctor about removing any dentures or artificial teeth before you’re taken to the operating room.
Whew! – that was a long article but I think well worth the read. You never know if one of these tips will save your life one day.
Readers: Have you had any experience like these you want to tell us about?
ZL, Al, and Doug: Thanks for the kudos. Will do! Al, the numbers mean nothing; just throwing a bit of fun into the interview!
Have a good one…
Gratefully your blog host,
michelle ?
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May 2nd, 2008 at 9:13 am
Michelle, as usual – great info, kinda wished you’d written it prior to my MIL’s knee replacement a few months ago! We learned all this as we went along…
Today – http://edgy1.wordpress.com/2008/05/02/beijing-chinaand-the-olympics/
On the fly today, so have a beautiful day everyone!
Oh, hey Al, thanks for the comment on new site, took me a half hour to recall my pasword at old one but I left a ‘last’ post there so you/others can still find Edgy1 or Zen Lill : )
- ZL
May 3rd, 2008 at 7:49 am
Michelle: Hi, and how are you? Some good advice about hospital stays. I am uninsured, so I receive all of my health care through the Public Health Trust (thank God there is such a thing).
Some of the services are a real joke. I will give you one example (Adam, you should enjoy this). I was attending and outpatient hepatology clinic, doing a course of Peg-intron and Rebital (both are very nasty meds, with many life threatening side effects).
My specialist’s assistant, Masoud, will usually see me first, prepping me for Dr. Shankar.
Masoud started with a standard form questionnaire, then he looked straight at me and asked “ are you now pregnant or nursing”? I said excuse me. He repeated the question, and I said you have got to be kidding me. He finally caught on a gave a slight chuckle.
His next question (and he was serious) was how long since my last menstrual cycle. I threw him out and demanded to see Dr. Shankar. Who apologized for his assistants lack of knowledge.
This type of incompetence is so common, nobody knows anything. And if you ask, or demand answers, they will simply put your chart on the bottom of the heap.
Luckily, I have a good primary care physician, but he tells me his hands are tied, and can only give me referrals for the most important stuff. I get so frustrated with this system, and must continually remind myself to be grateful that I can get any services at all.
Now in my sisters case, her husband has good insurance and has frequent hospital stays to either do chemo, or recover from having tumors removed. He has cancer, and it shows up all over and repeatedly. His last group of tumors were wrapped around his vena cava, his aorta, and his spine.
Ironic that he has never smoked, or taken drugs, and has been an athlete who has taken good care of himself all of his life. He is also a wonderful person and a good husband to my little sister.
Whenever he must stay in the hospital, my sister must stay with him 12 hrs. a day, and hire a private nurse to stay the other 12 hrs.
Why, because the nursing staff at this hospital will not lift a finger to help. They do not respond to the nurse call button, they constantly forget to bring him his meds, and basically give him no care whatsoever.
Remarkably, Bill (my bil) is doing ok right now. He is a little shorter from all the discs removed from his spine, but his markers are low. A lot of prayer was said on his behalf.
Another one of my recent experiences with our wonderful healthcare system. I had broken a leg, by ditching my bicycle into a ditch. A choice I made, rather than to become some Knuckleheads hood ornament.
Fire rescue gave me a lift to the nearest hospital. They immediately X-rayed and cat scanned my leg. They then told me to see my private doctor in the morning, telling me that they do not do casts at this hospital (ridiculous I know).
So I left without having my leg set, and with out a means home (I did get a pair of crutches) to late to catch a bus, I waited till morning (outside of course). I made it home, but still had no way to get to the public hospital, did I mention that I was hungry and in a lot of pain, with no cash on me.
They then had the nerve to bill me close to 3 thousand dollars for their services. I straighten that out via many phone calls. Then they still sent my account to a collection agency.
Oh, I finally did get me leg set a few days later, and had to travel by bus and foot to get there and back, a 50 mile round trip.
My experiences with health scare and hospitals are nearly always this backwards, and being terminally ill, it is not very comforting to know the state of the Public Health Trust.
Al
April 24th, 2009 at 4:06 am
Not that I’m impressed a lot, but this is more than I expected when I stumpled upon a link on SU telling that the info here is quite decent. Thanks.
October 8th, 2009 at 5:53 pm
Michelle,
I authored the book mentioned and I am glad some readers found the info helpful. All the best.
David Sherer MD
Chevy chase, Md