Did you know that medical errors are the third leading cause of death in the U.S. (behind heart disease and cancer)? Mistakes are even more likely to happen if you are in the hospital where numerous people are involved in your care and a lack of coordination among multiple medical teams is possible.
The most important thing you can to stay safe in the hospital, and avoid medical errors, is to be actively involved in your care (or the care of a loved one). Here are 11 tips to help you do just that. And you can find all of these suggestions, and more, in this Hospital Quick Guide and Hospital Discharge Checklist.
1. Be Prepared Before You Check In
Bring these with you so your healthcare team will be up-to-date on your medical history:
- Your updated health summary and medication list. Click here to get a free template.
- Your Hospital Quick Guide and Hospital Discharge Checklist.
- Medical records, scans, x-rays, relevant test/procedure results.
- Advance directives. Click here for a free guide.
- Notepad and pen (keep careful notes of EVERYTHING!).
- An advocate/support person.
2. Keep Careful Notes
There will be a lot of information to take in while you’re in the hospital. And it won’t be possible to remember every detail. You, or your support person, should keep careful notes, jot down questions as they come to you and make a list of everyone involved in your care. Also keep track of test results, procedures, new medications and other therapies that you have while you’re in the hospital.
3. Check Your ID Bracelet
Make sure the information on your ID bracelet or band is correct. Whenever you get medications, treatments, procedures, tests, lab work or any other interventions, a staff member should be checking your ID.
It’s not uncommon for patients to get the wrong medications or treatments simply because their ID bracelet wasn’t checked or the information on it was incorrect.
4. Track Your Progress
It’s up to you to keep track of how you’re doing when you’re in the hospital. Ask your healthcare team, every day, how you’re progressing. Let them know if you have any questions or concerns about your health or the care you’re receiving. And remember to write all of this down!
5. Don’t Be Afraid to Speak Up
Never be afraid to speak up when it comes to your health and medical care. If you have concerns, or just need questions answered, let your nurse or doctor know right away. Your support person can also alert your healthcare team if something needs to be addressed.
If you have specific issues with your care or progress that you feel aren’t being taken care of, ask to speak to the Nurse Manager. If you still aren’t able to resolve an issue, contact the hospital’s Patient Representative (sometimes called Patient Advocate or Patient Experience Officer).
6. Understand Your Medications
A 2006 Institute of Medicine report estimated that medication errors injure 1.5 million Americans every year at a cost of $3.5 billion.
If you’re in the hospital, be sure you bring your medication list with you. As soon as you’re admitted, your nurse should do a ‘medication reconciliation’ with you. This just means that the two of you go through each of your medications and decide which ones you’ll continue taking, and which ones need to be held while you’re in the hospital.
Here are a few other things you should do to make sure you are taking medications safely:
- Stay on top of your medicines! Over 60% of hospitalized patients miss their regular medications while they’re in the hospital. On average, 6.8 medications are left out per patient.
- Never take a medication without asking what it is, what it’s for and who prescribed it. This includes pills, liquids, creams, injections, IVs, and breathing treatments.
- Ask about the potential risks and side effects of EVERY medication that you take in the hospital.
- Ask if any new medications that you’re prescribed are compatible with your regular medications.
- When you’re being discharged, be sure your nurse does another ‘medication reconciliation’ with you. This way you’ll know if you need to start taking any new medications, which of your regular medications to continue and which (if any) you need to stop taking.
7. Know About the Rapid Response Team
Most hospitals have a team of clinicians that can be called to your bedside if sudden, unexpected changes occur in your condition, including intolerable pain. This team is called a Rapid Response Team (also known as Medical Response Team).
In some facilities, patients and family members can active the Rapid Response Team. In others, only staff members can make the call.
Ask your nurse how the Rapid Response Team system works in your hospital.
8. Ask About Every Test, Treatment or Procedure You’re Told You Need
Don’t just assume that every test, treatment or procedure you’re told you need while in the hospital is absolutely necessary. Unnecessary medical care can be harmful and costly. Propublica reported that a study in Washington state found that “in a single year more than 600,000 patients underwent treatment they didn’t need, at an estimated cost of $282 million.”
Of course, there will be tests, treatments, and procedures that you absolutely do need while you’re in the hospital. But you should still ask why and understand the risks vs the benefits. Be prepared with this list of questions.
9. Prevent Complications
Being actively involved in your hospital care can help prevent many of the potential complications that could arise during your stay.
Here are common problems and some tips on how to prevent them:
- Prevent hospital-acquired pneumonia
- Keep the head of your bed elevated to 30 degrees or more.
- Use an incentive spirometer (ask your nurse to demonstrate how).
- Get out of bed and move around as much as possible.
- Do active coughing and deep breathing exercises (ask your nurse to show you how).
- Prevent pressure ulcers (also called bedsores)
- Get out of bed and move around as much as possible. If you’re bedbound, make sure a staff member turns and positions you at LEAST every TWO hours.
- Make sure you have the appropriate support surfaces on your bed (ask your nurse about this).
- Be sure to get adequate nutrition.
- Be sure to keep your skin clean and dry.
- Prevent blood clots
- Get out of bed and move around as much as possible.
- Use compression stockings or compressions devices if necessary (ask your nurse if these are appropriate for you).
- Ask your nurse or provider if you need to be taking a prophylactic blood thinner.
- Prevent falls
- Keep your bed in a low position.
- Use the call bell if you need assistance getting out of bed or moving around.
- Wear non-slip footwear.
- Keep walking areas clear.
- Use an assistive device (walker, cane, etc.) if needed.
- Prevent infections
- Handwashing is THE MOST EFFECTIVE way to prevent the spread of infections. Ask anyone that touches you or enters your room if they’ve washed their hands.
- If you have any invasive devices (IV, tubes, drains, breathing tubes, etc.), ask your healthcare team – daily – when it will be safe to remove them.
- Ask anyone who is sick not to visit you until they are well again.
10. Pain Management
You may experience pain as a result of your condition or due to a surgery/procedure you have in the hospital. Making sure your pain is under control can help you get better faster.
Don’t be afraid to tell someone if you’re in pain. You may have to take medications to help you feel better. Also ask about alternative therapies such as massage, gentle exercise, heat/cold packs and relaxation techniques to help manage your pain.
You should be aware that your pain may not be able to be completely eliminated. The goal is to bring it to a level you can tolerate.
11. Get Discharged Safely
The discharge process is a complex, multifaceted care‐coordination plan that must begin on the first day of admission. All too often, important information and medication reviews take place only hours – or even minutes – before your due to leave the hospital. Because the discharge process is so complicated, it’s not uncommon for mistakes to happen, or things to get missed, during this time.
Here’s what you need to do to be safely discharged. And remember, many of these things should be taken care of well before you are set to leave. This way, you’ll have time to absorb the information, ask questions and make necessary arrangements for proper care when you are discharged.
- Use your Hospital Discharge Checklist to make sure everything is covered.
Ask for a discharge summary and instructions. Your nurse should go over these with you in detail.
- Ask about follow-up appointments.
- Ask your nurse to do a ‘medication reconciliation’ to go over every medication that you need to start taking, continue taking or stop taking after your hospital stay.
- Ask if your primary care provider/general practitioner has been sent records, or a summary, of your hospital stay.
- Ask where you will need to go when you leave (home, rehab, nursing facility, etc.) and who will arrange the transfer.
- Ask about what problems you should look for after you leave the hospital. Be sure to get the name and number of whom you should call for non-emergent issues. (For emergencies, always call 911).
Staying safe in the hospital requires you, and your support team, to be on top of everything from admission to discharge.
I hope these tips help you stay safe if you, or a loved one, has to be in the hospital. If you have any questions, please don’t hesitate to contact me: firstname.lastname@example.org